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rERMITTEE NAME/ADORE55.1+A~. e., e.p h.,.,. L,.:.n..., „P~p.vwp <br />NAME fRAPP~'? •Ir'f'+". <br />ADDRESS 'IRA P~Fn rlic T'r ';. <br />P. D. FS?y 1'17 <br />CNAI:: C7 R162b <br />FACILITY <br />LOCATION <br />n CT6: il• LQ4~11v I:cTi: G^ i:.,: _~U K J1 CiR <br />RATIONAL PgLLUTAHi DISCHARGE ELIMINATION.SYSTEM (NPOESI <br />~" DISCNARGE NIONRORMIQ REPORT lpMR1 <br />!I-l El (17.191 <br />PERMIT NUMBER o1scNARGE NUwaEa <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY- <br />FROM 99 DI 71 TO Aq 03 -{i <br />!267/7 !ZI-131 /ZMZ51 (18171 l18-191 130-311 <br />ForrlY Approved. <br />h T ~ A p OMB No. 200-0004 <br />`~ 0 c R N y, Approval ezpiree OS-31-98 <br />F _ fit:.lL .!iPlr <br />P7„~ e` TO qn yA^F: GtIL^F <br />oac ra DiSCkA4rC !~! ~aa <br />NOTE: Reed inetruetlorr befor EIRh letlnp this loan: <br />PARAMETER 13 Grd Onlyl QUANTITY OR LOADING !I Qrd only! QUANTITY OR CONCENTRATION NO. FREODUICY SAMPLE <br />3 /48531 !51.6/1 l3B-151 116-53/ /51-611 DF <br />l <br />1-371 <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS EX <br /> <br />!s7-s]1 <br />ANALYSs <br />Is1-681 TYPE <br /> <br />(sA101 <br />UIL AYU GBRP.SF SAMPLE ROAItr RC <br />G ( qe) 4PAfALttr b'-l3Rbtr R+?[EO x# <br />r <br />~Ss+II <br />u j i U A L MEASUREMENT O j Y <br />,0066 1 D It ! PERMIT 4S44Q0 <br />~ R6POR? ES=1 tr#~4.6r+CE IRi:IY~~.. :..:.alliRi~!IR#, Pp: `:r::: ;~~KLL ~~~:1 <br />~' FFLUEN'f GRDSS TA 1.tJ REQUIREMENT ~ ~ _ ~ .. <br />~ - ~ ~ <br />.. ~~. <br />.:~ ~:. . <br />. <br />-, :~ SAMPLE' ~ ~ - - .. <br />' ~ .. <br />MEASVREM~NT ~ ~ - ~ . <br /> <br /> PERMIT ~:~ <br />~ a:.:... _ <br />. - REOIJ~REM~NT ~ :. ~ - - - ~~'.'.=i <br />' <br /> . <br /> <br />~ SAMPLE <br />' <br />~ <br />~ <br />I MEASUREMENT ' <br />, <br />-~ ! ~ -~r PERMIT ~ ~ - <br />j!1". REQUIREMENT <br />~ ~ ~ ~;? -: <br />f SAMPLE <br /> <br />" ~ <br />1' <br />EA'-:UREMENT <br /> PERMIT <br />~ ~ ~ ~ . , <br /> flEQUIREMENtL : ;~~~ ~ <br />~"~ <br />:l;x ~ _ <br /> . <br />, <br /> SAMPLE ' <br />I IMEA.r+LIREMENT <br /> ~ <br /> PERMIT ~- <br /> REQUIREMENT ~ ~ ' ' - _ _ <br /> SAMPLE <br /> MEASUREMENT ~ - <br /> <br />' PERMIT <br />~ - ~ ~ ~ - ~ ~- <br /> QUIREMENT ". ~ ~. _ ". <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - ~ ~ ~ ~ ~ -. <br /> REQUIREMENT ~ - <br />~ <br />NAME(TITIE PRINCIPAL EXECUTIVE OFFICER I CERTIFY~IINDER PENALTY OF LAW THAT 1 HAVE PERSO <br />AM fAMIL~AR WITH TNE-INFORMATION lIMMITTED N NALLY E%AMINED. AND <br />ETDN <br />AND BASED OM - TELEPHONE DATE <br />~'_.__L~ f~,~f <br />!~•'~' : <br />MY INOl11RV OF TN09E INDIVIDUAL! IMMEDIATELY RESPON4BLE FOP <br />OBTAINING TNE INF(MWATION, T aELIEVE THE-9UaMhiiED INFOMIATION IS~ ~~ <br />~r <br /> <br />~ ~.~/iA4I~~I~MF TRUE, ACCURATE AND COMP},ETE. I AM AWARE THAT. TNERE ME <br />4GNIFIGIWT PENKTIE! FOR Su/MITTIhG FKSE INFORMATON <br />NICLUOING ~ 0 <br />~~7 <br />~ <br />~ r , <br />iNE POSSI ILITV OF FINE AND IMPRISONMENT <br />SEE to U <br />C <br />! 1001 AND !] <br />S <br /> . <br />. <br />. <br />. <br />u <br />S <br />C <br />'F 1lte <br />//M <br />ti <br />w <br />d <br />E <br />Y iIONATINIE OF PRINCI-AL EXECUTIVE <br />TYPED OR PRINTED . <br />. <br />. <br />. <br />r <br />. ul <br />r <br />r PuN <br />r. mEr <br />lcAld. eINP yP ro f IO,OOD <br />rwnnrrSiNAe:nPr:AanwnrNMrwrn sinmons rW6yAra/ OFFICER OR AUTHORIZED AGENT CODE" NUMBER YEAR MO DAY <br />{:Vmmvvl~grvV Url.nrvw nvn yr nrvr rw~n llvna lnnoencs en srmcnmenrs nNeV <br />:~•~ 6 LOTAL IP.DN LIMIT'; 11jLL >*F.~AT~1'De AND SLfTLSAtiLR 40LID8 LI!17" APPL7P.0 fi~N <=lOTRA2GRR PRBCIP gYrNT- <br />`~E:: 80RDEN DF PRDOF R2,9[RE9F.yT'.~ UND&R leA.3. PEf1J1TTT6F. MAST TARP ALL ltF.A50ltA8Lp MEASJIRRS TO R!DCCF DR <br />I <br />%r <br />may be used. ': /REPLACES EPA FORM TaiD WHICN MAVNUT BEV$ED.) A~D15rg904Z I~~~3~h PAGE ~OF <br />Z <br />