PERMITTEE NAME/ADDRESS O+d.47sWryNadfxeuee UDlD.,..'0
<br />NAME.. CTPt."= T4'"PA~ YIiT. ., - L "U'Pe
<br />,ADORES5IIP.`..'~ Lr )';~ 5p""'r ~:(~dh P5
<br />91C0 F:Ai* "Its`?1. _. ~?c
<br />FACam
<br />LOCATION
<br />PARAMETER l3 Grd OnIYI QUANTI
<br /> 106531 !546/1 l3B-4.51 !1653 151-611
<br />EX 0
<br />TYPE
<br />137.371 MursTS
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS /shell /
<br />581
<br />64- 159-701
<br />_U.•''UC "[: ["} SAMPLE ^?Cd~t<= Q#O G'~,. ~',:r•,.•;, ! I1) -
<br />~
<br />/ n
<br />/,
<br /> MEASUREMENT ~ ~ ~ /Z
<br />11~i1 ~y 1 '' '' PERMIT ~ Lt r,;;: ~,:Y~' .'e fe rA le=O ; A`, :: T;~KLr+- qo nnnm 1oT~^. "•FT. 'nHn/ ~ e'!'kLT >I'A=
<br />~' ~. J .:: '. ~ `~ S Y A L !! t REQUIREMENT ~ ~ ~
<br />~ ~.,. O ~ h R.~ u p~y/~, r=. tr+' fl y ~ y r9 ,
<br />~
<br />r{ SAMPLE r,. r: ~: ~ -: t:?
<br />r~Qa:t ~ Y,: ~,A ~}r.- ~ ( ) n) h
<br />
<br />MEASUREMENT . r
<br />( ) '^s~i//
<br />IJ')li .'0 1 ~ - ~: PERMIT
<br />~ rclh Mtt #.~~ ~' D:,C'X C'k*k. t *.~'~:: Ct. ~S - ~ 4''3kb##Y< q~.^ ~_' F}'P,~P'LT '44~
<br />_P°LU°'I" _LU5:1 V4Lnc REQUIREMENT ~~ ~ «y,. K.L'p~~RrlF. -~ ~ kAK~Z>4?I}!~~ S!!
<br />.i:.':,LDSF ^~.. °,7L
<br />' SAMPLE .':: ;:Cr,: r.^,G O!o •: .•a r: rrye,. ., I 1'~)
<br />LL . ;' r .J (J : •I MEASUREMENT ~ ~~
<br />'~~': .', () U f) PERMIT ~ :F'+rF ~;a ;s'. °; lY4r St'"f0 -0 L:.+,-;: 1>h (S:YY-.^,: 'ln t`rlrm nc P(,':,.. . 'si^F~l( •p.A c.
<br />•.~
<br />i;': CU`fh~:NTS -Pr• REQUIREMENT ~ :~ ORp^ ?!)^A
<br />4 '!" rATTV N'V °riT ^I'
<br />)"'T':I
<br />, ... . , .
<br />,.)L1 i'tie ~f pTl1L SAMPLE -+a, -:`rf ;t?:e .. -`.e't :'~' t 1'71
<br />~
<br />~, c A, ;-1 !: _/ MEASUREMENT ~ ~J~J
<br />_
<br />~,f0 1 0 D PERMIT o:;:r,OFAI::.~ 't:fi~-•zan r ~.a :~07C....: ~r ~~ ' ItJ':x/ •cE,T
<br />°'LUEST GRDS4 L~1F REQUIREMENT ^.:::R^ ir}^.C RV^ !)A.S!Y' vY Y•^/j, vpTt
<br />"7Lf (i a SETTLE' L~- SAMPLE {e ;!R7^:: C#C': '.t ;: ~O"': r'•k ( ~j) i~
<br /> MEASUREMENT ~
<br /> ~
<br />:J~'~'+5 t) C :' ~. PERMIT :;<#'.r ~.- '{: p;;^r~•:~:;s .. 5:5.71yr„y I7c n~)?7T 1'I.c t IN^':/ ~'e`
<br />,
<br />_ CCI°'t r.t_, '"L7J REQUIREMENT *.'-3G ~ ?OhA: AY° ",A`'(.Y N'Y `T./'. ?'~1:'^F
<br />_'i'.1 D[iF t. _~'-T. '. r. I'?. F, SAMPLE •. ~^: r. ;r (:a FR',t ~t {: f,. o'-': ~•f+ ( ^S)
<br />~
<br />~
<br /> MEASUREMENT < f 3 ~~I/
<br />~l.; .ALL] 1 '1 PERMIT O:O,kd$ r,'.¢;Y •k (F tr q :'!:: 's rr+::!IR+r pF nA+
<br />PA: qi• (1v^
<br />0
<br />c
<br />rlf'a/
<br />;;7A~
<br />:' 1. !1 F. N'C ..:' ~' ~ P P. L I" .REQUIREMENT •, ,xt: ; - 'i'T T1 1 p y ^ n a T' r T . y Y r rT, !f'7'", q
<br />1. A!dD .A`~9 c.. SAMPLE ;: r, R'k .•~ r,:nnr: A:~ cr.!s n,. .: ... .'=t` ( ]']) I
<br />~'KUN E)::.-.."t.'~ "`•'^~.: MEASUREMENT ~ '1n
<br />Nn ~~
<br />:J`756 1 I; C7 PERMIT '~;g~z It4'ruOO ::;tdr,•.^•:: r`t~:~i;!.t+G•':. L'` / U't''I" 'n~a
<br />F F L U E H'P ' ° `.` S '/ 9 1 ^ ` REQUIREMENT - T •' @ ^ ^
<br />NAME/T1TLE PRINCIPAL EXECUTNE OFFICER I eennFr UNDER PENALTr of Lww THAT I NAVE PensoNAUr ExAMINED MD
<br />AM FAMILIM WITH THE INFORMATION SUBMITTED HEREIN; MD BARED ON TELEPHONE DATE
<br /> MY INQUIRY OF THOSE INDINOUALS IMMEDIATELY RESPONABLE FOR '
<br />{
<br />ti
<br />'(( LIEVE T~S
<br />TO
<br />ED
<br />~g
<br />NI
<br />~
<br />A ~
<br />/ ^
<br />l
<br />$
<br />RlchDrd I TNA
<br />A000MTE
<br />COMRETE
<br />AWME
<br />THERE ME
<br />UE,
<br />AMD
<br />SiONIFlCMT PENALTIES FDR SUBMITTING FALSE INFORMATION
<br />INCLUDING (
<br />.jig
<br />.2r."
<br />nrnental 6tana
<br />Envirr ,
<br />MHE POSSIBILITY OF FNE MD IMPRISONMENT
<br />SEE 1e U
<br />S
<br />C
<br />1 1001 MD SJ
<br />.
<br />.
<br />.
<br />.
<br />.
<br />610NATURE OF PRINCIPAL EXECUTIVE '
<br />~
<br />'
<br />~
<br />O
<br /> U.S.C. 1 131 e. /ANWIM/ IIr1Y e.r mom. nleY NcAd~ rPle/ W ro t 10,000
<br />R
<br />C
<br />E
<br />NUMBED' ~
<br />VEAR
<br />TYPED OR PRINTED war mexirwnhMsrnwlr er Nnr«nsmonohe rd sYeenl OFFICER O
<br />AUTHORIZED AOEM OD MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lReterencs en sttecnmenn oars/
<br />.";''"x,7A,~, rr.. l,..- :•-, m:r-F 1-.n _!:r^~-.a( '^T rf'": (L.)^ r~r) r-1 "T.v riv rY
<br />.. .. - Tr - .rt_va _,;_ar ona ,: t~T
<br />.. (:La I't :.C. ~ re •Tr •• 1HF F19 iJ4r) 6 rP t'a)!t F' ~.,^'TI~Trc v';.: •w •-e 'ITT r
<br />. r.,v. .`._p_•-•r :/1 '1^"(~T° ~'/
<br />r ^•
<br />.• v . am I^ •.r
<br />T ^ ^
<br />^
<br />(REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.)
<br />Previoue editions may be used.
<br />EPA Fwm 3320.7 108-s51 ,I ,~ ~ ,^ ~ / ,: , r _ .~ _ 1 ~ ,I _ PAGE r OF
<br />NATIONAL POLLUIMT OISCHMGE ELIMINATION SYSTEM (NPDES! FOIm ApprOVed.
<br />DISCHARGE MONITORING REPORT (DMR) „ r ,. ONIB No,12040-0004P .r
<br />17-161 17-191 "' T r ~"I"~ T'') 1 L L ..~~yy~~
<br />ApproveL azpl ~ee.05.31-98
<br />PERMIT NUMBER DISCHMGE NUMBER ~ _ r T I• F T
<br />MONITORING PERIOD " a t r ^ ~ ~ ~.
<br />YEAR MO DAV YEAR MO DAV ~ !!.
<br />FROM 9 1 "J i ,. 1 TO n ~ n ~ l? .. ,;,. .. ,, ~- .:-.. .; a r, ,.:_ I __ ~ r ,r ~.
<br />lI67// 177-73/ /14151 11617/ /ZB-?9/ !3631/ NOTE: Rssd Imhuctiwu bstors eomplelln0 thb IGrmi~~ ~;;
<br />TY OR LOADING !I Grt/Onlp QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE
<br />F
<br />
|