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NAME— RQahnA- UaL-Lc an 1 (17-191 Appr- -expires9. <br /> _La iuth--Y e-----------_ C00000213 006A F <br /> FLab-ff,—A7 86001--------- PERMIT NUM__R DISCHARGE NUMBER <br /> -- ————————————————— MONITORING PERIOD <br /> FACILITY— NuCIa -------_ YEAR MO I DAY YEAR I MO I DAY <br /> LOCATION --------'-- ------------ FROM 87 04 TO $7 <br /> (20-211 (22.23) 124-25) (2627) 12N-29) (30.31) NOTE: Read instructions before completing this form. <br /> (3 Card Onh) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION <br /> PARAMETER (46-53) (54-61) (38-45) (46-53) (54.61) NO IFR..-.NCV SARIPLE <br /> (32-37) EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS>< 62-63)I (64-68) (69-70) <br /> 0 & G VISUAL SAMPLE 0 * * * * 0 VI <br /> MEASUREMENT <br /> 84066 1 O PERMIT — 0 een * * * * 01/07 VI <br /> REQUIREMENT 1=Visible <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT i <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> 1 <br /> W PERMIT <br /> Lrl REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REOUIREMENT <br /> r <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED TELEPHONE D A T E <br /> AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN AND BASED <br /> ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br /> OBTAINING THE INFORMATION 1 BELIEVE THE SUBMITTED 'NFORM ATION <br /> James S. Lunan IS TRUE ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE SIG <br /> NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION INCLUDING <br /> Manager - Permits THE POSSIBILITY OF FINE AND IMPRISONMENT SEE 18 USC 1100' AND SIGNATURE OF PRINCIPAL EXECUTIVE 602 774-5253 87 107 27 <br /> 33 USC S 1319 'P-01,— under rhr- Amr.1r, n ,,,Id, I-- up n' Fln lerr <br /> TYPED OR PRINTED nm! ".maimrum mrP••�•'•Im••nr•'/h.•ru•rrn s m••nrh.and i.ra.. OFFICER OR AUTHORIZED AGENT AREA NUMBER YEAR I MO DAY <br /> coop <br /> COMMENT AND EXPLANATION OF ANY VIOLATIONS (Rejerencr all di—hosent, here) <br /> EPA Form 3320-1 (Rev. 10-79)PREVIOUS EDITION TO BE USED (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) PAGE OF <br /> UNTIL SUPPLY IS EXHAUSTED <br />