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<br />NATIONAL POLLUTANT OISCHARpE ELIMINATON SYSTEM INPDES/
<br />DISCHARGE MONfTORINC REPORT lOMR)
<br />17-761 I7-191
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<br />PERMIT NUMBER DISCHMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM 'd l .: TO '• I . ? j
<br />140.711 /12-231 !14751 !76771 l1B-191 /30.31/
<br />Form ADproved.
<br />~ T +' v± o r ti 1` T '^ 10MB)No,~ 2040-0004- .
<br />~ - ., .- ~ ~. ~ 7 Approval expires 05-31-98
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<br />NAMElTITLE PRINCIPAL EXECUTNE OFFICER I CERTI
<br />AM FA FY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EAAMINED AND
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<br />MY INpUIRV OF THOSE INDINOUALS IMMEDIATELY RESPONSIBLE FOR
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