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PERMITTEE NAME/~SS p, Y4Fr+4pNaWfs.aNaw UDlpsm)
<br />NAME i..ll l-f ;'i .S! ~'.: ,`iaF ;IY i,.I'.
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<br />NATONAL POLLUT MMGE ELIMINATION SYSTEM INPDESJ
<br />DISCH2AR! ITORING REPORT (OM9~
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<br />PERMIT NUMBER DISCHMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM 9;3 jr) 111 TO qA ~ 1? 31
<br />!26271 /1I-231 /71-251 !26.171 128-29/ I363T/
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<br />PARAMETER 13 Grd On/yl QUANTITY OR LOADING 144rd Only) QUANTITY OR CONCENTRATION NO FREQUENCY SAMPLE
<br /> 146-531 546! I3B-151 116-53 151-61 OF
<br />l31-371 EX ''faALY~s TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !6]-e]! /(,4-681 (63701
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<br />NAMEI'IITLE PRINCIPAL EXECUTNE OFFICER I CERT IFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED AND TELEPHONE DATE
<br /> AM fA MIl1AR MATH THE INFO RIAATION SUBMITTED HEREIN; MID BASED ON
<br /> MY INQUIRY OF THOSE INOIVIDUMS IMMEDIATELY RESPONSIBLE FOR.
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<br /> OBTNNINO THE INFORMATION, I BELIEVE THE SUBMITTED INfORMADON IS '., _ •1
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<br />SIONIFLANT PENALTIES FOR SUBMITTING FALSE INF011MATION
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<br />THE POS9BIUTY OF NNE AND IMf41150NMFNT
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<br />~ 610NATURE OF PRINCIPAL E%ECIJTfVE ; ' i
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<br />COMMENTS AND [AYLANAIIUN Vf ANT VWLP,I IVND IXiTerenCe eI)etOCOmsnlS Oars/ ~ i
<br />Sr.':'i'1.c:6i•I,i ..~!.!f':; t,?I'.Ii' ;•.CaPLT.ES C11lLY LF C= 10-YRr ?U-iiR i`P.FCIP °YFNT IS CC.aiMI:C. ,. •.'1.~1T" r"~'}:')l`?P. .~y
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<br />EPA Form 3320-1 108.951 Previous editions may De used. (REPLACE6 EPA FORM T-0O WHICH MAY NOT BE USED.I n Il0 a: 3 / ~ of ,/' .a _ 3 1 PAGE OF
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