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<br />NATIONAL POLLUTANT DISCNMOE ELIMINATION SYSTEM INPDESI Form Approvatl.
<br />DISCNARGE MONITORING REPORT IOMRI ... ~ -. , . ~.OMB•No~2040-0004-. ~~
<br />l1-161 117-191 r -
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<br />MONITORING PERIOD '
<br />YEAR MO DAY YEAR MO DAY
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<br />PARAMETER !3 Grd On/Yl QUANTITY OR LOADING !4 Grd On/yl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE
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<br />131-371 ANgLYSIS
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS rat-s31 164681 169-701
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF
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<br />EPA Form 3320-7 106-961 Previous editions mey be used. IREPLACEB EPA FORM T-40 WHICH MAV NOT BE UBED,I ^ D t ^ ; I r ^ , /, ,:., ~ _ t ~ ~ _ PAGE .r OF
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