ML18036B075
| ML18036B075 | |
| Person / Time | |
|---|---|
| Site: | Browns Ferry  |
| Issue date: | 10/31/1992 |
| From: | TENNESSEE VALLEY AUTHORITY |
| To: | |
| References | |
| NUDOCS 9212010072 | |
| Download: ML18036B075 (17) | |
Text
ACC ".LERATED DIS %3BUTION DEMONS TION SYSTEM REGULSTG INFORMATION DISTRIBUTION STEM (RIDS)
.i ACCQ , ON NBR:9212010072 DOC.DATE: 92/10/31 NOTARIZED: NO DOCKET FOCI :50-25'9 Browns Ferry Nuclear Power Station, Unit 1, Tennessee 05000259 50-260 Browns Ferry Nuclear Power Station, Unit 2, Tennessee 05000260 50-296 Browns Ferry Nuclear Power Station, Unit 3, Tennessee 05000296 AUTH. NAME AUTHOR AFFILIATION
- ~ Tennessee Valley Authority RECIP.NAME RECIPIENT AFFILIATION
SUBJECT:
ADEM discharge monitoring repts for Oct 1992 for Browns Ferry Nulcear Plant, Units 1,2 6 3.
DISTRIBUTION CODE: IE23D COPIES RECEIVED:LTR L7 ENCL SIZE:
TITLE: Environmental Event Report (per Tech Specs)
NOTES:
RECIPIENT COPIES RECIPIENT COPIES ID CODE/NAME LTTR ENCL ID CODE/NAME LTTR ENCL SANDERS,M. 3 3 HEBDON,F 1 1 ROSSFT. 1 1 WILLIAMSFJ. 1 1 INTERNAL: ACRS 5 5 NRR/DREP/PEPB9D 1 1 NR+R PMAS ILRB12 1 1 OGC/HDS3 1 1
-REG FIL 01 1 1 RGN2 1 1 EXTERNAL: NRC PDR 1 1 NSIC 1 1 NOTE TO ALL RIDS" RECIPIENTS:
PLEASE HELP US TO REDUCE WASTE! CONTACT THE DOCUMENT CONTROL DESK.
ROOM Pl-37 (EXT. 504-2065) TO ELIMINATEYOUR NAME FROM DISTRIBUTION LISTS FOR DOCUMENTS YOU DON'T NEED!
TOTAL NUMBER OF COPIES REQUIRED: LTTR 18 ENCL 18
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ADEM DISCHARGE MONITORING REPORT MONTH: OCTOBER'992 COHPANY: TVA - Browns Ferry Nuclear Plant .IX1 HONTHLY LOCATION : .S. Highway 72 NPDES NO. AL0022080 MhJOR Athens, Alabama 35611 DBN001 6 Hr Hourly EFPECTIVE : 10-15-89 PARAM1Plow 1 pH Cl, TA 1 Amb,RT 1 DRT 1 Temp,R Temp 1 Temp Hyd 1 6/ Report Violations Only AvG 1 Hon 1 6.0 min. N/A N/A 1 N/A 1 N/A N/A 1 N/A N/A 1 2/ 5/ - Measurement Prequency HAX 1 Hon 1 9.0 730 I Mon 1 90P I 10F 92 P 1 93 F 0.01 1 in your permit.
PREQ I Cont I 1/wk 1 6/ 2/ 5/ 1/day 1 1/day 1/day 1 1/day 1/wk II UNITSI MGD I s u. PPD I
--->>- - deg. F 1 deg. F deg F. 1 deg. F mg/I 1 1835.0 I I >>.5 I 73.1 lo.goo lo ooo I 73 4 ls3s.o 1 1
>>.5 1
>>-9 10.600 Io 000 1 73.4 3 1835.0 I I 72 ' I 73 ' I 1.70 10 F 000 I 74.8 4 1835 ' I I 72.0 I 74.2 I F 00 10.000 I 75.6 5 1835.0 I 71.1 1 74.1 1 3.00 lo.ooo 1 73.0 6 1835.0 1 7.40, 7.401 70.8 1 72.2 1 1.50 lo.ooo 1 72.5 REPLICATE 7 835'0 1 8'Ioi 8 101 70.6 1 71.7 1 1.40 10.000 1 72.4 010 @
< 010 1 REPLICATE 35.0 69.9 1 71.2 1 1.40 10.000 1 71.9 9 835 0 I I 69.4 I 70.8 I 1.40 '0.000 I 71.2 I 10 8350 I I I 68.9 I 70.2 I 1 60 Io 000 I 71 2 I 1 I 11 1835.0 I I 68.3 I 69.8 I 1.70 10.000 I 71 ~ 4 12 1835.0 1 I 67-9 I 69.5 I 1.60 10.000 I 69 '
lAIE:
13 1835.0 1 8.09 I 68 0 I 69 1 I 1'10 10 000 I 69 7 I< 010 ~ fllP 14 1835.0 I 68.5 69.6 1.30 10.000 70.9 PIQa.
I I I I ~ QQ 15 1835.0 1 1 68.8 1 70.3 1 1.50 10.000 1 71.4
'CU tD 16 1835.0 I I 68.8 I 70.6 I 1.90 10.000 1 71.3 17 1835 ' I 68.5 I 70 4 I 2 00 10.000 I 70.1 le ls35.o 1 1 67.3 1691 11.80 10.000 I 68.6 hu
-QO 19 1835.0 I 1 66.6 I 67.9 I 1.40 lo.ooo 1 6s.o QP 20 1835.0 8.15 65.8 67.1 1.30 <<C I I I I 10 000 I 67. 1 I <.010 Q 1835 ' 1 I 65.7 I 66.7 I 1 00 10.000 1 67.4 le3s.o 1 I 66.5 I 68.0 I 2.00 lo.ooo 1 68.7 23 835.0 I 1 66.4 1 6s.o 1 1.6o lo.ooo 1 6s.l 2 35.0 I I 66 ' I 67.8 I 1.60 10.000 I 69.6 25 1835 0 I 66.5 1 67.8 1 1.40 10.000 1 69.0 26 1835.0 I 66.4 1 68.3 1 2.40 10.000 1 69.0 27 1835 0 66.2 1 68.1 1 2.00 10.000 1 68.6 1<.010 28 1835.0 8. 14 I 66.2 I 68.1 I 2.10 10 F 000 I 68.6 I 29 30 1835.0 1835 0 I I 1 I
66.6 66.7 1
I 68.4 68.5 1
1.80 1.80 10.000 lo.ooo I 69 0 6s.s Uoj "jQI I 1 1835.o I 1 66.8 68.3 1 1.50 10 000 I 69 3 M AVG 835.0 1 7.91 68.4 1 69.9 1 1.65 10.000 1 70 ' 1<.010 MAX 1835 0 1 8.15 1>>.5 I 74 2 I 3'0 lo'000 I 75 6 I 010 I I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assurq that qualifxqd.personnel prqperly gather an/ evaluatq the information submitted. Based on my inquxry of the persqn or persons who manage the system, or those persons dxrectly rqspqnqxble for gatherxng the jnfqrmatxon, the xnformE'hiqn suhyitted xs, to the best of my knowledge and belxef true, a rate, and complete. I am aware that there are sxgnxfxcanf penaltxes for suhaxttxng f se Informacion( xncludxn the ssibility of fine and imprxsonment for fmowxng violatxons.
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signature of Responsible Official D<<e November 25I 1992 ADEN POSH 261 (B) 1/88
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ADEH DISCHARGE MONITORING REPORT MONTH I OCTOBER, 1992 IX I FavrHLI "oMPANY : TvA - Browns Ferry huclear Plant LOCATION : D.S. Highway 72 NPDES NO. AL0022080 MAJOR Athens'labana 35611 DShoola (Fo rerly 103) EFFECTIVE 10-1.5-89
?ARAHIFlow I 0 s G I Tss I I I I AYG I Mon I 15 ' I 30.0 I I I I I I I MAx I M0Il I 200 I 100'0 I I I I I I I I FREO I 1/wk I 1/wk 1/wk I I - I I I I I
'JNITSI MGD I ng/) ng/1 I I I I I I I I I I I I I I I I 2 I0.067 I<5.00 I 6.oo I I I I I I I I I I 4 I I I I I I I 5 I I I I I I I I I I 6 I I I I I I I I I I I I I I I I I I I I I I I I I I I 9 Io 096 I<5 00 <5 ~ OOI 8 00 6 OOI I I I I I REPLICATE 1O I I I I I I
>> I I I I I I I I 12 I I I I I I I I I I I I I I I I I I I 14 I I I I I I I I
>> I I I I I I I I I I 16 Io-100 I <5.00 I 9.00 I I I I I I I I I I I I I I I 18 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 2+0. 0 84 I<5.00 I 26.0 I I I I I I I I I I I I I 25 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 29 I I I I I I I ~ I I 30 I0.192 l<5.00 I 3.00 I I I I I I I I I I I I I M AvGI0.108 I<5.00 I 9.67 I I I I I I I MAX lo 192 I<5 00 I 26 0 I I I I I I I Iqua>>fie<(
<<rnif~v under Penalty of law that this docunent and,all attachnents.were prepared under.ny direction or supervision in accordance with a systen designed persons Personnel prqperlv gather and evaluatO the infornation subaitted. Based on ny inquirv of the person or persons who Iaanage the systeu, or those to assure that directly respo>>ib)= for gathering the infornation, the infornation suhnitted is, to ge best of ny knowledge and belief true, accurate, and complete. I au aware hat there are significant penalties for subnitting false infornation, including the possibility of fine and irlprisoIuaent for /mowing violations.
signature of', Responsible official Date ADEM FORM 261 (B) 1/88
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ADEN DISCHARGE HONZTORZNG REPORT HGNTH: rcTGBER, 1992 TVA - Browns Perry Nuclear Plant lxl IDcpzloN: G.s.
HcmNI,Z Haghway 72 hPDES hO. AL0022080 HLTOR COHPANY:
Athens, Alabama 35611 DSNoolb EFPECTIVE : 10-15-89 PARANIFlow I 0 & G I TSS I Cu.T I Fe.T I I I I AvG I Hon I 15.0 I 30.0 I N/A I N/A I 2/ will be applicable only when chemical metal cleaning HAX I Hon I 20.0 I 100.0 I 1.0 I 1.0 I 2/ I solutions are being used. The rest located in Pemit FREQ 11/Bat I 2/wk 2/wk I I/Batch I 1/Batch I I I I DNITS I HGD I mg/1 mg/1 I mg/l I mg/1 I I I I I I 1 10.031 1
<5.00,<5.001 2.00, 2.001 I I I I I I REPIICATE I I 2 10.031 I I I I I I I I I 3 I Nom I I I I I I I I 4 10.030 I I I I I I I I I 5 10.031 1
<5.00 1<1.oo I I I I I I I I I 10.012 1
<5.00 1<1.00 I I I I I I 10.018 I I I I I I 9 10 ~ 031 I I I I I I I I I 10 10.031 I I I I I I I I 11 I Nom I I I I I I I 12 10.031 1
<5.00 I 2.00 I I I I I I I 13 10'031 I 5'00 1<1.oo I I I I I 14 10.025 I I I I I I I I 15 I0 ~ 031 I I I I I I I I I 16 10 ~ 031 I I I I I I I I 17 10.027 I I I I I I I I 18 rom '
I I I I I I I I 19 10.031 I 14.0 I<1.00 I I I I I I I 20 10.031 1<5.00 1<1.00 I I I I I I 21 10.027 I I I I I I I I 22 10.031 I I I I I I I I Io.o27 I I I I I I I 10.041 I I I I I I I 25 10.031 I I I I I I 26 10.031 I <5.00 I <1.00 I I I I 27 10.030 I<5.00 I<1.00 I I I 28 10.031 I I I 29 10 031 I I I I I 30 10.114 I I I I I 31 10.104 I 10.0 I 60.0 I I I H AvGI0.035 I<6.27 I<6.64 I I HAX lo:114 I 14.0 I 60.0 I I I Z centi-'v under penalty of law that this document and.all attachments. were prepared under.my direction or supervision in accordance with a system designed to assure that qualxfxeB personnel prqperlv gather and evaluate the infomation submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gatherrng the infomation, the infomatxon submitted as, tj slgnif>cant penalties for submitting false infomatxon, xncludhng the posslbxlltythy best of my knowledge and belief true, accurate, and co~lete.
of fine and imprisonment for feowing vxolatlons.
I am aware that there are Signature Cf Responsible Official Date ADEN PORN 261 (B) 1/88
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ADEM DISCHARGE MONXTORING REPORT MONTH: OCTOBER, 1992 IX I MOiaTHLY MMPANY: TVA - Browns Ferry Nuclear Plant LOCATION : G.S. Highway 72 NFDES NO. AL0022080 MAJOR Athens, Alabama 35611 DSNOOlc (Formerly 107) EFFECTIVE 10-15-89 ARAMI w I 0 s G I Tss I I I I I I I AvG I Mon I 15.0 I 30.0 I I I I I MAX I Mon I 20 ' I 100.0 I I I I FRE0 I 1/wk I 1/wk I 1/wk I I I I JNYTSI MGD I mg/1 I mg/1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 4 I I I I I I I I I I I I 6 I I I I I I I I I 0.022 I<5.00,<5.00I 2.00, 2.00I I I I I REPLICATE I I I I I I 9 I I I I I I I I I 10 I I I I I I I
>> I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 14 I0.011 I<5-00 I 2 ~ 00 I I I I I I. I I I 15 I I I I I I I I 16 I I I I I I I I I 17 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 22 I0.004 I<5.00 I 1.00 I I I I I I I I I I I I I I I I I I I I I I I I I I I I 25 I I I I I I I I I 26 I I I I I I I I I 27 I I I I I I I I I I I I I I I I I I I I I 29 I0.005 I<5.00 I 6.40 I I I I I I I I 30 I I I I I I I I 31 I I I I I I I I M AVGI0.010 I<5.00 I 2.68 I I I I I I I I MAX I0.022 I<5.00 I 6.40 I I I I I I I Y cer~fg under penalty of law that this document and.all attachments were prepared under.my direction or supervision in accordance with a system designed to assurO that
<tualxfxO~ personnel prqperlv gather and evaluate the information submitted. Based on my inquxrv of the person or persons who manage the system, or those persons directly responsible for gathering the information, Qe information submitted xs, tj the best of my knowledge and belief true, accurate, and complete.
sxgnxfxcant penalties for submxtung false xnformatxon, xncludxng the possxbxlity of fane and im~prxsonment for I<nowing vxolatxons.
I am aware that there are Signature of Responsible Official Date ADEM FORM 261 (B) 1/88
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ADEN DISCHARGE MONITORING REPORT MONTH: OCTOBER, 1992 CDMFANY: TVA - Browns perry Nuclear plant LCCATION :
lxlQ.S.McmHLI Highway 72 NPDES NO. AL0022080 MAJOR Athens, Alabama 35611 DSN001d (Formerly 110> EFFECTIV : 10-15-89 PARAMIPlow.. I 0 S G I TSS I I I I I I I I I I AVG I Mon I 15.5 I 30.0 I I I I MAx I Mon I 20.0 I 100.0 I I I I I I I I FRE0 I 1/wk I 1/wk I 1/wk I I I I I I I I UNITS I MGD I mg/1 I mg/1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 41 I I I I I I I I I I I I I I I I I I I I I I I I I I
.7E-41<5.00,<5.001 2.00, 2.001 I I I I I REPLICATE I I I I I I I I I I I I I I I I I I I I I I I I I I I 11 I I I I I I I I I 12 I I I I I I I I I I I I I I I I 14 11 7E 41<5 00 I 2.00 I I I I I I 15 I I I I I I I I I I I I I I . I I I I I I I I 17 I I I I I I I I 181 I I I I I I I 19 I I I I I I I I I I 20 I I I I I I I I I I I
>> I I I I I I I I I I I 22 12 'E-41<F 00 6.00 I I I 2 I I I I I I I I I I I 25 I I I I I I I I 26 I I I I I I I 27 I I I I I I I I I I I I I I I I I I 29 I 1.7E-41 19.0 I 25.0 I I I I 30 I I I I I I I I I I I I I M, AvG11 ~ 8E-41<7.80 I 7 ~ 40 I I I I I I I MAx 12.2E-41 19.0 I 25.0 I I I I I I I I certify under penalty guallflecr personnel of law that this document and.all attachments were prepared under.my direction or supervision in accordance with a system designed to assuredirectly the system, or those persons that prqperlv gather and evaluate the informatlen Submitted. Based on my inquiry of the person or persons who manage I that there are respqnsibl for gathering the Infqrmatlon, the lnformatlan submitted ls, tq thq best of my knowledge and belief true, accurate, and complete. am aware significant penalties for submlttlng false lnfermatlon, lnCludlng the posslblllty of fine and imprisonment fOr klOWlng vlolarlons.
Signature of Responsible Official Date ADEN FORM 261 (B) 1/88
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ADEN DISCHARGE HONZTORZNG REPORT HONTH: OCTOBER, 1992 Ix I raNTHIz "OHPANY: TVA - Browns Ferry Nuclear Plant LOCATION : Q.S. Highway 72 NPDES NO. AL0022080 HAJOR Athens, Alabar<<a 35611 DSNO02 (Fort<<erly 102) EFFECTIVE 10-15-89 PARAHI Flow I pH I 0 & G I TSS I Hyd I I I I I I AVG I Hon I 6.0 min I 15.0 30.0 I N/A I I I I I I I HAX I Hon I 9.0 I 20.0 I 100.0 I 0.01 I I I I I I FRE0 11/Bat I 1/Batch I 1/Batch I 2/Batch I 1/Batch* I>> Discharge no longer has the potential to contain Hydrazine JNITS I HGD I s.u. I r<<g/I I ng/1 ng/1 I I I I I 1 10.241 I 7.56 I<5.00 I 4.00 I I 2 10 ~ 241 I I I I I I 3 10 ~ 241 I I I I I I I 4 10.241 I I I I 5 10.241 I I I I I I I 6 10.241 I I I I I I I 0.241 I I I I I I I I I I e 102411 I I I I I I I I I 9 10.241 I I I I I I I I I 10 10 241 I I I I I I I I I I 11 10.241 I I I I I, I I I I I 12 10 241 I I I I I I I I I I 13 10.241 I I I I I I I I I I 14 10.241 I I I I I I I I I I I 15 10.241 I I I I I I I I I I 16 10.241 I I I I I I I I I 17 10.241 I I I I I I I I 18 10 241 I I I I I I I I I I 19 10.241 I I I I I I I I I I 20 10.241 I I I I I I I I I I 10.241 I I I I I I I I I I I 22 10.241 I 8 ~ 47 I I 3.00 I I I I I I I Nom I I I I I I I I I I I Nom I I I I I I I I I I I 25 I Nom I I I I I I 26 I Nom I I I I I I I I I 27 I Nom I I I I I I I I I 28 I Nom I I I I I I I I I rom I I I I I I I I I 30 I Nom I I I I I I I 31 I Nom I I I I I I I H AvGI0 241 I 8 ~ 02 1<5.00 I 3.50 I I I I HAx 10.241 I 8.47 1<5.00 I 4.00 I I I
~4 Iqualifieu cerfifY under penalty of law that this docunent and.all attachr<<ants were prepared under.ny direction or supervision in accordance with a systen designed to assure that personnel properlv gather and evaluate the inforr<<at>on subc<<jtted. Based on r<<y inqusrv of the person or persons who nanage the systen, or those persons directly responsib e for gathering the infoanation, the infort<<arson subnitted as, t<<) the best of ny knowledge and belief true, accurate, and complete. I an aware that there are sxgnxfxcant penalties for subcittxng false znformatxon, ancluding the possxbxlity of fine and ir<<prisons<<ent for knowxng vxolations.
signature o Responsible official Date ADEN FOEH 261 (B) 1/88
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~ ADEM DISCHARGE MONITORING REPORT MONTH: OCTOBER, 1992 TVA - Browns Ferry Nuclear Plant Ix I MCiiTHLY COMPANY: LOCATION : Q.S. Highway 72 NPDES No. AL0022080 NIJOR Athens, Alabama 35611 DSN005 EFFECTIVE 10-15-89 PARAMIFlow I Te-p I I I I I I I I I AvG I Mon I Mon I I I I I I I I MAX I Mon I Mon I I I I I I I I FREQ I 1/wk I 1/wk I I I I I I I I I UNITSI MGD I degrees F I I I I I I I I I I I rom I I I I I I I I I 2 I horn I I I I I I I I I I I 3 I rom I I I I I I I I I I I 4 IhvmI I I I I I I I I I I 5 IhomI I I I I I I I I I I I 6 I hONE I I I I I I I I I hoHE I I I I I I I I I ~ I I Nom I I I I I I I I I I 9 INomI I I I I I I I I 10 I rom I I I I I I I I I I 11 I hONE I I I I I I I I I I 12 I HONE I I I I I I I I I I 13 I rom I I I I I I I 14 I Nom I I I I I I I I I I 15 I NONE I I I I I I I I I I 16 I Nom I I I I I I I I I I I I NONE I I I I I I I I I I 18 I Nom I I I I I I I I I I I 19 I Nom I I I I I I I I I 20 I HONE I I I I I I I I 21 I HONE I I I I I I I I 22 I Nom I I I I I I I I Nom I I I I I I NONE I I I I I I I 25 IromI I I I 26 I hoNE I I I I 27 I BCNE I I I I I I 28 I rom I I I I I I I 29 I Nom I I I I I I I I 30 I horn I I I I I I I I I I I I I I M AVGI HONE I I I I I I I I MAx I lmm I I I I I I I I I cer"iQ under penalty of law that this document and.all attachments were prepared under,my direction or supervision in accordance with a system designed to assure that personnel prqperl gather and evaluate the infornation submitted. Based on ny inqui of the person or persons who manage the sys em, or those persons directly responsible for ~atherxng 8e gnfqrnatxon, the information submitted is, to the best of ny knowHege and belief@true, accurate, and complete. I an aware that there are sxgnifican't pena ties for submxttxng false xnfornatxon, including the possibility of fane and inpr sonment for owing violations.
Signature of Responsible Official Date ADEN FORM 261 (B) 1/88
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ADEM DISCHARGE MONZTORZNG REPORT N)hTrI: OCTOBER, 1992 coMPANY: TYA - Browns Ferry Nuclear Plant LOCATION: '.S.
IXI MONTHLY Highway 72 Athens, Alabama 35611 NPDES NO. aA022080 MAJOR DSN011 EFFECTIVE 10-15-89 PARAMIFlow I BOD (5) TSS I I I I I I I I AVG I Mon I 30.0 I 90 ' I I I I I I I I I MAX I Mon I 45.0 I 1.35.0 I I I I I I I I I FREo I 5/wk I 2/no I 2/no I I I I I I I I UNITsI rm I ng/1 I ng/1 I I I I 1 10018 I I I I I I I I I 2 10.018 I I I I I I I I I I I I I I I I I I I I I I I I 41 I I I I I I I 5 10.018 I I I I I I I I I I I 6 10.024 I 16.0 I 40.0 I I I I I I I
.o18 I I I I I I I I I 8 0.024 I I I I I I I I I 9 10.024 I I I I I I I I I I I I I I I I I I I I I I I I I I I I 12 10 031 I I I I I I I I I I I 13 10.024 I I I I I I I I I I I 14 10.024 I I I I I I I I I I 15 10.024 I I I I I I I 'I I 16 10.040 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 19 10.018 I I I I I I I I I 20 10.018 I I I I I I I I 21 10.031 I I I I I I I I I 22 10.018 I I I I I I I I I - I 2~0.024 I I I I I I I I I I 25 I I I I I I I 26 10.013 I I I I 27 10.018 I I I I I 28 10 '24 I 33 ' I 22.0 I I 29 10.018 I I I I 30 10.018 I I I I I I I I I M AVGt0.022 I 24-5 I 31 ~ 0 I I MAX 10.040 I 33.0 I 4o.o I I I I I certify under penalty of law that this document and.all attachments.were prepared under.ny direction or supervision in accordance with a systen designed persons to assure that qual>f>e~< personnel properlv gather and evaluatO the infornatxoO submitted. Based on ny inquiry of the person or persons who manage the system, Ioran those directly responsible for gathering the xnfornation, the xnfornatxon submitted xs, to +o best of ny knowledge and belief knowing a~rate, and complete.
true, vxolatxons. aware that there are signifxcant penalties for submitting false information, Including the possibxlxty of fane and imprisonment for signature of, Responsible Official Date ADEN FORM 261 IBI 1/88