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PERMR"TEE NAME/ADDRE$$ (Inefude Faciliry Name/Lacarion i/O ffennq
<br />NAME ECN2E kEECrJtiCE_° II*I7EL'
<br />ADDRESSPCYlE NC. 2 ~IkF
<br />P.o. iicx ve3
<br />FACILITY YAChLA CG 81428
<br />LOCATION G Y 7 E
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<br />_ __ _ _
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved.
<br />DISCHARGE MONITORING REPORT (DMR; OMB No. 2040-0004
<br />(2161 (1]-91 1lINOR
<br />Approval expires OS-3T-98
<br />PERMIT NUMBER DISCHARGE NUMBER (SUE & M C )
<br />F - FIDFI CEITI
<br />MONITORING PERIOD Y d T F T C C E E 5, T E A l l C I 9 C H
<br />YEAR MO DAY YEAR MO DAY __
<br />FROM 1 TO 0_ 1 Y3~• _HG LISCEARGk 1__ 1
<br />~ a a n n ~,,y ~ n r e • r [ P. [ J h . , A 1 N ~ l1 V N 1<o-<rl 1«-<al lee-zq 1<o-<rl 1<a-<rl I/wr/ .•v.e. nvu.. u~au wuuua uomo w uHie niy u.,
<br /> (3 Card Ony) QUANTITY OR LOADING (a Card Onty) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER (46-53) (5961) (3845) (<B-53 (54-81) E7C OF TYPE
<br />(3277 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br />rr>z-4Tl ANALYSIS
<br />(6968)
<br />69-70
<br />ECD, S-UAY SAMPLE ='~~`$^= «~~~~ $~~-'e~3
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<br />• SAMPLE +4303:, 430443 333Y33 ~ ( It)
<br /> MEASUREMENT 7, f ~ 3
<br />CC4UU 1 U C PE s33
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<br />EtFLUENI GROSS YAIL
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<br />SOLIDS, TOTAL SAMPLE -.r.Y;. ~, 3=:Y+Y3 -.=)33t+ ( 1S)
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<br />UGS.3U 1 U C PERMIT 0?3YSAr0 t :§N Y3 O~ik>k ~ #0'= ( a I .3°
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<br />EFFLUENT GROSS YAIG REQUIREMENT r" h '' ,, ~~~ CK33 ~'`~! ,' +y~ ~. •,
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<br />CIL ANC GREASE SAMPLE a+33%Y +,--.r ,+rY~ -••+3" ( ]S)
<br /> MEASUREMENT
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<br />MEASUREMENT +~^-~%+ 3++3434 a+4333 33.3;...
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<br />NAME/TITLE PRINCIPAL EXECUTRE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMIUPA YlRH THE INFORM LAW THAT I HAVE PERSO
<br />ATION SUBMITTED HERE NALLY E%AMINED AND
<br />IN
<br />AND BASED ON MY TELEPHONE DATE
<br /> INQUIRY OF THOSE INDIVIDUAL S IMMEDIATELY RESPON :
<br />SIBLE FOR OBTAINING
<br /> THE INFORMATION, I BELIEV E THE SUBMITTED IN FORMATION IS TRUE,
<br /> ACCURATE AND COMPLETE.
<br />PENALTIES FOR SUBMITl1N 1 AM AWARE THAT TH
<br />G FALSE INFORMATIO Er1E AIiE SIGNIFICAM
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<br />INCLUDING THE
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<br />POSSIBIUTV OF FINE AND IMPRI
<br />1319
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<br />SONMENT. SEE 18 U.S.C. § 1001 AND 33 U.S.C.
<br />I
<br />SIGNATURE OF PRINCIPAL EXECUTIVE QQ~~~~
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<br />TYPED OR PRINTED §
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<br />OFFICER OR 4UTHORIZED AGENT
<br />coDE
<br />NUMBER
<br />YEAR
<br />MO
<br />DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (ReJelBnce ell etlachments here)
<br />hEFGRT "NOT" (NO CRICF.INE THEATCT) IF NO CHLCFINE USED--SFE G/. CII E GCFASE - ].E.1.C, FE. 8. (ITFLY
<br />• ShCFLING 1NSTFUCTIC1c_-I.C.6, PG. 5.
<br />Epp Form 3320.1 (08.95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) PAGE OF
<br />COCOS/9SG7]E-15sE 1
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