HYDRO30953

• Permit No: C1981008
• IBM Index Class Name: Hydrology
• Doc Date: 8/3/2001
• Doc Name: 2nd Q 2001 DMRs/ cant read
• Permit Index Doc Type: DMR’s
• Media Type: D
• Archive: No

i DFgMITTEE NAME/ADDRESS (Inclyde Paciluy Name/Location ifDiffermr) NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOESf FDrm ApprOVed.
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NAME(TITLE PRINCIPAL EXECUTIVE OFFICER ICedrty untler penelry of law that this tlocument and au attachments were
TELEPHONE
DATE
preparetl under my direction or superwslon in accortlance with a system tleslgneo
"rC~ ', _ to assure that qualified personnel properly gather antl evaluate the information _-_ - /
• ~ - ~ submitletl. Basetl on my inquiry of the person or persons who manage the system, / - j _ ~ I ~ ~~ ~ ~ y
~. or Nose persons directly responsible for gathering the IMOrmatlon, the IMbrmation '. ~ (
.'r ' ! ' ~ ~ . submittetl is, to the best of my knowletlge entl belie( wa, accurate, end complete. SIGNATURE OF PRINCIPAL EXECUTIVE % ~ l ` '

TYPED OR PRINTED I em aware thel there ere signilicenl penallles for submming false mformauon,
inclutlin Ina ossiblli of line and im nsonment br knowin violations.
OFFICER OR AUTHORIZED AGENT
NUMBER
YEAR
MO
DAY
i"~rvunon r a nnu uruu~n l ivn ur nrv r n~u+i Iona Inernrenca an eaacnmen[s nere)
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EPA Form 3320.1 (REV 3/99) Previous edifions may be used. - ~- r THIS IS A 4-PART FORM PAGE OF