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PERMITTEE NAMF DURESS (Include NATIONAL POLLUT ISCHARGE ELIMINATION SYSTEM(NPDES) 'ormApproved
<br /> FactlityNa,gglLocat iff'erent),. D►SCHAI IONITORING REPORT (DhfR) )MB No.2040-0004
<br /> 2-. 17-19 Approval expires9-30-85
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<br /> PARAMETER (46.53J (54-61) (38-45) (46-53) (54-61) OF
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<br /> t f AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 62-63 (64-68) (69.70)
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<br /> NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CeRT'" UNDeR PKHALTV or LAW THAT 1 .AV. vewfonw LLY exwM IN..-, - TELEPHONE D A T E
<br /> AND AM FAMILIAR WIT. T.e INFORMATION fU.-TCD ..Re1N AND ..SKD
<br /> ON MY IN O UIRY OF THOfe INDIVIDVALS IMMCDIATe LV Ref PONSIBLe FOR '
<br /> OBTAINING THe INFORMATION, I Be LIe Ve THe 1UBMITTeD INFORMATION
<br /> If TR Ue. ACCVRAT. AND COMPL.Te. I AM AWAR. T.AT THeRe ARe SIG•
<br /> ' NIFICANT Pe NALTIe• FOR SUBMITTING FALSe INFORMATION. INCLUDING. '
<br /> T.e ►Of S181LITY Or FINe AND IMPRISONMeNT. fee 19 U.S.C. ¢ Io01 AND SIGNATURE OF PRINCIPAL EXECUTIVE -
<br /> 33 U.S.C. S 1319. (Penalties under these statutes may include fines up to$10,000
<br /> TYPED OR PRINTED and/or maximum imprisonment of between 6 months and 5 years.) OFFICER OR AUTHORIZED AGENT AREA NUMBER YEAR MO DAY
<br /> CODE
<br /> COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) -
<br /> EPA Farm 3320-1 (Rev. 10-79) PREVIOUS EDITION TO 13E USED IFLPLAC,C:3 EPA F0I1..1 T-AG WI11cu1 MAY NOT .IL 'USED.) F
<br /> UNTIL SUPPLY IS EXHAUSTED.
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