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PERMI7TEE NAME/ADORE56(ArW.irduyxa./fornm Unrpr...q
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<br />NATIONµ POLLUTANT OISCHMGE ELIMINATON SYBTEM //NPDESI Forrn Approved.
<br />DISCHARGE MONITORING REPORT (OMRI $040-0004 r
<br />1.161 17-191 `Lr :.. ). r ~,.• "-. ~•Olklli 1110.,
<br />~ - , ~ t ) 'a ... , , \ (: . - ~ ~ :~) APPiovel~eZ[P,iree 05=31-98
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<br />PERMIT NUMBER DISCNMGE NUMBER ,
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<br />MONITORING PERIOD ' ' ' -
<br />YEAR MO DAY YEAR MO DAV __
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<br />PARAMETER !3 G.d only) QUANTITY OR LOADING !4 Grd only/ QUANTITY OR CONCENTRATION NO. mEOUENCY SAMPLE
<br /> 146-53) 154-6I1 135-051 46-53 154.61
<br />EX of
<br />TYPE
<br />l31-37I ANALVSS
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS N'S-s1! /61.681 !6&701
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<br />NAMERTTI.E PRINCIPAL E%ECUTNE OFFICER I CEgTFY UNDER PEMµTY OF lAW THAT I NAVE PERSONALLY E%AMINED MO
<br />AM FAMILIM WITH THE INFORMATON SUBMITTED HEREIN; MD BASED ON ,'~/ /~ TELEPHONE DATE
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<br />~ OBTMNINO THE INFORMATOH, I BELIEVE THE SUBMITTED INfORMATION IS ~
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<br />SIONIFICMT PENALTIES FOR 5UBM(TTING FALSE WFOgMATION
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<br />THE POSSIBILITY OF RNE MD IMPNSONMFNT. SEE IB U.S.C. ! 1001 MD 30
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