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<br />FACILITY
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<br />NATIONAL POLLUTMT DISCNMGE ELIMINATION SYSTfl.1 /NPDESI
<br />DISCHARGE MONRORINO REPORT IDMRJ
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<br />YEAR MO DAY YEAR MO DAY
<br />FROM gg o4 Di TO ?9 06 3n
<br />176211 !11.731 !14151 116171 118.19/ 136311
<br />Form Approved.
<br />R f N 4 P OMR No. 2040-0004
<br />(S U n R ti Y) Approval expires OS-31-98
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENµTY OF UW TNAT 1 HAVE PEflSONALLY EXAMINED Mp
<br />AM FAMIDM WITH THE INFORMATION SUBMITTED HEREIN: MD BASED ON ~ TELEPHONE OATS
<br />W, GOLdOII PotaLB MY INOUIM OF 'THOSE LNOIVIDUALS IMMIEDIATELY RESPONSIBLE FQR
<br />OBTNNING THE INFOflMAT10N, I BELIEVE THE SUBMITTED INFORMATION IS
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<br />ACCl1MTE MD
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<br />SIGNIFICMT PENALTIES FOR SUBMITTING FALSE INFORMATION
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<br />THE POSSIBILITY OF RNf MD IMPIIISONMENT. SEE 18 U.S.C. E 1001 AHp SS
<br />' 610NATUIIE OF MIIMCRAL EXECVE
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