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PERMITTEE NAME/ADDRESS (Include TIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDF.S) Form Apprond
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<br /> NAME-S..iy tL I ��-Y�i"((!///��� 1 I-16) - 17-19) 1- '� FINAL ,. Approval explM 12-31-87
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<br /> NAME/TITLE P NCIPAL•EXECUTIVE OFFICER I CERTIFY UNDER FENALTY OF4 LAW }HAT I HAVE PERSONALLY EXAMINED S e _ ,C e _ �. w TELEPHONE - D A T E
<br /> AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN. AND BASED
<br /> �,?<i/(7 ti� �� ON My INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR t
<br /> �'`J.('r�f�-/( OBTAINING THE INFORMATION. I BELIEVE THE SUBMITTED INFORMATION I 'J� I = -
<br /> 15 TRUE ACCURATE AND COMPLETE II AM AWARE THAT THERE ARE SIG , [�± �'L.� ..
<br /> / NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION INCLUDING`
<br /> -� ` THE POSSIBAL OF .NE AND IMPRISONMENT SEE IB USC 1 IGOI AND p •1 ,F )
<br /> T T / • �81 NATURE bF.'PRINCIAAL EXECUTIV[ �� �J
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<br /> COMMENT AND EXPLANATION OF ANY VIOLATIONS (Re/erenre all areuchmew, here)
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<br /> EPA Form 3320.1 (RAY. 10.79)PREVIOU9 EDITION TO BE USED (REPLACES EPA FORM'Y• O WHICH MAY NOT BE USED.) r A
<br /> UNTIL SUPPLY 19 EXHAUSTED UUO G:�I Yus':I—C�[ V
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