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NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED AND AM FAMILIAR WITH TXE INFORMATION SUBMITTED HEREIN; AND BASED ON TELEPHONE DA ME r ~ ~ ~ /( r,-I.ll~l /~ -~~r Ll.r\)(`7L MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOP OBTAINING THE INFORMATION, I BEDEVE THE SUBMITTED INFORMATION IS ~ i' ~' ~ - TRUE, ALCUMTE AND COMPLETE. I AM AWME THAT THERE ARE I~r~~• ~ ~ ilJlk~JF'y- 7r ~~ " ' SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION INCLUDING , _ T ~' ~ S ~. y" "ti '` , THE POSSIBILITY OF RNE ANp IMPRISONMENT f 1001 AND ]] SEE 16 U S C _ ~ _ ! ~ ( ~ ` ~ / z r. ~_, _, 1 / le . . ` . . . . f 1 ]t 3 U S C P YM M t IO ODD SIGNATURE OF PRINCIPAL EXECUTNE / ' . . . . I m . VIM UIIY mron. nrr , CAd~ rxwa up ro AREA TYPED OR PRINTED MdwmuinVnimpis++rnr of MrwwnemonNa nMePrral OFFICER OR AUTHORIZED AOENi CooE NUMBER YEAR MO DAV COMMENTS AND EXPLANATION OF ANY VIOLATIONS IRe/erenee ell ettschmenrs here! i5S d TOTAL IkhN LIMITS FEILL fSt NAIVtUr ANU St7TLLADLt S.JLIiJ;i LIMIT AFPLItu Fi;n 1UYkF~4Hn ahECIP tVENT- Stc bUKiiLN OF PdOUF RLUUIkEMtNT1 UNOEk I.A.3e P. 8. JIL t. ~fcASE - SEE [.u.1.C. ~0 JAY Akt:NA~c IS Lt• ~~cf M•'i A.TLtI v •.rA ntw (.•!' nCn tnn nC Of'.OTCn eCC i r .. " EPA Foim 3320-1 108-95) -Previous eBi4ions iriey tie used.-~ ~ ~-- ---/REPLACES-EPA FORM~TalO ICH MAY NOT BE USED.) PAGE OF - - UUC00/dc,UV10-J9?a 1