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PERMITTEE NAME/' 9E58 QwWO FrrLryNa/Lxarm /DrS...np
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<br />NATIONK POLLUTAN CHARGE ELIMINATION SY6TEM (NPDESI FOFm A' 'ed.
<br />DISCHARE 3NITORINO REPORT OMRI - ,OMB N~ .40-0004
<br />(7.751 17-191 Eft l:':'i`; !. .' ,.
<br />,; r , .l ~ _ n (I_ `, - I ; Approvel'expireH OS-31-98
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<br />YEAR MO DAY YEAR MO DAY __
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<br />PARAMETER l3 Grd Onryl QUANTITY OR LOADING a Grd on/rl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE
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<br />131-371 E%
<br />ANKYSIs TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MA%IMUM UNITS l63~H31 164681 !69.701
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<br />NAME/EITLE PRINCIPAL EXECUTNE OFFlCER I CERTI
<br />AM FA FY UNDER PENKTY OF
<br />MILIAR WITH THE INFO lAW THAT I HAVE PERHONAILY E%AMINED N1D
<br />RMATION SUHMITTED NEREIN~ AND eAHED ON TELEPHONE DATE
<br /> MY INQUIRY OF THOHf IMDINDUKH IMMEDIATELY RESPONHIHLE FOP /
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<br /> OHTNNINO THE INFORMATION, I eEIIEVE THE HUHMITTFD INFOFUAATION IH 1.
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<br />• I ` /l r ' ` I . 1 THE FOHSIeNTY OF RME AND IMPRIHONMENT. SEE le U.H.C. 1 1001 AND 73 NATURE Of R11NgPAL E1tECUTNE
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<br />TYPED OR PRINTED .nd nrrMxirriwr irpYamw,rWM,rwlemanNaw Hrwal .OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/eTenee a//sE(echmenn here/
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<br />EPA Form 3320''-Y 108.96) .'Previoue'e itions rrtey b"e udad, (REPLACES EPA FORM T~0 WHICH MAY NOT BE U6ED.1 PAGE OF
<br />CI4C,''i7/~i7 11~ 4-0 li I
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