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<br />LOCATION _______
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<br />V ,DISCHARGE MONITORING REPORT /DA7RI
<br />1-/6 17-l9
<br />PERMIT HUM S[R D~FCnwnc%HUHwfw
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<br />MINOR Form Approv
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<br />F - FINAL Ekplres 9-30.91
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<br />NAME/TITLE PRINCIPAL EkECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED
<br />A[ID AM fAYLLWI WITH THE INFORNAigN $UBMITTEp HEREIN
<br />AND BA$[O TELEPHONE D A T E
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<br />ON Yv INWIRY OF Tlq$E INOVIOUAL$ IMMEpATELY R[° ~NSIBLE FON
<br />OBTNNWG THE WFd11MTgN 1 eELI[VE THE $UBWTi[O INFORMATION
<br />I$ TIN[ ACCURATE AND COMRETE I AY AWARC THAT TNfRE APE $q~
<br />IxF1CwNT PEXAlT1E$ TOR SUEMtT(ING FALSE n1Fq{MAl1g1 WCIUtlNG
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<br />`TTLEAGLE SOLIDS LIMIT APPLIES ONLY IP <= 10-YRP 24-HH PRECIP EVENT IS CLAIMED. IF CLAIM APPROVED 8T
<br />Y~,)CU, S'S~ E IRON LIMITS YILL NOT BE APPLIED TO REPORTED MEASUREMENTS--SEE I.B.lAF PG 4 AND I.B.1D, PG 6.
<br />PA' '{ Rev. P !ll y E!. IR [PLACES EPA FORM T-t0 WHICH MAY MOT [[ U[[D.I PAGE OF
<br />01039/920900-1914 1
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