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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDE$)
<br />DISCHARGE MONITORING REPORT IDMRI
<br />2-161 17-191
<br />:;7u%3SC032 (iUL r
<br />PERMIT NUMBER OISCHAIIGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM •. 1. ~-r J TO U.3
<br />12621/ /22.231 !24251 /26771 ITB-T9I l3P311
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<br />NOTE: Read Inatructione betas eomplatin0 this form.
<br /> PARAMETER !3 Cord Ontyl QUANTITY OR LOADING 10 Grd On/vl QUANTITY OR CONCENTRATION ND RiEOUENCY SAMPLE
<br /> lOG53 /5161 38-05 IOG53 I546/I OF
<br /> 131-371 EX ANAtras TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ta2.asi I646BI l5&701
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<br />~ E/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTI
<br />AM FA FY UNDER PENALTY Of L
<br />MILIAR WITH 7NE INFOI AW THAT I HAVE PERSONALLY E%AMINEp AND
<br />U.IATION SUBMITTED HERDN; AND BASED ON TELEPHONE DATE
<br /> Mr INDUIRY OF THOSE INDIVIDUALS IMMFDIATELV RESPONSIBLE FOR
<br />-• ,L OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INF011MATON IS '
<br />_ TRUE, ACCUMTE AND COM0.ETE. I AM AWARE THAT THERF ARE
<br />SIGNIHCANT PENALTES FOR SVBMITTIN6 FALSE INFORMATION
<br />INCLWING .,,~
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<br />THE POSSIBILITr OF RNE AND IMPRISONMENT. SEE 18 U.S.C. f 1001 AND OJ
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<br />EPA Form 3320-1 108-951 Previous editions mey be used. (REPLACES EPA FORM 2-40 WHICH MAY NOT BE USED.) PAGE OF
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