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PERMITTEE NAME/ADDRES611nclude Ficlllly None/LoceNon !I dl/Ierrnll NAME ~y F C .~C~. BJ ~'.SLkL,~ iaCL~ F~I.SZF-IL I.... '_ _ _ - ADDRE66u e .r ILQ3ITa~~ IL+1LF _ _ _ - _ _ _ _ _ _ __~__-_ ---P~QII_f101L h r ------ --_fiUS.LS-_________s2l:124.-- FAGILT• _ LOCATION -_--__-_-_----±-_-----___ ATT'Y.: R. LANCE MADE ML?:.'..i1ANAGFii NATIONAL POLLUTANT DISCHARGE ELIMINI.TION BYBTEM (NPOL'f) DISCHARGE MONITORING REPORT (OMR) (1-16) (17-I9) CoOGOGZI3 Ov2 A PERMIT NUMBER RucHwRCC NvuecR MONITORING PERIOD YEAR MO DAY YEAR MO DAY FROM 1) TO (10-II) (11-13) (14-25) (16.17) (I8-19) (30.71) '? i 1: 0 R (SUHR YC) °V°d• ~' - FINAL OMB No.20x0-0004 PonD RU NOFF~6'RIffi~9fC~I.~"~RAw °~'~ NO, DISCHARGfi~4r# NOTE: Reed instructions bef ' CO tlRg this form. (J Grd On/y) QUANTITY OR LOADING (4 Grd Only) QUALITY OR CONCENTRATION ~ ~ ' N0. ~ ~~ Y SAMPLE PARAMETER (46-5J) (541) (38-45) (46-SJ) (541) ~ ; MULY94: TYpE (JI J7) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNRS (6}61) (64b8)- (f9-7G) li SAMPLE y[{f t4#Gh :}t[Ih ~:¢Q =44;k0#'.`- ( ~. z) - ~ ' MEASUREMENT - I 1' r~ /~ G V ~ V I '~ 4.' .P8B41l -.... yy .y ~y QY""lti 4r y ` _ Y~Y.~~~ ?. If i:l: y ~,.. _ ..._ 1kf~~#~~ ' :' ~~ iY+n. , ~' , FFLUIiNT GROSS VALUE ~~!u • - - °aI ;[ 17IN tfUtt ,~ °y. ~ I1N= SU 'ULIDSe SET'"LEAR,.E SAMPLE r:+•'•'!j ~: t[::: ¢!:C:'+F:';: ( 2L)" 4'~ MEASUREMENT u545 L G p~;;T a~io~aa+u ao~Y,ary:. -[;::, oPZIONAL R8DOR4' ._ ~: , :r:~;.;r fFFLUElIT CnUS~ VALUE RE°uuzsMEx+T '~°::4[ RTR AYG 30DA': AVG . 'D ML L IL AND ,iR :tJ~ SAMPLE L•~.I+: lr [`•t+ :}14:4 L: rpO ;t iaQ f,::$s:: fl Fjl¢Q¢'t ( 19)- '" ~ MEASUREMENT S,: 35P2 1 0 C 'PERP1iT . 4#~asxd 1~#>L't~6S>eLt. ;[ :~ ICeaalaark also##~ ° Z¢-~= ~ ' + I E'FLUEt:T GR053 YAi.UE ~au~^e~ '~'%'~° ~iNSi A~ :1G/L LL~yF IN LG:: (iG ITOR SAMPLE ( '.. 3) .: ;iiY ft C[:Y [?Ii~~G'Y ~[f/ra fl4lp ~ r-.~ RRU TkEhiME:NT PLAdT MEASUREMENT ~~y JO50 1 0 0 p~~T :3EPOR? P.EPpRT. aaao~xn ~+~~'~+~~ "O#6~p1a1 °°° EFFLUENT C=ROSS VALUE nelaulREMENr, 3GDA AYG DAILY t7X i;;i) ~' }"`° '~[~>k>x ~. ' ' ~`. :OLIOSF '['i)ThL SAMPLE •r4+?fce,[::. l,.C....•4$ ':['`•[4+r'-+. .. ( 19) ~•' w I 155ULYE~ MEASUREMENT ai• 0295 1 0 •J pEq~1p•~ #a[40Yi*i t1'QI~I!A$# 1><:'x I:ia04'fa REF-UR3 ': QP. I, - 'FFLUENT GRO55 VALUE REqugal~elvT ~°'~°'[=' RT?*"AYG` A28fgl8'x MG/L < L' SAMPLE 1 OO'e4.^..?: ( ~ h ;t :::',: •t~: +?fi~4O:Y b3 OOIGI ~" r ~ u AL MEASUREMENT ~ _- - ~' ' - 1:1065 i 0 0 : Wi fi44##IC6 ? y F:,-~=1 U:4on'tOO tf44 fiifvt'=; ttKa+Oi!b4ri #;: := rer - T W . ~ ,~...~..,.: .~ ` 'tf:.UENT l', BUSS VA'..UE RE°u EMEN ~NS~:' 9AX :tl)=:1 4 {F::4 SAMPLE - r (~ MEASUREMENT - u_ •PER-BT c a t'~ ~ ar pp ~ ys y NAME/TITLE PRINCIPAL EXECUTIVE OPFICER I CERTFY UNDER PEN4TY of Lww THAT I HAVE FERSONAUr E%AMINED - TELEPHONE •' -' D:I. T E ' T u `- AND AM FAMLLUR W[TH THE INFORMATgN SUBMTfED HEREIN: AND .ED CN MY INOl1RY CF TFq$E WgVIDUALS WMEDMTELY RED NyBLE FOR _ /'i J ^ r/ ~ OBTAWING THE INFORMATIpi I BELIEVE THE SUBMITTED WFCRMATeJN IS / ~ TRUE KCURATE MID COMPLETE I AM AWPRE THAT THERE ARE NFOR [ I gNG F P F ' F T C - ' L' SKsNI ICANT ENALTES pi SUBMn~YK NSE I Mw q 1 N W T B f o D ~,p,~ ~l ,7 • ~~ y (( ~ h v p/ + THE PDS,sIBILTrY of FWE .wD MPRLSONMEN sEE 1 l ol AN USC i de ! rv f 13 9 Pl l i N n e l M SIGN RE OF PRI IPAL EXECUTIVE //V / / 7 / PRINTED TYPED 1 . ( ne [ er ne t mru m Y nc u mu up 33 USC n u f/ODW Ff1(I ar mFnmum impruanmmt of berran 6 mondu .nd S yx.aJ OFFICER OR AUTHORIZED AGENT EA ~ NUMBER' YEAR T10 DAY COMMENT AND EXPLANATION OR ANY VIOLATIONS (Reference •/l ellachmenls here) S~TTL~ADLF; 3JLID5 LI'!IT WILL iir adIVT'D ~Oe >1C'tR,7•IIIR :3cCIP F:Vi:;1T-S E£ I. A.1(D), PG v, FOR REQUIREMENTS: ;ZHTkLY SAYPLI1i, :r1S:RUC':IUGS-..C.B, I''. R.. ~ Dl.Y ;:'!~ -3 i::;ilES: :'0!iTNLY AYr, DURING PERIOD RF.PORT£D. EPA FOrm 3320-? (RSV. 9-BB1 Prevldls BO'l(IWIS Tay r>e USBU. (REPLACES EPA FORM T-10 WHICH MAY NOT BE USED.) _ ,I / ,1 ~ ~ ~ D 7 - 1 I ~ ~ pgOE t OF