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PERMITTEE NAME/ADDRESS (/MrAr Fae6.ryNsrlLeranm dDlp...,N/
<br />NAME C 7 n~ ~, ~. ~ .. ~ r .. l l' ~
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<br />FACILITY
<br />LOCATION
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<br />NATIONAL POLLUTMT DISCNMGE ELIMINATION SYSTEM (NPO£$J
<br />DISCHARGE MONITORING REPORT (OMRI
<br />1-161 117-191
<br />PERMIT NUMBER DISCHMOE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAV
<br />FROM "7 :J „; TO 9n r L,
<br />/10-111 /JJJ31 /J4J51 /J6J]I IJ9-J91 /.'M3Il
<br />Fonn Approved.
<br />^•: , - ~' T r , -- +~ ~ T TOMB No.,2040-0004
<br />F_Lf„ 11 ,,,` ~ Approve! exprtes 05-31-98
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<br />l31-371 EX
<br />MALVas TYPE
<br />- AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 163-6]1 rbF-691 re9-)w
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTI
<br />AM FA FY UNDER PENALTY OF LAW TNAT I NAVE PERSONALLY EXAMINED MD
<br />MILIM WITH THE INFORMATION SUBMITTED TELEPHONE DATE
<br /> HEREIN; MD BASED OM _
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<br />~~~f:1Ti. 1'Ti L'.I~~F MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
<br />OBTNMING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS
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<br />SIGNIFICANT PENALTIES FOfl SUBMITTING FALSE INFORMATION
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