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PERMITTEE NAME/ADDRESS (lndvde Fpciliro Name/Locanon iJOgerenU
<br />NAME p1C:(LT4IfiE FNCC E:SING, LLC
<br />ADDRESS,y ~~ „ ;; i A ~~ S h f
<br />1317 L'FfZvTWCCC CFIYE:
<br />FACIUTy EVAt. ;iVILLC Ih /17711
<br />LOCATION~t`,.Ch CC F1C91
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<br />NATIONAL POLLUTANT DISCHARGE EUMINAngNSYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (DMR;
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<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />f,AR MO DAY YEAR MO DAY
<br />FROM '. TO `~ • '- =
<br />!) (22-231 (2J.25J (162]1 (29291 (90)1)
<br />Form Approved.
<br />r i N C F OMB No. 20a0.0004 • .,
<br />Approval expires OS-31-98 `
<br />(SL'cF EE)
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<br />NAME(TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSO
<br />ATION SUBMITTED HERE NALLY EI(AMINED AND
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<br />AND BASED ON MY TELEPHONE DATE
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<br />" INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPON
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerence all attachments here)
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<br />EPA Form 3320-1 (OB-95) Previous editions may
<br />nDl ba used. ~
<br />(REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) C G C ~ 1 / ~ G C 17 1 - I E i C PAGE 1 OF
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