Laserfiche WebLink
PERMITTEE NAME/ADDRESS (rndrde Faculty Name/Locanan JD~gerenB <br />NAME 56HOCA CJ0.L CJhIAi~Y <br />ADDRESS) Ii A N 'c H D <br />HAYDEIr CJ x1639 <br />FACILITY <br />LOCATION <br />^AYDEN CO 0103) <br />0.TTH; dJD ti r.i)%Y~ CEN~i(AL 7fAtiA;;LR <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) FDRI1 ApprOVad. ~1 '_ ' <br />DISCHARGE MONITORING REPORT (OMR~ OMB NO. 2040-0004 .r-°% a' <br />0000002)1 O11 A (SUar{ Nli) Approval expires 05x1-98 <br />' ~ PERMIT NUMBER DISCHARGE NUMBER F - FINAL flJL T T <br />';, MONITORING PERIOD SE6. POND USG,tl YO GNASSY CND. <br />YEAR.,.LMO: DAY YEAR MO DAY <br />FROM ~y vl .:TO yy v0 Ju Y+ic :70 DI SCtlA:tGE ~( rt~:= <br />rzo-zl) rzs=z3/ T14-25),,; C (zs-zr) tze-z9) (aoa+) NOTE: Read IrIBVUC[ions bef completing this form. <br /> (3 Card Ony) QUANTITY OR LOADING ,- {(4 Card Ony) GUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) Sd-6/) ~ `~ (3815) 48-53) (54-Bi) E7C OF TYPE - <br />(323n AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />IszdT) ANALYSIS <br />(Base) <br />69-70 <br />J1L A7J v.{EASG SAMPLE FuTf754 ( ylt) 3M 4SL`4 aa,:aur O:: Lt6~Y ~< <br />Y 1 S J A L MEASUREMENT <br />J'lObb 1 ) U PERMIT' •" R °'~~ ~I1~ ES=1 y <br />t iyiBp' q ~G: tl BE~L1I LSUAI. <br />LF'F'LUG:I2 v~J5:i YdLUi REQUIREMENT _ ` ~~ <br />y M0=0 i ' <br />: <br />~r '~'-f is i~ C,: L+: <br /> SAMPLE <br /> MEASUREMENT ~`~' L ` <br /> ~ ~ ~ s <br /> REQUIREMENT ~ - ~~,~ <br />~ - `- <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> .REQUIREMENT - c-~ '~.. •~~ .. <br />~~y °> <br /> ~. .:...:. <br /> SAMPLE '"'~~ <br /> MEASUREMENT <br /> ;~ i"PERMITi•-. ~ t`t; y `:; ~ I+~s;. <br />~ <br />' <br />- .:. ~.~ ;-. <br />- <br /> REQUIREMENT - „~'" - ~y =u'* ~ <br />,= <br />- <br /> SAMPLE <br /> MEASUREMENT ~ ' <br /> <br /> REQUIREMENT- .r .-,:~ ° <br />.~' <br />' ~~ <br /> - : <br />,~ <br /> SAMPLE <br /> MEASUREMENT <br /> ERMIT~~, <br />P <br />r F~" ::.~sr ;, <br />.! +' -. sh;", <br />- t ~ ~r ~,d <br /> , <br />, <br />REQUIREMENT . <br />- , <br />r, <br />~ >'` _` <br />r ~: + <br />,A <br />`* t~~~. "` <br />..a°AJ~c~stu,~' <br />t~ <br />~ ~..~., .' <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> REQUIREMENT --; z x "~ :; v~,`.; ~. . J4: ~..na. a'" ~'4z' ~ I' `~'.'"- -" ~. 'A'`3 <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMILIAR Wm1 THE INFORM LAW THAT I HAVE PERSO <br />ATION SUBMITTED HER NALLY EXAMINED AND <br />EIN <br />AND BASED ON MY TELEPHONE DATE <br /> INQUIRY OF 7HOSE INDNIDUAL S IMMEDIATELY RESPON ; <br />SIBLE FOFi OBTAINING <br /> THE INFORMATION, I BELIEV E THE SUBMITTED IN FORMATION IS TRUE, <br /> ACCURATE AND COMPLETE. <br />PENALTIES FOP SUBMITTIN I AM AWARE THAT TH <br />FALSE IN <br />MAT ERE ARE SIGNIFICANT <br />ON <br /> <br />POSSIBILRY OF FINE AND IMPR FOR <br />I <br />, INCLUDING THE <br />G <br />ISONMEM. SEE 18 U.S.C. § 1001 AND 33 U.S.C. <br />SIGNATURE OF P CIPAL EXECUTIVE <br /> <br />TYPED OR PRINTED 4 1319. (Penett/es antler Mess arenrtaa mey Include erl9.s up b f10.000 end w <br />mefimum rmpnsonmerrt ol6elweonBmonllu erMSyeers.) <br />OFFICER OR HORI2ED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/arence all aTlachments here) ~ - <br />1':a5 °. (ROW LIMIT.; '+'T~LL do NAIYEL AV) 9CTYLF.AoL~ SOLIDS LI:'I?~~~YLPFLLdu FON :=IUYN.245H t~d.".C11 cYiNT; 'I S:; o <br />(HJY LIflITS MAIYt.D F'UH >17Yii,2U!!d HdE:iP EYFNT SUGJS:T 7U 9J~i172N OF P@OCF IN I.A.L. UIL 5 GhEASE-4Ed <br />f _ f h Oq~- Yr\ul~w., [. r,. _C CC • a. 1 <br />EPA Form 3320-1 (08.95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) ~~ ~ 1,~pyQ 513 1 Z 4 O PAGE 1 OF <br /> <br />