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I PERMITTEE NAME/ADDRESS (/nclude Facdlry Name/Location ij Di)JmenU
<br />NAME CYFfiU~ ECFIfif CCFPCkagICN
<br />ADDRESSEAGLE i7IbE COlFLEX ~ -
<br />P.L. vox ne
<br />FACILITY ChAIG CG 81b26
<br />LOCATION
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<br />Form Approved.
<br />NATIONAL POLLU'IAM OISCNARGE ELIMINATION Stt: STEM (NPDESJ OIYIB No. 2040.0004
<br />DISCHARIGE MONITORING REPORT. (DMRisI } 1 V L F Approval expiBS 05-31-98
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<br />' ,NUh1BER ~- (•jENUMBER F - F 16,11
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<br />.VE DAY YE MO DAY '•}° --
<br />FROM TO L I.- ] O G LISCb'16CE )__~ ;'~%
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<br />33 U VSIGNA TURE OF PRINCIPAL EXECUTIVE f ~ ~
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<br /> § tats (Penetties under rnese srelures may include Ine s up l0 510,00 0 end w pif ICEA OR AUTHORIZE D AGENT NUMBE R YEAR MO DAY
<br />TYPED OR PAINTED maxim um impnsonmenr or denva en b months antl 5 years.) 0 0
<br />COMMENTS AND EXPLANA I IUIV V r Am vwlw I I V IYJ (nmc+ouw o~. e.•..~•,,. ~~. ~,....-. -+
<br />F1L~ LIlII1 APPLIES 1C CCr'bIhEP FLCM FNC"~ CC., CL2 E C24. CIl ~. CF,F•~-`i CARE SA81IE AlAIY_S7P EE(C7FFt 3F
<br />VISIBLE SNEEt+ IS Gt9EfVEC. GHTELY SArPLIAG INSThLCTLGS°-I.C.t, rG I.
<br />EPA Form 3320-T~ (0895) Previous editions may not be used. (REPLACES. EPA FORM T~0 WHICH MAY NOT BE~USED.) Q O 36 9 / ~ 0 C 3 Z JL ~ 2 E ,i G,, . PAGE 3 OF
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