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PERMITTEE NAME/ADDRESS (111c(ude Facillry Nmne/Laradon i/Digerenq
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<br />NATIONAL POLLUrAM DISCHARGE EUMINATON SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (DMR;
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<br />Form Approved.
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<br />Approval expires OS-31-98
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<br />NAME/TRLE PRINCIPAL IXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSO
<br />AM FAMILIAR Wm1 THE INFORMATION SUBMITTED HER NALLY E7fAMINED AND
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<br />P+icherd Miils INOUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPON
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerence all attachments here)
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<br />EPA Form 3320.7 (0&95) Previous editions may not be used. (REPLACES EPA FORM 740 WHICH MAY NOT BE USED.) ~ „ r t1 ,I ~ ~ ~ ~ ,, ~ ~_ T ~ ~ ,I PAGE ,~ OF
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