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PERMIfTEE NAME/ADDRESS (GrY4 flurry Nw./Lorrtron dDrQirw)
<br />NAME
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<br />FACIIf[Y ~ h 4 ~
<br />LOCATION ~z.-~.--1~ A L t.' ` : ~.~.Yyf1• FR
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<br />Form Approved.
<br />QAQB-Nor20A0.Ofb4
<br />Approva4 a:piwe.,05-31-98.
<br />NOTE: Reed Imtruetlme before compMtinp thle form.
<br />PARAMETER /3 Grd Onryl QUANTITY OR LOA G /~ QUANTITY O ~CONCENTRATIO
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<br />191.371 1663 61.81 µ
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<br /> AVERAGE MAXIMUM 17S MINIMUM AVERAGE MA%IMUM UNITS /ea.Ba µKVy1e
<br />/µ8g1 /B&701
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<br />NAME/TRLE PRINCIPAL EXECUTIVE OFFICER I cEgn
<br />AM FA Fr UNDER PENUn DF uw rNAT I HAVE PERSO
<br />MIUAfl WITH THE INFORMATION SUBMITTED NALLr ExAMINED AND
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<br />ER TELEPHONE DATE
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<br />; AND BASED ON
<br />MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
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<br />;~ OBTNNINO THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS
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<br />ND COMPLETE. I AM AWARE 7HAT THERE ARE
<br />SIONIRCANT PENALTIES fOR SUBMITTING FALSE INFORMATION
<br />INCLUDING ~ I / ~~
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<br />THE POSSIBILITY OF FNE AND IMPR
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<br />Ie U.S.C. 1 1001 AND 39
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<br />l ONATURE OF PRINCIPAL EXECUTNE
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<br />EPA aim 332 -1 1
<br />8.961
<br />Previout editions mey be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED
<br />) .
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