|
PERMITTEE NAME/ADDRESS pMi6FxreryNaw/l14011q UD~...nq
<br />NAME.. - L i' : '. • I r .. I~ t r " 1 T ^ ~ ~ L~
<br />ADDRESS . '. , . i L r ~ ~ ' ~ .'
<br />J'. ~~. VE.. vT 1. .. ,~.1 r~.~.-.
<br />L
<br />FACILITY
<br />LOCATION
<br />'-~ ;T^ ~ rL=9 x'.'71 1°'IY
<br />NATIONAL POLLUTMT DISCNMOE ELIMINATION SYSTEM IIVPOE$/ Form Approved.
<br />DISCHARGE MONITORING REPORT lOMRI
<br />!1-151 117-191 ~~* .} r. t ~ n'tv n -~ wi.OMB,No..2040-0004-;
<br />"'• ~'1 i 7 1 ~ '1 r n c / ~ ~~ - •~ ~ 1 APProvel expires OS-31-98
<br />- PERMIT NUMBER DISCHMOE NUMBER r _ t -
<br />MONITORING PERIOD ~ '
<br />YEAR MO DAY YEAR MO DAV _ ,
<br />FROM '7J ni 'lI TO nv P] T] ...:, rr` ~?-r;+E'~^;. ~_-I `~'•'
<br />114171 I11-13I 11e-15I /16171 /18-191 /36371 ,NOTE: Rsed IrniruedoFw W}on eomplatinp thu form.
<br />PARAMETER l3 Grd only QUANTITY OR LOADING /e Grd Onhl QUANTITY OR CONCENTRATION NO FREDUencr SAMPLE
<br /> (1653 !54611 l38d5 !1653 !51.61 EX DF
<br />l37-371
<br />MALYSIS TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !e1-e3l 154581 169-701
<br />r ~~
<br />-
<br />SAM LE
<br />E
<br />:p4 p ~;: ~:;
<br />. ~: E: p:t eY
<br />'.rR4tt: •. ,..
<br />~ 1 ,})
<br />
<br />3
<br />AA
<br />D :' i L ~ ~ J IJ ~• , ,I L v M
<br />ASUREMENT
<br />' /n
<br />'I')'i~Cl 1 P 7 PERMIT t`: tt:k 'x eF .^ r: rXh .:x ;k L` t?... kt,.4Ct`>" ~']
<br />] v .^{' t-:?
<br />p'
<br />algcr/
<br />'±1
<br />;RP
<br />. Fns •. .. "4 41 Irc
<br />L .REQUIREMENT r1 +-:t ~ ^
<br />7lS f?>t A9 R9TTY ~+l ~c lT r}1gq?It .
<br />'..
<br />:ILV ~: i,• .':_ :w*T4LLY SAMPLE ;tkP^R': 4S0.'Y~:t hL4KrY,-n Y: ^
<br />,,,~ l
<br />r t n'
<br />~/
<br />~~
<br />~~
<br />- T : ~ L. ? 1• ~ • MEASUREMENT (/7 ~ ~
<br />1104 D U ..PERMIT #rCO.>x4.' ~ rtzou~gr;c ^.rx (r.L'n0'L:'t- !i,!.1f73~ ~n„~17u. ~. : :Hg'pF/ ;~~n
<br />' FFLJr.", ~'~.~;; C"?,'!p
<br />I REQUIREMENT nrtSR - ~ in. ~ Y^ ~ 15/1 Y' NY 4C/1, 'hQ TY~
<br />-.1~.: ,.~ „
<br />,r ~q,.T. f.i Y SAMPLE ....
<br />I ~: ' Q L V ?'1 MEASUREMENT
<br />.1'St, 1 0 ~ PERMIT. 'k'aG X': ~.. :k4~q;5 :k lx S t: •:::: •; 0'r Y'#;: 71, n7? nA]] • ••In'. ?/ ''e?
<br />'L~:i:sT GR05' 'Ct
<br />S.'IF REQUIREMENT
<br />~ ..:,,:•ta: ~- •: ;c r. ~ vnn t r
<br />F. V r.!r w
<br />. T'Y X yr
<br />/r.
<br />,r,~„T„~
<br />~;:I '`C".i^.F ''I'~'I'~.'
<br />.. ~ ,; ~ ~ q _r I- c SAMPLE"
<br />MEASUREMENT {aO tc?^.: :7:Q9rk4 Ya: ~....Y ,;
<br />r a~
<br />r
<br />( , ~)
<br />/ 3 ~
<br />~/'/r/
<br />i1Llf 1 0 D p~~ P,ERMIT Stp{Lpfl10);;? ^•!c ;;: its fY f, ^,: •. 01:?~''"-#'.t.".. P>•'~nnT at r~'..T i c'v i+y : qtr
<br />~L'JFwT .^,ROS$^ bA1 ~° REQUIREMENT n;:::~ ~r,n~. .5gq 7aarTT ''X "'/L
<br />t..~k, IN L'~~-Dfl?" ^°
<br />• SAMPLE
<br />SUREMENT
<br />E (.)
<br />~ ~ ~ ( 3]) .~:.., ..~,.: :~r. r~:.. .. ~ ...........:. ~1 ~/ /,,MI,
<br />
<br />:;
<br />J mTt F,AT~pw- p! At;m
<br />M
<br />A l
<br />(
<br />/ ~ .
<br />!N
<br /> . 7 - ~/`
<br />t; ~~U 1 0 '1 PERMIT ~ RFP ~?T ?~F: F,rifii +~~Yt~':n "': -vgn:^ wp:x ^:h
<br />~ c~~T
<br />Y ''7""a1.
<br />.r°L~IiN? f."i''; VA;, fff REQUIREMENT 3Ga11 9YG ?AILC "4R Y~^ - ~ fi:""' .
<br />
<br />'IL aNP .!'l"='
<br />SAMPLE
<br />': rs73
<br />( l7)
<br />r.{: {: {::tF
<br />rr {s:t +:'i^
<br />r: ,Y (: Y::4 r,: I/
<br />
<br />i:I_,'! ~ L
<br />MEASUREMENT /3 V
<br />:~7 'J j..~ 1 f 7 ~ PERMIT rc iYf+ktrG~ ) T °.i=1 kWtY!A'+r. ry Tc;Y!rry :^' ,:',t ~.'.:;:v {. r:^ I v_rrv ,r.-.rET
<br />. vFi!!S•iT .-c ~~,- yr!, r•: REQUIREMENT Iy5^, '~tX w~=7 r. ,, ,.:,
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIT
<br /> REQUIREMENT
<br />NAMERRLE PRINCIPAL EXECUTNE OFFICER I cERTIFV uNDeR PENALTr or E AW rHAT I NAVE PERSONALLY ExAMINED MD TELEPHONE DATE
<br /> AM FAMILIM NATH THE INFO RMATION SUBMITTED HEREIN; MD BASED ON
<br />~l
<br /> MY INQUIRY OF THOSE INDINDUALS IMMEDIATELY RESPON9BLE FOR ~ ~~
<br />Richard F/~ill*; OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS / . / ~
<br />~
<br /> TRUE. ACCUMTE MD COMPLETE. I AM AWME THAT THERE ME
<br />SIGNIFICMT PENALTIES FOR SUBMITTING FALSE INFORMATION
<br />INCLUDING / ~ /~J7~y _~~~~
<br />~
<br />Envtronr7e~7tal ,.lana Pr ,
<br />THE POSSIBILITY OF FNE AND IMPRISONMENT. SEE 1B U.S.C. 1 1001 AND 33
<br />31
<br />/
<br />l
<br />e
<br />giONATURE OF PRINCIPAL EXECUTR/E 670 679-2712 4 ZS 99
<br /> e. !
<br />U.S.C. 1 1
<br />W W
<br />r. InNr I
<br />yy .yPm. nrY YICpW rira rp ro 110,000
<br />TYPED OR PRINTED erw ar mNrNNnr Yrpdsrm.neWe.nrwnemendu rWSyAVS/ OFFlCER OR AUTNORIZED AOENi CODE NUMBER YEAR MO DAV
<br />COMMENTS AND EXPLANATION OF ANY VIIJLAI IVNS Irlsrerencs en afrecnmenES oars/
<br />'.L.:''...;l:p- f.T..: _ ., -J _...,.,,~ _„1Lz °7LTf" (],fir .i.t r arv ,,.~ y Tr ._ ,~_t•L'. ,_~
<br />CL Ii. 't• ~ ..A• ~• T :r C'1'.> X114')= ')C 9^•t^T C: .IIy^v.-..mr~ nI• ~ ...~^.'-^r^ r.-i~.. a^t .,p 1'/ ~ ~.
<br />r
<br />EPA Form 3320-1 108-96) Previow editions may be used. (REPLACES EPA FORM T40 WNICN MAY NOT BE USED.( ~ ~ t t y / r) 9 !` f j ~ ~ _ 1 ~ T ~ PAGE ~ OF
<br />
|