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PERMITiEE NAME// -'RE558rA11. FrWryNwWfaranon dOrafvv,p
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<br />NATIONAL POLLUTAN' 'CNMOE ELIMINATION 9YBTEM (NPDESI
<br />DISCH1 R~ )NITORINO REPORT /OM9!
<br />PERMIT NUMBER DISCNMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM .) ? %7 L; I TO 5 7 C ~ C
<br />1(62/1 l2I-231 121-251 126171 128-291 !363/1
<br />Form A• •ed.
<br />~ ..- .. 1 ~,, ; ~ ,: OMB N. .40-0004 .
<br />' Approval expires OS-31.98
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<br />PARAMETER !3 Grd Onlyl QUANTfTY OR LOADING !I Ord Onryl QUANTITY OR CONCENTRATION NQ FREQUENCY SAMPLE
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<br />(32-371 EX µ•
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<br /> AVERAGE MA%IMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 162.69! !5¢88) !5&)OI
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I cERnFr u11DER PENALTr of
<br />AM FAMIUAA WITH THE INFO uw THAT I NAVE PERSONAUr ExAMINED AND
<br />NIAATION SUBMITTED HEREIN; AND BASED ON /' TELEPHONE DATE
<br /> MY INQUIRY OF THOSE INDINDUAL9 IMMEDIATELY RESPONSIBLE FOR
<br /> OBTAINING THE INFORMATION, 1 BELIEVE THE SUBMITTED INFORMATION IS I ~/ ;
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<br />TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT THERE ME
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<br />SIGNIRCANT PFNALTIE9 FOR SUBMITTING FALSE INFORMATION /y
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<br />, i ~ I\ ~ (, I 1 THE POSSIBIUTY OF FNE AND IMPRISONMENT. BEE IB U.S.C. ! 1001 AND as SIONATUflE OF PRINCIPAL EXECUTNE - " -
<br /> os.c. Etau. rPurld.• uW wr mnm, n..r r,KA•a. rn.a w ro f 1o,o0r1 AREA
<br />TYPED OR PRINTED AMnmuY,wnLTwbemlAnrM Wnrrwn6mendrs aM6yAA~A) OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRe/erence a//sftec~menfs oars/ r -
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<br />EPA Form 3320=1 106-95) ~' Previolis~editians rosy be uslid.' ~ (REPLACES EPA FORM T30 WHICH MAY NOT BE USED.( PAGE OF
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