Laserfiche WebLink
PERMETTEE NAME/ADDRESS (1tl~i fsmyNa./La•Nw I/DI•I.nnq <br />NAME Tkdtr'F'd:. ?I t ; :, :, ~ ..-, <br />ADDRESS I k A P F F .t ~. I ,. i•- <br />F.O. i1;~ig i~.-/ <br />ChAl~ <br />C :: • 2 ', <br />FACILITY <br />LOCATON <br />of"ih: w. GO•+D~it~ .`i:f..,~., F4c.~/... ~~( <br />NATIONAL POLLUTMT DISCHMOE EUMINATON 9rSTEM /NPDESI <br />DISCHARGE MONITORING REPORT (OMRI <br />1-761 17-191 <br />~D']G32115 CIE A <br />PERMIT NUMBER DISCMMOE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAV <br />FROM TO ~.. - <br />11011/ 121-131 !14151 /16-17I 118-191 /30-31/ <br />Form Approved. <br />C 1 5 C N A F G E ^. O S A G EGBIeINo.~BaD-oooa <br />(S U F P A ~) APProvellexpY}~s505-31-98 <br />F - FIFAL <br />"iNCS <br />NOTE: Bud ImtrucUam before eompletlnq this form. <br />PARAMETER 13 Grd Onlyl QUANTITY OR LOADING !/ Grd Onlyl QUANTITY OR CONCENTRATION ND• FREDUENCr SAMPLE <br /> (a6-531 l5a-efl (38-•F51 (x6531 !5467 <br />EX of <br />TYPE <br />l31-371 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !e1-eel MALr51s <br />(54.881 /69-70I <br /> SAMPLE . ,-cn~ia ti: :~ At{9t+4 ( 12) <br /> MEASUREMENT <br />~tiuUU 1 0 11 PERMIT ~:.:.e;I ~:: :,^.t,:~3:;s#i ~ ;t 0# ,5 .. a{{Aq~L~ 9`~C'~.~: .. ~ ~ ~ GEF.:). IRSzT <br /> <br />LFFLUdN'f GROSS YA LII <br />'REQUIREMENT <br />Oar,-p <br /> <br />"1 Z;:#IRIti!! , <br />` ;. <br /> <br />:i!lkX1!ll3t[: <br /> <br />SO <br />' <br />~i .. ~~ A SAMPLE .. .. ... .., .. gg00q< ~ ( 19) . <br />-+ U :i i' e h J ~' U MEASUREMENT ~ ~ ' <br />JUS3J 1 0 U ": PERMIT : qc {:~::: K: y,: K:;X; +f =."• ::~.:. ... .: ~.~ `.. .4c. .: .: .. ~ ~'~~.. .~: ~ ~~ ~;+I~~Lf-~ ~r'.I~~~y :~`: <br />~.FP~LUB`JT VRO-`,.i gALIJ REQUIREMENT a+ta 30CA AYG `RA2!"f N:%. tIG/L #tAHT. <br />~ ,, ~G SAMPLE ~• ~ JA'Jfly{ ( 2S) <br /> MEASUREMENT ) <br />/ <br />'iU~uS 1 0 /l PERMIT '^'%'•`^%'%^~ '~^~-~! ~ <br />/ <br />•`~'•' ~` ~{;• CGAL R$.3CFT.. >rGF'/ $A (f <br />cFfLUEN'P GROSS YALU REQUIREMENT •~ 3CCA AYL TAY:>;Y MY ML/L :: 41x-`r'<'H . <br />- SAMPLE .,f, `}:'` fi,y{{,}t ( 19) <br />(A:i FED MEASUREMENT <br />v1t/~5 1 0 •1 PERMIT ,.rv.: •'~ K:s•k.i'•tix #}~: yffi{LCQ .7.Q [l•(; NCE/ +RA13 <br />cFP•LUENT GSO.`-, '~ YALU REQUIREMENT [:'-C:7 3FIE eYC r.A~,~Y R3(. MG/L MO'FTR <br />~ ,. c.K ~ .- SAMPLE ')'~a +<,p K:{: +:: ~: +:: rr •,:{: agg4E{ rtKgO;'I :: ( 19) <br /> MEASUREMENT <br />Jj5~1 1 0 J PERMIT u.rf -.• ,.,-.::`,*.. .. 4Y LS 1Q sALq>?fi. :1'.:':::. Ot1TFN "RAK <br />cFF'LUENT GRDSS YALO REQUIREMENT L+t'~1: ;.j'NSZ:,!!AR MC/L ,EhT <br />.~LUe, H L N .)r: SAMPLE ( 3) OAa'{{ {{qOq+' K`t>n>CI ;=r <br />'1'yrtU THI:ATMEhT }'LAN MEASUREMENT <br />~UU`.0 I 0 U PERMIT iiEt'7'.tT R.• DNT K' ~~ r{ t.q grrit+h,+G •'r f'' Ei:}:.LY INSTA <br />:.FF'LUEhT GR053 YALU REQUIREMENT jUilA AYG DAILY Ma Mil` >7::a K"1' <br />U • SAMPLE ' ' '< ' L " <br />LL550LYdD MEASUREMENT <br />70195 1 0 0 PERMIT f ~`'"~ ~ .CNAL. FnRT T LY 'k.iR <br />FPLUEIiT GAO55 YALU REQUIREMENT ~ ~ G:+>=rt GR3F~ AYG :~ DAILY rrE MG/L <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I cERnFV UNDER PENUTV of <br />F <br />M WITH THE INFO uW THAT I NAVE PERSONALLr ExAMINEO MD TELEPHONE <br />MD BASED ON <br />RMATION SUBMITTED HEREIN DATE <br /> AM <br />AMILI <br />Mr INDUIRr OF THOSE IN <br />OBTAINING THE INFORMATION ; <br />DIVIDUALS IMMEDIATELY RESPONSIBLE FOq <br />, I BELIEVE THE SUBMITTED INFORMATION Is <br />~/~ ~yr~ <br />FI• Gordon P~tere TRUE, ACCUMTE AND COM RETE. I AM AWME THAT TNERE ME ~^'~ ~ ^~ <br /> <br />President ~ GeneZBl NB.QAger SIDNIFCMT PENALTIES FOR <br />THE POSSIBILITY OF pNE MD SVBMITTING FALSE INFORMATION, INCIUDINO <br />IMPgISONMENT. SEE 1e U.S.C. E 1001 MD 73 <br />iIONATUl1E OF PRINE3fAL EXECUTIVE 970- 24-4401 98 1D 23 <br /> <br />TYPED OR PRINTED U.S.C. f 131e. !I°MYIOYr +•1/. <br />.wo-wrY...un bndewlwNa I eNM mfuros ++MY NCI,dI fwa ye ro S10,OOd <br />arw«e r+none+.w eYwa/ <br />OFFlCER OR AUTHORD:EO AOEMT <br />COpE <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRe/erence ell sttschmsnro hers) <br />.'ate G TOTAL IP.OH LIMIT.i JILL UE +aIYEDe AFu ~r.TTLF.AI'L?. GjLIC4 lIMI". AEFI.i''D FCF <=l0YR,24NR PEr.CIP rY"NT- <br />~.iL BUhUEh GF PROOF Re;UIHEI:hHTS UHDEd I.A. 3. TDS r.ONIT~RIb'G - I.F.7. OIL +' GPFASE - 53F 1. P.. 1.{U). <br />~ •'.sY eU6'P•^c re ur CUrc,T M^NT At.Y AYv BAGF ',iiL TMf: DLLTn1 DF DI'-TGi_ <br />EPA Form 3320.1 (08.961 Previous editions may be used. (REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.1 0 (715 P / G 71 ? ] 1-16 u n PAGE lOF <br />