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PERMITTEE NAMEr' -'~1RE55 Ond,4F«WryNa/vrm,m //Dlpinn0
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<br />NATIONAL POLLUTAI' "cCHMOE ELIMINATION 8YSTEM (IVPDE$1 Form A• •ved. _
<br />DISCHAR' ONITORINO REPORT IOMRI OMB h >,40-0004
<br />!2-l L. 17-191 - "~' 'i ; 1 _ '
<br />,~ , „ ., I ~ f ;- ~, , ' ~ ~ Approval e><pirse 05-31 ~98
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<br />YEAR MO DAV YEAR MO DAY
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<br />l10-211 l22-731 121-251 126271 128-291 13631/ NOTE: •Reed Inetructloru b~fori ompletlnp thb form.
<br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING !~ Grd OnNI QUANTTY OR CONCENTRATION ND fREOUENCY SAMPLE
<br /> !/6531 154-511 138-i51 !<653 !54611 of
<br />/32 371 EX MuYSIS TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 162
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTI
<br />ANI FA FY UNDER PENKTY of
<br />MIUM WITH THE IMFO uw THAT I NAVE PERSONALLY E](AMINEO Mo
<br />0.MATION BUBMITTED HEREIN
<br />MD BASED ON / ~ TELEPHONE DATE
<br /> ;
<br />MY INOUIIfY OF THOBF IMDINDUALB IMMEDIATELY RESPONSIBLE FOfl
<br />OBTAINING THE INFONAIATION
<br />I BELIEVE THE SUBMITTED INFORMATION IS // /~7
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<br />' TRUE, ACCUMTE MD COMPLETE. I AM AWME THAT THERE ME
<br />SIGNINCMT PENALTIES FOR 9UBMITTINO FALeE INFORMATION
<br />INCLUDING ~ ~ ~~'
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<br />THE POSSIeRITY OF RNE MD IMPw90NMENT. SEE 1B U.B.C. 1 1001 MD 93 ~
<br />BI ATURE OF PRINCIPAL EXECUTIVE ~ ;.
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<br /> U.B.C. 1 1710. lPNWIYr uW drAr 00nPr nMY ~E,d. rvr. W ro J 10,000
<br />TYPED OR PRINTED .na armvY,x.n hrtdesvnanrWMwwn enNnYls eMaFw•al OFFlCER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY
<br />LVMMCn IJ AnU CAILAnA 11Vn Vf' NnT VIVLAIIVna 1/reTMIJICI a//IrreC/1/lle/1r9 /lore/
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<br />EPA Form 3320.7 108-961 Previous editions may be used. IREPLACE6 EPA FORM TAO WHICH MAY NOT BE U6ED.) PAGE OF
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