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<br />RERMIT7EE N~DD11E55l1rLi fsWryNr~larula yDl~ .,q
<br />NAME ~ .. 1 :,
<br />ADDRESS d A , : ~.' :.'
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<br />FACILT'
<br />LOGTXIN
<br />NATIONAL POLL T pSCNAROE FLMINATIOM SYSTEM /NPDES)
<br />DISC •ONRORWO REPORT lOMRI
<br />17-19
<br />! PERMIT NUMBER dSCNMOE NUMBER
<br />1 MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM L TO
<br />176711 l77-I31 l7L7fi1 /]6]71 l7RJ91 l3Q1/1
<br />r _ r i
<br />For roved.
<br />'40-0004
<br />A it • OS-31-98
<br />.. 9
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<br />NOTE: Ned ImWCTIarIB belon compMWp thM loan.
<br />PARAMETER !7 Cerd Onh/ QUANTITY OR LOADING JI GN OMP/ OUANTRY OR CONCENTRATION NO. /REOUDICY SAMPLE
<br /> 166 51-61 38-15 166 61-611 of
<br />!37.771 EX M1ALY95 TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS rrt-sal !61.691 169701
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<br /> MEASUREMENT
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<br />NAMERFILE PRWCWAL E7EECVINE OFFICER 1 CERTI FY WDU PEIIALTY OF l AW THAT I NAVE PERSONIV.LY ExAMIMED AND TELEPHONE DATE
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<br />htlwlf.I. OBTNMIMO THE INFORMATION, 1 BELIEVE THE SUBMITTED INFORYATIOM IS ' '
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<br />EPA Farm 3720-7 IO!-56) PFBtiouB ditionB mBy ba uBed. (REPLACES EpA FORM T-40 W WCN MAY NOT BE USED.1 .. / ~ ., 1 I C _ 1 } J PAGE OF
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