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PERMITTEE NAME/ADDRESS (TMA~srrdlryNa/EIXdlm UD+OFwvl <br />NAME TnF J..~'. ~, ,~ ;r I. -. <br />ADDRESS T H A 2 I ~. <br />P.'J. ='~.i 1 ' 7 <br />CksA:., lG elt•l.ti <br />FACILITY <br />LOCATION <br />u~l i'~. YI• ,; C'+U1, I: 1'-".'F}~~r e'RES/+:: 1: "G4 <br />NATIONAL POLLUTANT DISCMMOE ELIMINATION SYSTEM JNPDESI <br />DISCHARGE MONITORING REPORT IOMR1 <br />l1-161 117-191 <br />'~G032115 C75 P <br />PERMIT NUMBER DIBCNMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAV <br />FROM '~ '~ TO ~ ' <br />O(A]fl /]]-]31 114]51 r]8-]7/ (28-291 (3G3/1 <br />Form Approved. <br />F a N C 0? T ~~ r I D~ L t°MBf'WA7P i0-O00t'" t' <br />(~ U P P A a) ApProveLe~r~q~05-37-96 <br />F - FIAAL <br />"IVCP <br />NOTE: Reed 4EetnretMNr lEe/on compMTMp This fam. <br />PARAMETER 13 Grd Onlyl QUANTITY OR LOADING !~ Grd Onhl QUANTITY OR CONCENTRATION Np- FREQUENCY SAMPLE <br /> 146531 !5/-611 f38-451 1663 Ib467/ <br />E% of <br />TYPE <br />l37-371 MALY95 <br /> AVERAGE MA%IMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS Is7-s] l54-5B1 /69-701 <br />,r - E SAMPLE 4r>?.'YReo ( 94) 0??Ot; :>:?#AS'+ ?Xri~. <br />J ! ~ U A L MEASUREMENT <br />i~~65 L 0 0 .:.PERMIT <br />; xttcul O.=r. ':-R>rYQ$T.: BS=1 IG.+dlp±i#e #~00#v is4e>srq~i rlp~~: ~~~{~, VI~'UAi <br /> <br />cFr'LUgNT t,9D5S YALU . <br />R.EQ~JBEMEN.T' <br />:: .; ;.: <br />;'~N~..~!lI1X.. <br />NC=O <br /> <br />,.. ., ... <br />4+~r•a <br /> SAMPLE ~ ' <br /> MEASUREMENT <br /> ;: <br />; <br /> <br />'.RE¢UIREIiAENT ~ <br />..-: ~..... . <br />.. <br />.. <br />~ <br />. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - ~ ~ ?~.+: <br /> REQUIREMENT ~ ~ ~ 3~~~ <br /> SAMPLE <br />MEASUREMENT <br />~ <br />~js <br />~~~t <br /> PERMIT . ~ : z :;'::: ;~.: •~ <br />~ <br /> ~ ~ ~ <br /> REOUIHEMENT ;; :~ <br />.: <br /> SAMPLE <br /> MEASUREMENT - <br /> .. PERMIT -~ -:.. p,~ i:. ~ <br />- .. ~ " :~: ..:. ~ <br />~ <br />~ ~ ~ .. <br />~ ~~ <br /> ~:REOUIREMENT ~ ~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REDUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~. .~ ~ ~~ <br /> REQUIREMENT ~ ~ ~ : <br />NAME/FITLE PRINCIPAL E%ECVTIVE OFFICER i cERnFr uNDeR PENN.TY or <br />AM FAMILIM VATH THE INFO uw rHAr I NAVE RERSONALLr ExAMINED MD <br />RMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE <br /> MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESRONSIBLE FOR .. <br />[1T <br />(,Old OR PeteLe OBTNNING THE INFORMATION, 1 BELIEVE THE SUBMITTED INFORMATION IB ~~ <br />, TRUE. ACCUMTE AND COMRETE. I AM AWME THAT THERE ME <br />CANT PENALTIES FOR SUBMITTNO FALSE INFORMATION <br />INCLUDING <br />SIGNIF <br />9] 824-440 <br />9a <br />[(] <br />Preeident66 General Mane eI^ <br />B , <br />I 29 <br /> THE POSSIBIUTV OF RNE ANO IMENUSONMENT. SEE Ie U.S.C. 1 1001 AND 9] iIONATEME OF PRINCMAL EXECUTNE <br /> ~~~ ~ rn., .~ ro tfo.DOO <br />~ <br />e'n~ <br />ia <br />. <br />l <br />a <br />a n~ <br />M AR A <br />TYPED~OR PRINTED lw <br />e <br />m. <br />xA <br />n <br />iR <br />i <br />er <br />yvAl <br />OFFICER OR AUENORIZED AGENT <br />CDDE µUMIIER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRSrarsnce N/ ~re~cnmsnfs nerel <br />;~:i G TJTAL IfiGti LiYIT_ MILL BL :dAIYED, AN6 SETTLEA6LF. SOLIIS 17MIT AFFLIF~ FCP <=1GYk,2UF?h FRECiP !Yf;NT- <br />.;lir. BUNDE,9 OF FnOGF FE~UI<<?i~r:NTS UND}:R I.A.I. TDS GONIT~H IpG - I.P,3, OIL E GFE.4SP. - SEE I•A•1. (U) <br />10 DAY AY~(tA~E tS hT(.fIFSP M(INPHLY ayPpAGP n~larNr- Dparnn acpl^p~I- <br />EPA Form 3320.1 108-951 Pravioue editions mey be used. (REPLACES EPA FORM TalO WHICH MAY NOT BE USED.1 C 0 G 7 N / 9 7 1211-16 u 6 PACE ~OF ,~ <br />