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<br />NATIONAL POLLUTAM DISCHARGE EUMINATON SYSTEM (NPDES) Form Approved-
<br />DISCHARGE MONITORING REPORT (OMR; OMB ND. 2040-0004
<br />n,6i n~ 9) _ . , . ,.
<br />Approval expires OS31-98
<br />PERMIT NUMBER DISCHARGE NUMBER _ ~.. r , -t .. _. ,.
<br />MONITORING PERIOD -"' •w' '"' ~ ~ -'~ T•-`T^.' r-~^cc
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<br />PARAMETER 46-53) 59-67) (38<5) 46-53) (54.61 DC OF TYPE
<br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE ,I~
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<br />(64-66)
<br />69-70
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSO
<br />ATON SUBMITTED HERE NALLY EXAMINED AND
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<br />-(I^~;~ YtI S~Ifls INQUIRY OF THOSE INDMDUAL
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reherence ell attachments here)
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