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-RMITTEE NAME LESS flriClude NATIONAL POLLUTAN CHARGE ELIMINATION SYSTEM(NPDES) rmApproved
<br /> cllityName/Locatiot erentJ; DISCHARG NITORING REPORT (DN1R) IB No.2040-0004
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<br /> PERMIT NUM 8E:R:::] DISCHARGE'NUMBER
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<br /> 1 ! { (3 Card Only) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION FREQUENCY
<br /> AMPL
<br /> PARAMETER E (46-53) (54-61) (38.45) (46.53) (54-61) Eo. OF STYPEE
<br /> ' 02-371 { ANALYSIS
<br /> ><t j AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 62.63 (64-68) (69.70)
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<br /> MEASUREMENT
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<br /> AME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDEW PC NA LTV Or LAW THAT I HAY. P.REDNALLY EAAMIN.D, TELEPHONE D A T E v
<br /> AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN AND SAa1ED
<br /> _ ON MY IN G UIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
<br />\•Y�-`+l fS'� 1,• J , OBTAINING THE INFORMATION, I B.LIEVE THE SUBMITTED INFORMATION
<br /> IS TRUE, ACCURATE AND COMPLETE. 1 AM AWARE THAT THERE ARE SIG-
<br /> NIFIC ANT PENALTIES FOR SUEMITTING FALSE INFORMATION, INCLUDING �J a' -
<br /> \ �'•^ THE POSSIEILITY OF FINE AND IMPRISONMENT. SEE 1• Y.E.C. 2 1-AHD -- '7
<br /> r �.ti>k.,,ltt ., SIGNATURE OF PRINCIPAL EXECUTIVE �';, -.t`�,.,f ''ti `
<br /> as u.E.c. g ,a,a. (Penalties under these statutes may include fines up to$10,000 �� '. '- ,
<br /> TYPED OR PRINTED and)or maximum imprisonment ojbetween 6 months and 5 years.) OFFICER OR AUTHORIZED AGENT AREA CODE NUMBER YEAR MO DAY
<br /> OMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
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<br /> PA Form 3320-1 (Rev. 10-79) PREVIOUS EDITION TO BE USED (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) PAGC OF
<br /> UNTIL SUPPLY IS EXHAUSTED.
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