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PERMITTEE NAME/ADDRESS (lnc(ude Fad(iry Name2ocauon ifDi$erenq <br />NAME BUYIE RESUU6CE° IINITEC <br />ADDRESS P.OYIE NG. [ F.llF <br />Y.C. BC% 483 <br />FRCN]A CC E142E <br />FACIl1TY <br />LOCATIONEGkIE CG E1428 <br />,3T1h: YIILIAC A. '1kpE Jk., dINE CGH <br />NATIONAL POLLUTAMDISCHARGE EUMINATIONSYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR; <br />(Z-161 (f ]~ 9) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Ro-zf/ Razz) Razs/ R6-1]) R6-z91 f.66Jf) <br />n1NCA <br />(SUB9 YC) <br />F - FI6.?i <br />YYTF 7C LEEF <br />Forrn Approved. <br />OMB No. 2040-0004 ' ~ ~ r <br />Approval expires 053 <br />~.~+: ,~ ( <br />1IEII LITCA Y' ~I. <br />_ i %' <br />eNOTE: Read Instructions before completing this form. ~~ ', I <br />re <br /> (a CeN Onryl QUANTITY OR LOADING (a Card Only) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (4653) sa-Bt) (ss-as) ae-5B) (sa~s7 <br />EX <br />of <br />TYPE <br />(32 7n AVERAGE MAXIMUM UNfTS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS <br />6&70 <br /> l6z~1 (6a-BB) <br />LI?'U i1lr. E AL SAMPLE '~'~~" ;::0~~: 3Tt'k++ ( 1.) <br />CekkAAL MEASUREMENT ~3S ~~ ~~ ~J ~IL <br /> <br />'/4USS 1 0 U PERMIT ~' -' <br />~ '+~ <br />m <br />+' .. ~' / <br />IFFLUEh1 GROSS VALC REQUIREME ~~ ~~+~+~ ~k ,: <br />~~, p .~: „#~ 1 t ~>d. <br />y~„- <br />-. 1CCCI <br />L AN'S f,S EASE SAMPLE '~~~~'f ( 94) ~~~'~x~ ~~#~$~ ?:X+'.:t // <br /> <br />S U A 1 <br />MEASUREMENT ~~ <br />84066 1 U U PERMIT T`= <br />r` E~=1 9:# <br />EFFLUENT GA055 YA.IL REQUIREMENT t <br />~,t "~'j`~~~ rC=O ;-4 !-~ ~~~ - ,., o-`"•": !";~ ~ +~+'~ _ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ,~+.~n, - <br /> <br />~ .~ aatiTFi, $ <br /> <br />'~ . ,.o ~~ <br /> <br />~ . ';~. <br /> <br />~" F <br /> <br />`~ ~ <br />F <br />'~"* <br /> REQUIREMENT ~- ~ <br />+ ,-.~.y -a +,~. - <br />~,. ~ ar( <br />}* .~:~„ , <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ,-;= <br />- ^~ v , .~ <br />~ <br />T <br />~~ - ",'.^ -~, :, ! , .+4`'~ " <br />~ ~tar;F~ .xf~;, <br /> REQUIREMENT . ~~ <br />- <br />°,a ~y `„_ ~ r~ ,~+~~ = <br />? <br /> , ~ <br /> SAMPLE <br /> MEASU <br />REMENT <br /> R <br />-PERMIT~._ <br />${ <br />~ ~~v"~ <br />P f 'Y <br />~ {. <br />+~~ <br />t~ ~ 3S]9~.`'~ <br />I`S /4`~ 'Y^' <br />~'~~Ij~.~ <br />l ~ <br /> REQUIREMENT - ., <br />_ ~ c:~s: <br /> SAMPLE <br />• MEASUREMENT <br /> PERMIT ~ <br />;.. <br />o `• r 3- r ~, r s -+ _ <br />' <br />, <br />' ~ ~,. i~c <br />~~ <br /> REQUIREMENT + a `' ~ <br />r, <br />. . <br />` ' ~ r > ~' '~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />~ K- ~.,r <br />~ ,~ "•,. N ,~ ~•~ <br />~ Y r ~ .±~ 9 <br /> REQUIREMENT ~ '~ ,. ` <br />~~; a ~" <br />I--. <br />r` ;iik_x. <br />'S a ~ ;, °* <br /> , <br />F,- ~ <br /> <br />ti <br /> <br />~ _ <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDEq PENALTY OF <br />AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSO <br />ATION SUBMITTED HERE NALLY EXAMINED AND <br />IN: AND BASED ON MY TELEPHONE DATE <br /> INQUIRY OF THOSE INDIVIDUAL S IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> THE INFORMATION, I BELIEV E THE SUBMRTED INFORMATION IS TRUE, <br /> ACCURATE AND COMPLETE. IPM AWARE THAT THERE ARE SIGNIFICANT <br /> <br />/~(- ~ M PENALTIES FOR SUBMRRN <br />POSSIBILITY OF FINE AND IMPRI <br />~ <br />l G FALSE INFORMATION, INCLUDING THE <br />SONMEM. SEE 18 U.S.C. § 1001 AND 33 U.S.C. <br />fi <br />d <br />ff0 <br />000 <br />tl ~,l q <br />SIGNATURE OF PRINCIPAL EXECUTIVE ~/ / <br />O <br />S <br />TYPED OR PRINTED nes up ro <br />en <br />a <br />. <br />w <br />befween8months end So <br />maamvm lm~ <br />mme~al <br />veers.) OFFICER OR AUTHORREO AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANAI ION OF ANY VIOLATIONS (RelBrenCe all attachments here) <br />FEFO&T "NCT" (NC CBCC6IlE TAEATI!4) IP HO CAICBINE LSEC--SEE G/. GIL E GPEASE - ].E.1.Ce F6. E. CE7FII <br />53hPLING IdSTbOC1ICY~-I.C.6r PG. 4. <br />Epp Form 3320-7 (OR-95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) C U C 0 6 / 9 9 G i ] E -1 ~ 2 E PAGE L OF <br />R~ <br />d~;, <br />«f <br />-n <br />,`k <br />