Documentos de Académico
Documentos de Profesional
Documentos de Cultura
1 Protection Agency
OMB No 2040-0042
&EPA
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W hlngton, DC 2M
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h-ko-LL
and Adclnp
of Surface Owner
v-operh-es, Lt~.
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Surface Location Deacrlptlon
~()'k County
Locat. Well and Outlln. Unit on Section Plat 640 Acrea N I 1-J._L.l_ I . .l_L.l_ I I. 1/4 of 1/4 of
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1I18/200S
Lab Report
5498 Rey Oil and Gas
Attention:
172047
DIII~ Sampled
1113/2005
13:00 1/28/2005
Time Sampled
Dille
Requested
Rush StllllU
Misty King
o Under NE~C
POI
----------------1
B &: L Tank Banery Water Tank Stowers Field
Lllb
Sample IDlorm.tioD
------------------
R~eorl
Barium Iron (Fit)
172047
(Sa)
Result
0.172
6240 0.303 5120 58300 73720 288200 7.16 1.Q82
MDL
mg/l mglL
mg/L
Method
200.7 200.7 200.7 200.7 200.7 325.3 120.1 150.1 271 OF 375." 160.1
Date
1/20105 1120105 1/20105 1120105 1120105 1120105 1120/05
1118105
Time AnlJ/y.t
16:28 16:38 16:28 18:38 18:38 12:42 14:04 11;40 11:10 10:20 10:35
0.002 15
0.007 30
mg/l. mgIL
mgll.
70
100
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NA
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@25C
Conductlnce
pH
Specific Gravity
umhollcm
pH Unit. mglL
CSO CSO
SAG
@21C
@21C
0.001
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490
25
10
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SAG
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QAlQC Procediuct required by ihe M.th04(s) were followed unl.I otherwise noted. Performlllco and ICtcpW'lCC slUdaI'ds for requiTed NELAC QNQC proeldllR' WCR lehlcved unless olherwi-= noted. No siamficanl modification. ha" been m"to !he MCIJlOd(I).IIItISlIllaI. baed upon my inquiry oflhose Indlvlduall immediately re"onlibl. for RVi1winC the information. Iho material eontalned in 1111.eport ii, !Dthe best ol my Jrnowleqc md belief, I"urlte IIId eomplere. r
These JesulU te'lIC only !D Ihe items te6~. This repon 511a11 be ftprGcNccdexcept in filllllld wjlh pennission ofdlis'.boralory. not " ;,01 '"" _ bee ~ .
The Inc.-lory
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Envirorunental Protection Agency - Region 4 Gro~ Water & Undergroud Inj. Control Section Attention: Bill Mann . 61 Forsyth St:reet:S.W. Atlanta, Georgia 30303
RE: EPA ID
-#
(TNSI29(XX)1XTNIOOI3)
Dear Sir: Enclosed you will find t:he annual Monit:oring Report and Water Analysis Report for Plateau Properties -# 2, EPA ID -# (TNSI29CXX)IXTNIOOI3). Please let:me know if anything else is needed Sincerely, ~~ Office Adnrinisttat:or Rey Oil & Gas
-ANALYTICAL
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1/2812004
112612004 14:00 '1J 912004
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Lab R.eport
5498
Rey Oil and Gas Attention:
Misty King
Normal
(423) 569-8999
Oneida, TN 3784 t
o U"d~,. NELAC
POll
Sulp" laIonutioD
BltLTonk_ WafIIit Tank Stowert Field
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0.007
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SocIum(Na)
Chloride
337Y
"9'l
200.7
200.7 200.7
3
35 100
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Conductance 021C
pH
O,'C
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10
N4 0.001 50
TOS
10
QNQC ProcecIurca,.quIrcd
_1ICIIieved uaI_
,be ~.) __ fitllowed unless otblrwi noted. Pedbnn_ aDd_punas otberwlse noted. No $lgnlfIeaaC mocSlfiClliOdS haft beeo I'IIIdc to the Melhod(s). 1 _II _
"y
SUIIdanIa for requirelf NF.LAC QAlQC pR)ccclurn based upOn my inquiry ollhoso Individuals
itmnoclilfaly rcqIOfIsiitle ~r reviewina the Information, the maletial c:oncained Ia tJri. repon: Is, CDdie bcsaof my knowlc4&*and belief. ac;c:u,. lAd c:omplcle.
TOTAL P.02
FOI'IIIApproved
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ANNUAL DISPOSALJINJECTION
11_ Addr.-ofE
TN
37841
TN
N
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a.---.Plateau Properti;.i.... # 2
s
IIOIITH
Jail 2002
- CAs.G AMIULUSPRESSURE
~~-&I
_1IPS18
BBL
,fi, ,,0 =;7=; 560 =;=;o ,RO 585 Cl7n 535 Clfin ,C;O C;RO
~ln 280 3Hl ~OO 310 ,)qR 310 1q=; 77=; ~nn 70n 300
Cartillcallon
Feb 20c}1
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nCT. 2002
555
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ANALYTICAL INDUSTRIAL
North Carolina Certiftcation# 340 Tennessee CeTtiflcation# 02034
AccredittUion: LELAP #Al856971 Cen# 04006 Effective Dates: 7101102 06130103 to
1550 37TH STREET, NE CLEVELAND, TENNESSEE 37312 (423) 476 - 7766 Fax: (423) 476-7714
Lab Report
5498 Rey Oil and Gas Attention: P.O. Box 5225 Oneida, TN 37841
..------------------1
B & L Tank Battery Water Tank - Stowers Field
147850
Bill Reynolds
Date Received Date Sampled Time Sampled Date Requested Rush Status Phone Extension [;2j Fax PO#
Sample Information -------------------
Lab Report
147850
Barium (Ba) Calcium (Ca) Iron (Fe) Magnesium Sodium (Na) Chloride Conductance pH Specific Gravity Sulfate TOS (Mg)
Result
0.104 4863 31.8 3701 34133 70630 317000 7.18 1.075 820 183000 mg/L mglL mglL mglL mg/L mg/L mg/L mg/L umhos/em pH Units
MDL
0.002 7.5 0.035 3 35 100 500 NA 0.001 50 1000
Method
200.7 200.7 200.7 200.7 200.7 325.3 120.1 150.1 . 2710F 375.4 160.1
Date
1/20/03 1127/03 1/22103 1/22103 1/27/03 1/21/03 1/17/03 1116/03 1/21103 1/21/03 1120/03
Time Analyst
16:21 14:24 14:52 14:34 14:24 13:00 13:50 12:10 16:00 15:00 11:25 SRS SRS SRS SRS SRS CSO CSO SAG CSO CSO SAG
QNQ(:. Procedures required by the Method(s) were followed unless otherwise noted. Performance and acceptance standards for required QNQ(:. procedures were achieved unless otherwise noted. No significant modifications have been made to the Method(s). I attest that, based upon my inquiry of those individuals immediately responsible for reviewing the information, the material contained in this report is, to the best of my knowledge and belief, accurate and complete. These results relate only to the items tested. This report shall not be reproduced ownership of data until full reimbursement has been made. except in full and with permission of this laboratory. The laboratory retains sole
n
Pagelofl
&
NAME
~ PA
AND ADDRESS,OF
U."'".,. ..
EXISTING
e:
ANNUAL orSPOSAt./INJECTION
PERMITTEE ,
WELL MONITORING
NAME AND ADDRESS
REPOR{J
tl'1?J
OF SURFACE OWNER
(fJ5r';t1 dtltJ /
;,I4 60S
TN
PERMIT NUMBER
SURFACE LOCATION
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I
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45
RANGE
57E
UNIT
LOCATE WELL IN TWO DIRECTIONS FROM NEAREST urflC' Loutio;,3..2.l and2..2..3 WEll.
UNES OF aUARTER
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INJECTION MONTH YEAR AVERAGE PSIG PRESSURE MAXIMUM PSIG TOTAL VOLUME BBl INJECTED MCF TUBING - CASING ANNULUS PRESSURE (OPTIONAL MONITORING) MINIMUM PSIG MAXIMUM PSIG
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CERTIFICATION
J- ?J?J O~crcJ
I certify under the penalty of law that I have personally examined and am familiar with the information submitted in this document and all attachments and that. based on my inquiry of those individuals immediately responsible for obtaining the information. I believe that the information is true. accurate. and complete. I am aware that there are significant penalties for submitting false information. including the possibility of fine and imprisonment. (Ref. 40 CFR 144,32).
NAME AND OFFICIAL TITLE (Plus. ry~ or prmO SIGNATURE DATE SIGNED
ChVI$
1284)
See-Trease
4~J;
..
&,-~1.21'i,v,' ~
;:) - 4-"O~
Ef'B&L
6787 Lee Highway
Land Company
Chattanooga, TN 37421 (423) 892-8380 (423) 483-1726
Ms. Jackye Bonds Ground Water & Underground Injection Control Section EPARegion4 61 Forsyth Street, S.W. Atlanta. GA 30303 Dear Ms. Bonds: As you requested, I am again mailing B & L Land Company reports to you. Enclosed please fmd the annual Form 7520-11 for the Disposal/Injection well. Also enclosed is the Water Analysis Report for Stowers Field. The MIT test was mailed to you last year. It is our understanding that this report is due every five years. I called the Am South Bank regarding the Letter of Credit and Letter of Trust. They have said that they are still in place with the EP A. I presume, if copies of any this material should go to another office or department of the EP A, that you will forward it to them. If there is anything else that is needed, please let me know. Thank you.
1273 B & L Land Company/Cambridge Resources Attention: Elsie Blair-Davis/Mike Gamblin 1120 Lewis Ridge Circle Lawrenceville, GA 30045
,..------------------B & L Tank Battery Water Tank - Stowers Field
ASAP
(865) 483-1726 (865) 483-1726
Phone Extension
~Fax
PO#
Lab Reporl
133679
Barium (8a) Calcium (Ca) Iron (Fe) Magnesium Sodium (Na) Chloride Conductance pH Specific Gravity Sulfate TOS (Mg)
Result
0.17 2580 0.034 3570 30780 68430 .211000 6.67 1.08 452 132500 mg/L mg/L mg/L mg/L mg/L mg/L umhos/em pH Units
MDL
0.00200 1.5 0.00700 3 35.0000 1000 250.000 NA 0.00100 25 2000
Method
200.7 200.7 200.7 200.7 200.7 325.3 120.1 150.1 2710F 375.4 160.1
Date
217/02 218/02
2112102
Time Analyst
21:17 14:51 15:35 14:51 14:45 13:25 10:50 9:55 11:30 11:15 14:20 SRS SRS SRS SRS SRS KRK SAG SAG KRK KRK SAG
N/A
mg/L mglL
QAJQC Procedures required by the Method(s) were followed unless otherwise noted. Performance and acceptance standards for required QAlQC procedures were achieved unless otherwise noted. No significant modifications have been made to the Method(s). I attest that, based upon my inquiry of those individuals immediately responsible for reviewing the infonnation, the material contained in this report is, to the best of my knowledge and belief, accurate and complete. These results relate only to the items tested. This report shall not be reproduced ownership of data until full reimbursement has been made. except in full and with permission of this laboratory. The laboratory retains sole
~~~~
-.-_._--------------
VVednesday,Februa~13,2002
Page 1 ofl
r--':"",
:oEPA
ANNUAL DISPOSAL/INJECTION
PERMITTEE
WELL MONITORING
NAME AND ADDRESS OF SURFACE
REPORT
OWNER
TN
I UIC
PERMIT NUMBER,
~ b U lj.
TNI 0013
~----.~ANGE
SURFACE LOCATION
DESCRIPTION '.4 OF
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CERTIFICAT ~ N
v
, I certify under the penalty of law that I have personally exa ined and am familiar with the information submitted in this document and all attachments and that. based on my inquiry of those individuals immediately responsible for obtaining the information. I believe that the information is true, accurate. and complete. I am aware that there are significant penalties for submitting false information. including the possibility of fine and imprisonment. (Ref. 40 CFR 144.32).
NAME
AND OFFICIAL
f'l S;e,
EPA Form
e \a.'t'
TITLE (PI
I. ry~ or print]
SIGNATURE
DATE SIGNED
-Dttll"'s Sec-Treas.
(284)
Afl.~.:~~ -
a.~
.Q . /~ -() (
7520"
(423) 892-8380
~)
483-1726
~u6
February 12,2001 Ms. Jackye Bonds Ground Water and Underground Injection Control Section EPA Region 4 61 Forsyth Street, S.W. Atlanta, Georgia 30303 Dear Ms. Bonds: As you requested a few months ago, I am addressing all my correspondence to you. In past years I was instructed to address it to the Compliance and Enforcement Officer, Water Programs Enforcement Branch at 100 Alabama Street N.W. Atlanta. I assume that, if any of this letter and enclosures should go there, that you will forward them on. A copy of the EPA Report Form 7520-11, Monitoring Report for the injections well owned by B & L Land Co., Inc. is enclosed. Also, please find enclosed a water analysis report for Stowers Field I am also enclosing a copy of the check that was mailed to the Treasurer of the United States i~~ the amount of $1,930.00, Docket No. 4-UICC-015-96 on this date, February 12, 2001. ~~ The AmSouth Bank assures me that the Letter of Credit and the Standby Trust Agreement are still in effect and current. If you have questions regarding this, you may call Jennifer Wolf in Chattanooga, Tennessee, (423) 321-6413. If there is anything else needed, please notify me. Thank you. Sincerely .: ""7
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("23) 476-1'714 2/1012001 211912001 Rill" suma ASAP Ph()M (86.5) 48317').6 .
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60 20.0000 NA
2114101 18:23 JJD 2/15101 15:48 JJD .211 6101 115:~ JJD
2115101 18:00
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pH
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1ZO.1
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1 he.reby certify that the analytical ~ employed. are those approved by the Envil'Onmcntal Protection Agency or other applicable methods for these analyses.
Signed ~~ ~
9? ~ .
..c
~-~~o~~v.d.
.
OMB No
2040-0042
Expl.re!l
9-30-91
&EPA
NAME AND
PROTECTION AGENCY
20460
ANNUAL DISPOSA'L/INJECTION'WELlMONITORING
' NAME AND ADDRESS
REPORT
OF SURFACE OWNER
TN
I UIC
',4 SECTION
FROM NEAREST
PERMIT NUMBER,
4 b U t$
TNI 0013
SURFACE LOCATION
DESCRIPTION
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UNIT
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line of querter section Line of ouarter section
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1-pWell Number
lease Name
'i
No
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I I I
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s
,
TUBING - CASING ANNULUS PRESSURE IOPTIONAL MONITORING) MINIMUM PSIG MAXIMUM PSIG
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CERTIFICATION
bee..-
I ,~I'll
I certify under the penalty of la w that I have personally examined and am familiar with the information submitted in this document and all attachments and that. based on my inquiry of those individuals immediately responsible for obtaining the information. I believe that the information is true. accurate. and complete. I am aware that there are significant penalties for submitting false information. including the possibility of fine and imprisonment. (Ref. 40 CFR 144.32).
NAME AND OFFICIAL TITLE (Pins. ry~ Of print) SIGNATURE DATE SIGNED
g4;
::PA Form 7520-" 12841
4~- /1" ~
-? ~B&L
6787 Lee Highway February
Land Company
Chattanooga, TN 37421
(423) 892-8380
(423) 483-1726
21, 2000
Compliance and Enforcement Officer Water Programs Enforcement Branch United States Environmental Protection Region 4 Atlanta Federal Center 100 Alabama Street, N.W. Atlanta, Georgia 30303-3104 To Whom It May Concern:
Agency
Please find enclosed EPA Report Form 7520-11, Monito~ing Report for the injection well owned by B & L Land Co., Inc. Also, please find enclosed a water analysis report for Stowers Field. I am enclosing a copy of the check that was mailed to the Treasurer of the United States in the amount of $1,930.00, DOCk!t No. 4-UICC015-96, on February 3, 2000. The First American Bank in Knoxville, Tennessee, in1forms me that the Letter of Credi t and the Standby Trust Agreement have been renewed and are current. . In previous years I have mailed this information to a Mr. George Ford. If Mr. Ford is no longer in this office, please direct this information to the person who is now handling our files. If there is anything else needed from us, please notify me. Thank you. SinCerelY'~/
rC)~
/0>/.
;C~(.~
r:
OPERATIONS ANALYTICAL
LABORATORY
SERVICES
CONSULTATION LA13C>RA..TC
INDUSTRIAL RESEARCH 1550 37TH STREET, NE CLEVELAND, TENNESSEE 37312 (423) 476-7766 LAB.
NO.:991221-1S7
CUSTOMER:
1273 B & L LAND COMPANY P.O. BOX 4423 OAK RIDGE, TN 37831
ATTENTION: MICHAEL GAMBLIN DATE REQUESTED 12 / 2 a / 5 (423) 483-1726 FAX: CUST P.O.: SAMPLE :B & L TANK BTRY :STOWERS FIELD - B&L ~~~l? xxxxxxXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX: ANALYSIS M.D.L. Methods Date Ini1 Chloride Sulfate TDS pH Barium Calcium Iron Magnesium Sodium Specific Gravity Specific Conductance
..............
68000 510 285000 7.5 0.067 5300 1.94 4350 30800 1.080 330000
mg/L mg/L mg/L pH Units mg/L mg/L mg/L mg/L mg/L mg/L umhos/cm @25 C
325.3 375.4 160.1 150.1 200.7 200.7 200.7 200.7 200.7 2710F 120.1
12/23/99 12/23/99 12/24/99 12/21/99 12/23/99 12/23/99 12/23/99 12/23/99 12/23/99 12/24/99 12/21/99
DG DG DG DG JD JD JD JD JD DG DG
c en
G)'"
~;g
0:;:0
~m
CD~
..
Notes:
a ~
::z:
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX.xXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX: We hereby certify that -<theanalytical procedures employed are those approved by the Environmental Protection Agency or other applicable methods for these analyses. ANALYTICAL INDUSTRIAL RESEARCH LABORATORIES
~------.
Explor 9-30
&EPA
ANNUAL DISPOSAt./INJECTION
I
WELL MONITORING
REPORT
Inc.
STATE rCOUNTY
Chattanooaa.
TN
37421 TN
PERMIT NUMBER ,. 4 b U tl
Moraan
I
1 I 1
I
1 I 1
--+--I-+'
W
H=
I
1
I : : :
I 1 I
;. 'Il SEcnON TOWNSHIP 45 RANGE 57E LOCATE WELL IN TWO DIRECTIONSFROM NEAREST UNES OF QUARTER SEcnON AND ORIWNG UNIT
Surfac. t.oc.tio~
Carter
Coordinates
of quan.r lection
I
1 1
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INJECTION PRESSURE
P'-"'+-~-"'l1
; ~We/l
No
I
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TUBING - CASING ANNULUS PRESSURE (OPTIONAL MONITORING) MINIMUM PSIG MAXIMUM PSIG
MONTH
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s..
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CERTIFICATION
I
5.,,'[
I
In f
~I
(OX
t..(f)
/Jp,l, 7)4..,.
I
1
!Dlo
I certify under the penalty of law that I have personally examined and am familiar with the information submitted in this documentend all attachments and that. besed on my inquiry of those individuals immediately responsible for obtaining the information. I believe that the information is true. accurate. and complete. I am aware that there are significant penalties tor submitting false information. including the possibility of fine and imprisonment, (Ref. 40
CFR 144.32).
I
ry". '"
print}
SIGNATURE
Elsie
Blai;r/2841
Sec-Treas.
(J
f'~ !?).~H
DATE SIGNED
~.J_'tq
P.02/02
OPERATIONS
.ANAL YT:X: AL C
LABORATORY SERVICES
CONSULTATION
INDUSTRIAL
RESE.A:...~CH LABORA.TORY
JAN~61999
LAB.
CUSTOMER. 1273 B & L LAND COMPANY P.O. BOX 4423 OAK RIDGE, TN 37831
NO.:999114-99539
I OAT! REQUESTED : 9 J. / 2 1 /9 9 (423) 483-1726 FAX: CUST P.O SAMPLB :B , L TANK BTRY :STOWERS FIELD ASAP XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX ANALYSIS Initial M.D.L. Methods Date
ATTENTION
Chloride Sulfate TDS pH . '"' Barium Calcium Iron Magnesium Sodium Specific Gravity Specific Conductance
...................... .............................. ...................................... ..................................... ................................ .............................. .................................... .......................... ................................ ............
..
6711111I 588 142"11I11I 7.3 B.1l7 3858 11I.424 3838 166 BIll 1.1181 35211I11I11
mg/L mg/L mg/L pH units mg/L mg/L mg/L mg/L mg/L umhos/cm 25 C
1.11I 325.3 11I1/25/99 11I1/25/99 1.11I 375.4 11I1/22/99 1.11I 160.1 B1/14/99 B.1 158.1 III. B1112211I11I.7 81/19/99 8.11I15 288.7 1H/19/99 B.1II111788.7 2 81/19/99 B.939 2"9.7 1'll/19/99 B.1II78 211I9.7 11I1/19/99 1ll122/99 11.091 27111F 1 1211.1 11I1/22/99
SS SS 55 SG TB TB TB TB TB SS SS
Notes:
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxXXXXXXXXXXXXXXXXXX We hereby certify that the analytical procedures employed are those approved by the Environmental Protection Agency or other applicable methods for these analyses. ANALYTICAL INDUSTRIAL RESEARCH LABORATORIES
TOTf'LP.02
z:
NAME AND ADDRESS .OF EXISTlNG I'RMlrnE
(LIC
OF SUIU'ACE OWNER
B & L Land Com~any, Inc. 6787 Lee Eighway f'h" .. anooaa TN 37421
STATt LOtATt WELL AND OUTUNE UNIT ON SECTION PLAT - s.o ACRES
4 b U l:I
TN
It OF
Moraan
DESCRIPTION '. OF SECTION
SURFACE LOCAnoN
I I I I I I I --+--+-....I ~ ~ ~ 1-;.-4--1--1--i
I I I I I I I I I wl--+--+--+-+--+-+--+---i t I' I I I-LI , -T-+-T I -t'I--t--t--i i I I I I I I I ! I I I
s
: : : I : :
4 <;
RANGE
57E
LOCATt WELL IN TWO DIRECTIONS FROM NEAREST UNES OF QUARTER SECTION AND DRIWNG UNIT Surf
Carter Coordinates
Uno '" _
L;no'" -
oection
I I I ----'---l.--!-!--i ! I : :
XI Brine Disposal
EI Enhlnced Recovery
D Hydroc.artxmStorage
nAr
11
:Ia
IndMdual
Number of WeU.1-
t.o Nomo
P'""""
. oW." Number
No
TUBING
INJECTED
MtF
MINIMUM
Fe/:;
Avv
oeo
fla
7(~
fJ,r
CERTIFICATION
I certify under the penll/ty of tsw thllt I bsv personlllly examined and am familiar with the information submitted in this document endst! attachments and that. based on my inquiry of those individuals immediately responsible for obtaining the intormstion, I believe that the information is true, accurate. and complete. I am aware that there are significllnt penalties for submitting false information. CFR 744.32).
NAME AND OFFICIAL TITLE /PI u trIM IN /NmO
(Ref. 40
SIGNArz
DATE SIGNED
O!tflll'Jo
1-13-93
'2841
'. &EPA
NAME AND ADDRESS .OF EXISTING PERMITTEE NAME AND ADOAESS OF SURFACE OWNER
~.I
TN
Surface Loca"~
.nd?~
.>.
PERMITNUMBER, 4 b U ~
. Moraan
'. OF
'LOCAnON CES...,I."uN
-1..1-1-1_1 : :
_+_'_~
1 1 1
1 W
'. OF
45
RANGE 57
UNIT
AND DAIWNG
1 1 1 liT-I
1
I
I
1
I
I
1
I,
f--t-t--t--i---t-+---t-i
WEll. ACTIVITY
E -W Brine Disposal ~ Enhanced Recovery Hyaroaroon SEDrag'
TYPEOF PERMIT
:iQ Individu.1
CAre. Numberof W.lls
l-LI
1 1
I
!
!
5
:
I
LeWell Number
. I I i _l.._I_l.._l..-:--7--1
1 1 1
I
.
PRESSURE
lease Name
1'1
ateau
Properti
No.
TUBING INJECTION MONTI-! 'fEAR AVERAGE PSIG TOTAL VOLUME INJECTED PSIG
MAXIMUM
BBL
Me>
MINIMUM
I qq 1
(,,73
1071. C,74 (,,7 )'
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'-/.s 7
7'71
_ 0 _
b~s
o -
c,?~
- o -
CERTIFICATION
I certify under the penalty of law that I have personally examined and am familiar with the information submitted in , this document and al/ attachments and that. based on my inquiry of those individuals immediately responsible for obtaining the information. I believe that the information is true. accurate. and complete. I am aware that there are signdicant penalties for submitting false information. including the possibility of fine and imprisonment. (Ref. 40
CFR 144321.
NAME ANO OFFICIAl.. TITLE IPI ~. tyt ", puntJ DATE SIGNEO
...
- _