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PERMITTEE NAME/ADDRESS llnrlude <br />P~Nllly Name LorJllon !! dl%rrcnU <br />" TE-~~y~L'-~9.yam'-~-~z~~'?v8D1!,-~1...~_--- <br />ADORESBJL{~,il ~O:jiL~N I'~1~ __________ <br />~__ <br />---LrQ.-~Q1L~~---------- <br />FACILfTY <br />LOCATION ____ _ _ __ __ ____ <br />ATTN: R. LAKCE WAUE, TINE c1AlfAGF-R <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SY9TEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />(7-lb) (17-19) <br />'-o000C213 OU7 A <br />PERMIT NUMBER ~iscHAwos: HVNerw <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM 1 1 TO t ~ - <br />(10-11) 171-11) (14.15) !Ib-17) (18-191 (Jo-JI) <br />hlNOa <br />(5 U H R ~ C) F44P~4Buvad• <br />F- F I V A L OMB fJo. 2L140-0OOM1 <br />RUNOFF 6 AG+~P4ro°P11~'N$fop~A~1HAGH <br />~a°% NO DISCHARGE ~~~ a'k'k <br />NOME: Read inetructbna before completing Vide form. <br /> (J Card Only) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION - <br />PARAMETER (46-SJ) (3461) (J8-43) (46-SJ) (5461) p~ ~ e <br /> <br />Ar1ALYELS~; TYPff <br />) <br />(11 J7 _ <br /> AVERAGE MA%IMUM UNITS MINIMUM AVERAGE NAXIMUM UNRS (fMJ) (616)) (69.70) <br />lL AND I; F.EASE SAMPLE ,•: •^y`#:) ( ')[;) C:x:t-t:_ :t ~:,`+k0;: 0414 {+/klk ~ <br /> <br />I:, U AL <br />MEASUREMENT _ <br />~~ <br />40G6 1 <br />J G 3~114~1ta!CI 0 c:;=i trLly~~~k #GOXsall~, 19t!QtSIQ010~" 3:x: <br />- <br />. _ <br />F'F:.Uc9T GROSS Ya,.U:i PER/.uT <br />REQUIREMENT . _ <br />THST MAX N'J=v _ ''" O~'k>k ,:~ <br />h. <br />-4' <br /> SAMPLE <br /> MEASUREMENT <br /> M <br />- . :~. y~: <br /> PERMIT 'i%;.- <br /> REQUREMENT ~ '.'v <br /> SAMPLE <br /> MEASUREMENT I <br /> v ~3+' iq.'~- - <br />: r .:. '~ <br />-F <br /> PERMIT <br />REQUIREMENT ~ <br />~ 4 <br />~ . <br />~ ~c~ <br />•.. <br />~ ;+' <br />: ` .... <br />4. <br /> s <br />sw ., <br />:^. : <br />a <br />•Y <br />'<Y <br /> 9AMPLE <br /> MEASUREMENT -, <br /> ~' ~~.: <br /> ~°• :frN ~ 'x <br /> REQUIREMENT - i:. <br /> SAMPLE - <br /> MEASUREMENT ' <br /> ~ ~. <br />- <br />" KM <br /> <br /> SAMPLE <br /> MEASUREMENT ' <br /> PERMIT ~ _' -,. `: : i' <br />}^. <br />' <br /> REQUWFMENT - s~. ,. <br /> SAMPLE <br /> MEASUREMENT <br /> ;I: ~ <br /> . WFAUWEb1EN7 - .. <br />t <br /> ' <br />NAME/TITIE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY aF LAW THAT I HAVE PERSONALLY ExAWNEp TELEPHONE D A T E <br /> AND AM FAMILIAR WITFI TYIE INFORMATION SUBMITTED HEREW: AND H4,Ep <br /> CN MY INOIIRY OF THOSE wpVIIX1AL5 IMMEOIATELT RESPoNSIBLE FOR _ <br /> 'OHrAWING THE INFCgMATlOf1 I BEIJEVE THE Sl10MiTTED INFORMATON IS <br /> TRUE ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE <br />F <br />T <br />TO <br />" <br /> ORMA <br />.NIFICANT PENAL <br />IES FOit SUBMrtTWG FALSE IN <br />N INCLUgNG <br />THE FOSSIRLL.fiv of FINE ANp IMPRISONMEHr SEE IB US.C / I W I AND <br />(/} <br />G 1 1319 <br />unCer lhCfC r(INIO ml <br />n[/u Ee finer u <br />33 US <br />RIG <br />10 <br />SIGNATURE OF PRINCIPAL EXECUTVE <br /> y <br />. <br />. <br />i <br />p <br />H <br />S O <br />UTHO <br />NT '1` E <br />TYPED OR PRINTED ymn) <br />f10AW ,M or rruumum impriWnmens of 6ervsen 6 months and OFFICER <br />R A <br />RIZED AGE NUMBER' YEAR MO DAY <br />COMMEM AND EXPLANATION OF ANY VIOLATIONS (Reference ell Jttachmrnts hert) <br />PSS FE 1..I~f`_iS iiILL eE IIAIVED !; SFT".?F.P.LP. SIl'.i':5 [,Ir!~- hPPi..IS:) FJd <=L-YR,24HR PR3CIP EVENT OtlL7 MHEN <br />RUNOFF' C:~~STITUTP.S HAJOP,ITY OF LOAD-SEE I. A.1 (D),^G Y, f'I;R Rt'~U1RF.NENTS. DETECTION LIMITS-SEE I.F.2. <br />Of 32 - fRBV: $-tl~ Pte/ 3(dls eL~Yims° Alay'b~ ls2d" "" - IIY~PCACES EPA f`bRM Y-~0 WFiI'L'~H I.~At'~Jd~BEL3l'US •• • ••~ ~ • ~ ~~••~ ••~ -••~~'~ ••~p ~a r.v~ _ <br />OG! 7/45^1?T-] 3':1 ,~ <br />