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<br />FACILITY
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<br />.'.I' HUBRIS ;i. Ki:cT, .. :'.! ~'1
<br />NATIONAL POLLUTMT DISCHMOE ELIMINATION SYSTEM lNPDES)
<br />DISCNARGE MONITORING REPORT lOMRI "
<br />1I-161 I7-191
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<br />PERMIT NUMBER DIBCMMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAV YEAR MO DAV
<br />FROM ti TO '+" I `~
<br />I]6Zf1 /]2-131 114151 /I5-I7l 128-291 /36311
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<br />Form Approved.
<br />T IOM&No: 2040-0004
<br />Approve4 expire } OS-31-98
<br />NOTE: Raed inetruetiorw betora completlnq this lorm.
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<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS lBT-BJI !54681 !5¢701
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED MD
<br />AM FAMILIM WITH THE INFORMATON SUBMITTED HERDN; MD BASED ON TELEPHONE DATE
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<br />v MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
<br />. OBTNNINO THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS
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<br />Environmsn*_sl Manager TRUE. ALLUMTE AND COMPLETE. I AM AWME THAT THERE ME
<br />SIGNIRCMT PENILLTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING /~/f
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<br />(970)870-2712
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