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J :.~t 'at_ - ~ t~ ~ .- <br />~PP~Ua'f~ ~` ~~~5~ ~I~L.U REQUIREMENT <br />. ., :r ~;: ;{~Pih ,=x`•rty ~.ti~ i' 'Y i'i:r; UGf~... ~'li~i•€ i! <br />~ Cvl' 't'~=~.r~.. :.:. <br />SAMPLE ,,.~? :;-Y: •i;-?4 3~••~ •#ii si".~' '.F•3ri#~ #3: 3.°•?F•?f3i•3~ •iF ~ ~ ( ~ `~) ~j <br />Y'~ N~ ~~ <br /> MEASUREMENT <br />CJ~~2~2 1. (~ f~ PERMIT -?ix ;~..# ~; {r. ~.~;.~;.~.:;. ;, •Jf•3f••?F F y :-~--~z ,#• :r -x * =# ;, , z1,',? • rc--`•:_ <br />~'~'I_U~i~Y (~f~©~~ ',~~~~t,,j~ :REOUIREMENT' <br />: ic-i~~~••I+' ~(`~s'`i`f ~'~T. ~!C-i/(.~ t7~f~T <br />"!_.Q~t Tfz1 +~L)Fs~1~U~~'t ~Pi SAMPLE <br />.... { {'J)! :f'.i•-:$~;S•'fi3'r ~,:~.F~~•b„~ •'f3g?FsF•~F~t' <br />~ <br />t~:~~~ <br />+-II~U TE~~c'•`+I~jl~.~v1T I~L <br />'T' EASUREMENT ~ <br />,~0~ (~~~~ ~ ~~ <br />. <br />. <br />~SQC)~(~ ~. G {3 ~ ~~ <br /><PERMIT= r <br />~~t'~ii~~~ - <br />~t?~(~G3r'', i .. <br />;~;t~srst n~; ~ <br />#di-#s: ;f•~ ~ ~:i ~ t•~~•~• ~F.~ .i_.'~ s Imo" ~ ~";i <br />~t~'t~ ~U~Fd"f Cf~Cl55 `~r'~a~.,.~5~ t~iE~UIREMEN* ~?c73,.,~F~ - ~~~;~ .r.~~-~ i €._'r # 3iti tw~0 3'r-'sc•~•3t. <br />~ja ~.f-'e,.~.'.~.'. <br />I+Jt~SUi~e~ SAMPLE <br />MEASUREMENT ,~•~r~•'..Y:°~• _/ <br />~ { ~r•E ~ ,. n ;!•5;#:~ ~i--;r„ :S•'~•' lri:•#•:: ;t3} ~ <br />~-~ <br />S~•C?btS :I. Ci C~ fERMIT_ ~-~tt•)t~:~# _ (3, t ~~~W ~ ~•~###~• 3F~-~i•-I<~k# ~r~~?~~•~• -r•~~S•# •.? ...1~Fa <br />'S'Fr LU~P~l~" t;~~55 I:i:~I~~I R~c1UIREMEN'C <br />........ ........ <br />...... <br />.. xl~~ ~ htt'~X i'«Cl =C) •s~•3E~•=k <br /> . <br />. <br />. <br />SAMPLE , <br /> MEASUREMENT <br />i <br /> ';,.f~ERMIT' <br /> REQUIREMENT> <br />PRINCIPAL EXECUTIVE OFFICER t "^'ty u er pens ty o sw mat m h document end ~u Nt~dtmenb were <br />t <br />h <br />d <br />l <br />d TELEPHONE DATE <br />NAME/TITLE s sys <br />em <br />es <br />`ne <br />prepared under my direction or mpervMon In ~ceurd~ntt wit <br /> <br />p'~, <br />~~ <br />J to aotrre thN qu~Nlled personnel properly `ether s~ evdusle the Information <br />submitted. Bocd on my I.~pulry of me person or peraoro who mona`e me system, <br />s~ <br />~~ <br />~ <br />• <br />a~ or those penoro dirtctly resporolbk ror pmertn~ me Inrormatlon, the Inrormstion ./'"_ '_ / <br /> <br />accurate <br />t of m <br />knowkd <br />e and beHer <br />true <br />and arom <br />kle <br />t <br />th <br />b <br />b <br />i <br />d b ~ <br />~ / <br />6 ~~ O~ <br /> y <br />~ <br />,. <br />, <br />. <br />p <br />. <br />o <br />e <br />a <br />su <br />m <br />tte <br />. IPAL EXECUTIVE <br /> I am aware and there art sl~nlllunt pendtla for submlttln~ hbe informatlon, IONATURE OF PRINC <br />pED OR PRINTED Includln` the poaslDllity or ene and Imprisonment for knowln~ .IolaUolts OFFICER OR AUTHORIZED AGENT CODE NUMEIER YEAR MO DAY <br />COryryMMEyyyyN/T~4S'ANpD~)EXPLANATIOrN OF AtNYp~vIVLAIIVNSh/Reiei~e/nc~slnt irr~cnpmepnyra n{erei{ ,!^. 'y ~~ p!~ {~ ~} q~ nT (~ q-'q~±q~ y-~ ~p ~5c {y ~9 spy-p~~71r~ <br />JL A.l Y'tT i'~Y~i~i~'~7~ li.~ I"7b V:~l-I~~~il• d 1~I~~Th 1A.. T t~V'rt. .iJ~ll 111i~ t`~~k-Y .66i'i.t .5i L.1-~!"`i~~."..1. Ll La ~6 'V.9!'V L:"1=71G •••• SAL .1.. ~. v. T8J o-7 1'14AItl <br /> .1 i t..OF[ <br />~{a "' ~. d~. ~. wt~~(,YL`~I,_ I'`~el~)~~~I~~~.I~~~'^-~ -' +~. ~. ~~ iy{y. ~. < <br />3/99 Previous editions ma be used: ~~~~~1~~~ 4-}~~rtfl. PAGE OF <br />EPA Form 3320-1 (Rev. ) Y <br />