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PERMITTEE NAME/ADDRESS frrYAFrelry Nmw/laallw dDIf1.Ir) <br />NAME ~'(t1 p'.i' '+ -~ r ^~qp, <br />ADDRESS 'T .. ~~-., , '7~'_.~ '.-'.'4'~ ~ . <br />FACILITY <br />LOCATION <br />NArIONDISCLEIARGEDMONTTORINO REPORT lOMRIPOESI <br />T-761 F7-191 <br />PERMIT NUMBER DISCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO bAV <br />FROM '+'J ''1. ~T 1 TO rJn " 7 T1. <br />!161!1 l11-13/ !74151 lT6171 !IB-T9/ !3631/ <br />Form Approved. <br />^~i n -)1• r r- ~, • T ..- P +OMB No.12040-0004 <br />r . , . , . [ APProve4 ex{jiri p.05-31-98 <br />- .. r ~ T <br />t •^- <br />NOTE: Rsad Inetruetlme belore complepnP thu form. <br />PARAMETER !3 Grd On/Yl QUANTITY OR LOADING !~ Grd Onhl QUANTITY OR CONCENTRATION NQ FREQUENCY SAMPLE <br /> l46-531 154-511 l38a51 f05-531 lF•I.5/ EX GF <br />l32-371 <br />AN,u.rsrs TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS m1~e9! !54581 !5&701 <br />:o^.,C~ .iT t~,^~'~ /9:1y <br />- SAMPLE r._r7n~n r=rtr:; Fi': //--~~~'1 <br />G ... r:'l ~`tl ~: ±:^;: I ?~~ //}} ~ 1^l <br />~' <br />~ <br />) <br />_ II .> ~ r <br />. 1 ~ , . • ~ <br />= C <br />• MEASUREMENT ~ I l <br />' ll ~ - <br />~ <br />. <br />T am 1 / <br />*"~'J~+ .. C ~! PERMIT <.~a~n fin>XF¢>t r r., L1. rsz:a:y;t: re.:f:x^i-:y ,a:•_ l ,TaL~ .P a?'^. <br />i '_ E C'r7 '+"' T, - a c r ~ i REQUIREMENT r. 3 a .y 9. 4.4-L7 " ~ !'r H T ~ <br /> <br />::''Ft:~; ~" d"'F 7!1AY <br />~ <br />- <br />' <br />SAMPLE <br />MEASUREMENT <br />:trvO~GY <br />dE:4C## <br />I <br />•.:;:•~tt~ <br />r=f.:;:.n..,,_ <br />~ ?l) <br />O C~}7~ <br />` (~ <br />/" <br />1 <br />~ <br /> <br />`i r P T <br />. <br />, <br />F. I =: 5 I.~J <br />/ [V C <br />~.y <br />f=~=.C -~ 'J J PERMIT' ~~ .+=.a 7eal< ~~*kc#~?.• IC ^'-:s t.a1 ~. .~ do a~yr. ~~=r~xs:«e~Fr... <br />' !: Cp';v -;.T? grL-1 f REQUIREMENT ~ ._:... M4 Y![L[?r~ - .. r.pu•I, <br /> SAMPLE <br /> MEASUREMENT <br /> .PERMIT <br /> REQUIREMENT. :.. <br /> SAMPLE <br /> MEASUREMENT <br /> ..PERMIT <br /> REQUIREMENT ~ .~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~ - <br />NAME/TTTLE PRINCIPAL EXECUTIVE OFFICER I cERn <br />AM FA Fr UNDER PENALTr of <br />MILIAR WITH THE INFOR uw THAT I NAVE PERSONALLr ExAMINED AxD <br />MATION SUBMITTED HEREIN; AND BASED ON <br /> <br />~ TELEPHONE DATE <br /> Mr INOUIRr OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR ~ ~ + <br />~ <br />~ <br />' <br />~ <br />~1 <br />nIC1181-U 11IIIF. OBTNNING THE INF011MATION, I BELIEVE THE SUBMITTED INFORMATION IS <br />TRUE <br />ACCURATE AND COMRETE <br />1 AM AWARE THAT THERE A11E / 7. <br />i _ <br />/ <br />' ~~( <br />- <br />~ <br /> . <br />. <br />SGNIFICANT PENAL71E5 FOR SUBMITTING FALSE INFORMATION <br />INCLWING ~ . <br />~j~ <br />i~l~~/,J <br />~ <br />Envlromm~ntaf 6ianan^er <br />:l , <br />iNE PoSSIBILITr OF FNE AND IMPNSONMENT. SEE 18 U.S.C. F 1001 AND ]J <br />e <br />I r sl e <br />n <br />rd <br />w d <br />a <br />s <br />4 , <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />Own <br />7D_ ~T ~ <br /> <br />TYPED OR PRINTED . <br />. r <br />lp <br />.e M <br />1eA1Ar <br />u. <br />. <br />M~ mllm. m.r <br />rA Ne ro ! fo.000 <br />rlermuimun NlAns+nllrlrwar.«wemala.weFrnl <br />OFFlCER OR AUTHORIZED AGENT <br />CODE <br />NUMEIER <br />YEAR <br />MO <br />DAV <br />COMMhN 1 S AND tAPLANA I wn ur nm rw~n I Ivno lrtererence en armcnmenra oars/ <br />~. [.; _ ;.~ <br />.- .LynTT )N~ i .. .- .-.. .. <br />1=T rl'+T I.i.•,111• N: \?'. Zi ~'JLT' .T^Lr•r <br />.. 1I?~T .. :L rt~ <br /> <br />, :~P:.T"Y <br />r4T"I .-oTT/;^r7y~ r.-, ,..,,r...r., nF row;,, <br />f:Pr TT~n.T.~•1 i. 1.1 'T/~\"T~ ^.rC .. [,'~, .. c -,r~;r._•T;',•t <br />T ^T i .. _ <br />,T <br />Il r]. .I fl r T, \I.-11 <br />nM1r irlC Ti'C p-. _ <br />^' <br />m ~ ~ I• ^ ~, -~ ~~ <br />^ <br />n <br />EPA Form 3320-T 108-95) Previous editions may be used. IREPLACE6 EPA FORM T-40 WHICH MAY NOT BE USED.1 <br />" - - <br />'PAGE <br />O <br /> <br />