Laserfiche WebLink
PERMITTEE NAME/ADDRESS (IKlude Faciliry NarnNLocation iJDigerenq <br />NAME crr~u; Y•.u ~•*.~ ~ ^,rL capr. <br />ADDRESS ?S I Y F. -'i 1 , 7 : 7 ~ (~ ^'P n, ~: r'. r i4 M F Y P I< <br />91UD FAT" 'i:"rpL :fv^L° <br />F,NCLF.G'1^n ~D 9D15ti <br />fACILlTY <br />LOCATION <br />'TT'1: r'ORNTS .. ~'l.FV, :F.N~•gAL A?4f <br />NATIONAL POLLUTANT DISCHARGE ELIMINATON SYSTEM (NPDES) Form Approved. <br />DISCHARGE MONITORING REPORT (DMR OMB No. 2040-0004 - <br />rz.tsi (tr.3s1 " e ~ ~ ^ Approval expires 05-31-98 - <br />PERMIT NUMBER DISCHAROE NUMBER _ .. ~ ~; A T F~~ rw <br />. <br />MONITORING PERIOD •IV° ~ • ^f1Y~ r Tn rnT Vic(, ^~>^I;K I~ <br />YEAR MO DAY YEAR MO DAY __ <br />FROM ~ ! ~ TO ~ I"" 7~ ^T °r•u anr° ( ~ tr. r: d <br />(zozr) rzz-z3) rzazs) rzaz>') rzazs) t3o-3t) NOTE: Read Instructiorts belore completing this form. ii <br /> (3 Ctlyd Ony) QUANTITY OR LOADING (4 Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER 46-53) 54-67 (38.45 46-53 54-61 EX OF TYPE <br />(32.47) AVERAGE MAXIMUM UNITS MINIMUM AVEAAGE MAXIMUM UNITS ~~) 'W~ g~ 6&70 <br />Nu`r `iul"A SAMPLE •.= a FR6 a# «grr ~ ~~) <br />( L <br />(A ~ F F) MEASUREMENT /~ <br />t/ 1 V O t I (~ I l ~ ` Cs;() F'n ~ <br />L'1D'J5 <br />1 D 7 <br />':P I ~ r~' <br />~+.#~ "~i <br />. <br />- ~' <br />rt~o <br />+. ~>' ~ <br />`'~'r'!~i~ t <br />»`tv w,. <br />' <br /> <br />`_' F !' L U E ~ :' ,~. n 7 ~ ~ :' A I C 1 <br />Q Jt~j `E' IJ -. <br />z <br />` <br />Y ~ <br />~ 5'• <br />y <br />'. ~ C: ~ <br />e i <br />~ <br />; r <br />~ i <br />x I. / L <br />~ <br />~ <br />: <br /> e <br />~ ~ <br />~ 8 ~ <br />' ;;., ~ l:, vi ~ T ~1. <br />' <br />' SAMPLE 11 ( DJ' OSO#+'# ##t#G'k 4#F±#;- r <br />~i ~~3 <br /> <br />.H? <br />I T9~41 <br />M°M* nLAM <br />MEASUREMENT <br />~t~~ b <br />`1' UtUOI04- F~ ~ S~S~i~A ( <br />50D5U 1 0 D x a <br />~ <br />~ a#a <br />iFh'LU ~:°T GF?SS YALI11 - <br />EOUI@EME" ~= ~~ <br />= ~a`- <br />. '!CD ' ~ ~~-~; q= ; '~ °" <br />}~ rs ~rr,;s <br /> . <br />'.. L , - t,,: v <br />u L ANl• ,t\ t. SAMPLE ~. ,.;e <br />~ ( q11) ,##~:~n #':I C,t^3 OtlAt*" <br />~ <br />ZI <br />` <br />} <br />V I S ~ } L ~ MEASUREMENT 3 ~ ~~ <br />~IJ r <br />lr <br />E406o 1 D D RMIT ~` ;~; -• _z cc_L +~ ~,* fa ~A Yttir <br />EF'?LU=.?+T .^,RD55 I11LUt IREMEN7 `~ (1~~' NO=D +'~'~ y.~~~t e~ ~ ~~ t '„`` <br /> ~ , <br />{ ~ , <br />~ SAMPLE I <br />'1~l <br />~ MEASUREMENT <br />, <br />- ''~ <br />PERMIT <br />nom, <br />i ~` ~? <br />5~ <br />~ <br />*'*_ t :'~ <br />'+~` <br />r = <br />`s°r - <br />.. ~ REOU~REMEN <br />r! ~E'~S - e <br />x~"' 4}s ., . 3~ '•, ..~ y, <br />i <br /> ~ t <br /> SAMPLE <br /> MEASUREMENT <br /> , <br /> FIE~UI EMENT r ' <br />t ~ ~. ~.« <br />:. '~ <br />'r <br />~ <br /> <br />" ., ~., .N' { . <br />aa <br />` z~, <br /> SAMPLE <br /> ME <br />ASUREMENT <br /> A <br />f <br />ERMIi _ `T ~r 1`~' <br /> <br />st If 1K <br /> <br />~ {r.+ . Y~ t Y'f ~? ~°k£ y <br />.4 4y i`4 i. <br /> "REQUIREMENT" :-s''c '~C '~ <br />4 . <br />, - r?li <br />'~ .;. "+ ~. "r'~ <br /> . ;, ( <br /> SAMPLE <br /> MEASUREMENT <br /> ~~PERMIT' _ . -_ i, wx ~~- - - 7 r - a+r ,~,; ( ~ ':=a~~' ei-- <br /> RE~UIREMENT - ' - <br />~ - - <br />_ ~ f <br />" <br />" <br />NAME/TfTLE PRINCIPAL EXECUTIVE OFFICER I CERTI <br />AM FAM FY UNDER PENALTY OF <br />ILIM WRH THE INFORM LAW THAT I HAVE PERSO <br />ATION SUBMITTED HERE NALLY E%AMINED AND <br />IN; AND BASED ON MY fI TELEPHONE DATE <br /> <br /> <br />t <br />T EUIINFORMATIONINI IBEUEV <br />E ITHE DSUBMnTEDN <br />FOIRMAT ONOS TRUE, ~ <br />~ <br />(,/~ , <br />kichard I <br />+~~~~3 ACCURATE AND COMPLETE. <br />A <br />TI <br />F <br />R <br />BMITDN I AM AWARE THAT TH <br />FA <br />E INFORMATI ERE ARE SIGNIFICANT <br />ON <br />TH <br />INCLUD <br />N ~ <br />//( <br />~ ~~~. , (~]D~•B]D-27~Z D2 2S DD <br /> <br />Fnvlronmental Mananer PEN <br />L <br />ES <br />O <br />SU <br />POBSIBIIfTYOFFINEANDIMPR <br />i <br />O , <br />G <br />LS <br />I <br />G <br />E <br />ISONMENr.SEE18U.S.C.§1001AN033U.S.C. <br />I <br />l <br />li <br />e <br />v$IGNATUREOFPRINCIPALEXECUTIVE <br /> <br />TYPED OR PRINTED rese statutes may <br />nc <br />rbv up b Sl <br />,eee and a <br />g tat e. (Poxrt <br />es urMw <br />ude <br />meximum/mpnsavners of betpsen Bnmritlu end5years.) OFFICER OR AUTHORIZED AGENT <br />nnnc <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/erence ell attachments here) <br />spp <br />7i!I <br />1 <br />.LTrHYATC LI'"Tt'; p~P T;S, Tk~R S°TPLF,F~LP S~LTCS (L'1^ r~rl ~^nL• nuL7 rc r, tn_vo~ ~p_pR ppTCrn ^cC~+T <br />L, ::LAI'!EU. Sf?5' f.A.?, r' 1H, r7R RIJRD°N )P Pa'lOP D°-`1TPr~t-qT~. ~~i. r r'a^p"°_.;~r c!lnr.•r,~w° F/~ y•- . <br />i'^Vt• <sMDT Tn': C APOnOTTV T4C PDIt ^r roof _p~l~sa n~nc ni <br />EPA Form 3320.7 (OB-95) Previous editions may not be used. (REPLACES EPA FORM 7-40 WHICH MAY NOT BE USED.) O n ~ T It 2 ~ ,~ ~ tt t ~-~ ~ ~ It PAGE OF <br />