|
PERMITTEE NAME)ADDRESS (Ilerlvdr FaNUry Name/Gxanon ljDlgavr8
<br />NAME BEST@hN PUELS-CCLOAACC, LLC
<br />ADDRES~EW HORIZON M]AF
<br />P.O. ROX 628
<br />FACILITYbUCLA CO 91414
<br />LOCATION
<br />ATTN: k. IANCE DACE EIeE [!AN6GEh
<br />NATONAL POLLUTANT DISCHAfiOE ELIMINATION BYBTEM MPOESJ FOrm Approved.
<br />DISCHARGE MONITORING REPORT (DMR~ h I M O H OMB NO. ~2040-0DD4~ 7~8
<br />Q-161 !f 7. 01 ~ ~~~ .jr-•
<br />(SUBR iC) _ _
<br />PERMIT NUMBER DISCNARGE NUMBER F- F I~ 1 C ~ I~ ~ A~ 7 5 S
<br />MONITORING PERIOD EUbCPF E AC73YJ !I.l E_CiA'I AA66
<br />YEAR MO DAY YEAR MO DAY
<br />FROM OC 7 ~JI ro CG G~ 1 afi'A NC CI_CHAEGF (__~. Ada
<br />Razfl (zazsJ rz.-zsJ ae-zn rze-zal l3o~f1 -NOTE: Read IrISWCUons before corgPleting lhle form.
<br /> (3 Card Ony) QUANTITY OR LOADING (4 cerdOny) QUANTITY OR CONCENTRATION ~ N0.: F REOUEN. SAMPLE
<br />PARAMETER 48.53 54-81 39-x5 48-53 5481 -EX' .' OF. TYPE
<br />(3f~>7 ~ AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNRS ' ~'~~ 670
<br />H SAMPLE or}a;Ya}y aa+}.,;ya -7
<br />( aaaa~}a ~ J;) ~ i
<br />'
<br />~~
<br /> MEASUREMENT / ~ $ ~ Q _ x
<br />O4U0 1 U U PERMI7 ~ gaafi++a' aaagfifi rC; aYi ,5 A600a>0 ,o ~ T F
<br />FFLUENT Gii0S5 YALUP RE0l7jREMENi , tt~l~} lIIMINUd tl~X JlU11 U
<br />'CLIGS, TOTAL SAMPLE aaafiefi aaaa::a ( Icy ,_ (~'1
<br />'U5P)rNDED MEASUREMENT z•SO 2•;So `~ °j0 (~Zfr7
<br />C53U 1 0 0 PERM!$ Oaafi+04 +aAaa!a4 Kc aa4 f?TIC511 O,,,v t.; ~
<br />
<br />:FFLUENT GA095 YAIUP
<br />REOUIRtSMENT
<br />ar::.}
<br />ETE YG
<br />OUA Y =
<br />•. ~, •_
<br />~~
<br />'OLIDS, SETILEAElE SAMPLE 9aaCfi0 aaCa::O (
<br />. ~ L
<br />E
<br />~
<br />Q ( 75~ .t. ~+/c ,
<br /> MEASUREMENT ~
<br />71,...
<br />Liz. ~J•Ol...r
<br />-C .•w
<br />v.O_
<br />•
<br />3 (
<br /> X J _
<br />OSUS 1 U C PERMIT. A+d040A. afia0q+0 p LYC PTIOYAI bJlE',GE4 ;~'
<br />
<br />FFLUENT GA095 VALUE
<br />REQUIREMENT
<br />Ka+~a
<br />ATII AYG
<br />340A lY ~ ,
<br />0!
<br />l
<br />NUN, TOTAL SAMPLE vaafifit: aafi4:IIC -
<br />~
<br />, 3 5 r •
<br />~~ "~
<br />Ga
<br />"3
<br />(A S F 2) MEASUREMENT ~ • l7 ~ (.~ • ~
<br />. = •p ll,
<br />1045 L U,• D -PERMII , o4900Q 90KLaat fi Kar! PTICDAL .0 . ~ ;. .a.ea+..~. ~.
<br />'FFLUENT GROSS YALE! REOUIR~MENT KK<.~ F.T 8V 0 6 G `~ `~.
<br />'IL A%U GAEASE SAMPLE ooaafia aKaK~s: avaaK~ aaaaaa
<br />( ' S)
<br />~ '
<br /> MEASUREMENT ~.t']- ,(,<~ R
<br />35H2 1 U C 'PERMIT a40+4AT4 aoaofio at tA* KfOgg04 49+~0>DO a )r ~
<br />"FFLUEtiT Gd055 VALUE REi}UIREMENi ;K•r., 11S M,1 _
<br />t1G 1 ~
<br />.
<br />~':
<br />LUU, IH CONDUIT 05 .SAMPLE I 03) o,raoao aaagaq a:aKaao '. ~ u..
<br />fHAU TF.EATIMEHT PCilA7 MEASUREMENT Q.Qq (j•23 ( _~ u CO.%T .G
<br />OUSU 1 U 0 pERMf[ EEPOBT AEFOFT ogaaLa ar094C9 '::pa•~,>lCiO •j! as
<br />•:PPLUEbT CROSS YALU! REOUIREME.NT 3UDA AYC DAIIY M.X . EGO ` (~ aas ~~~ ~'
<br />OLIDS, TOTAL .SAMPLE.
<br />M »:?fiL"}p iKar~gO acaaoa
<br />(~'~
<br />`
<br />~ O
<br />2 g
<br />( I S)
<br />~: ~
<br />((~..
<br />._. t
<br />II ~~~
<br />I 55 U L Y E D EASUREMENT Z!
<br />Z , 3
<br />(,,
<br />0295 1 U U ,,PERMIT ~ fiOAaL>p aIIafi4t~~ g Kafa ~ Ona0a0. ~ 5£Y06T -=. ~!~ ~
<br />~~
<br />'FFLUENT G8U55 YALUF REOUIPEMENi~ , Kaafi 5'J ;0 r r - !1G
<br />NAME/TRLE PflINCIPAL IXECVTNE OFFlCEfl I CERRFY UNDER PENALTY OF
<br />AM FAMILIAR WRH THE INFORM LAW 7FNT I NAVE PERS
<br />ATION SUBMITTED HER ONALLY EXANUNED AND
<br />EIN; AND BASED ON MY ~ - TELEPHON E; ~? n, DA
<br />'
<br />To /J ~ d~t
<br />/1 I~ r "' C INOUIRr OF THOSE WDMDUAL
<br />THE INFORMATION I BELIEV S IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />E THE 6UBMnTED INFORMATION 16 TRUE, ~~ • ; ~ - _ •-: = .~• ~ -
<br />~
<br />-'r
<br />? ACCURATE AND CbMPLETE.
<br />PENALTIES FOR SUBMRTIN I AM AWARE THAT THERE ARE SIONIFlCANT
<br />G FALSE INFORMATION
<br />INCLUDING THE .~ ~ .~~ ~~.I r
<br />~`- ~ ~CS
<br />m r / ~ ` ~ J (J r/ )~c.r
<br />POSSIBILf1Y OF RNE AND IMPR
<br />1
<br />1
<br />w
<br />M
<br />' ,
<br />ISONMENT. SEE 1 B U.S.C. i 1001 AND 33 U.S.C.
<br />I
<br />fl
<br />f1 _ _
<br />SIGNATURE OF PRINCJPALEXECUTIVE , ! ~ ~ y
<br />i
<br />
<br />TYPED OR PRINTED B.:IPSn
<br />uadr
<br />are
<br />3
<br />u
<br />9
<br />rmdmum imp4mmrr4dONlwe rdlfr4oa mry
<br />rlcNtlr
<br />rlea uP ro
<br />0.000 rM a
<br />nBmanW UMSyvua.) OFFlCER OR AUTNOR~D AGENT
<br />-
<br />NUMBER- ,`.,
<br />YEAR
<br />M
<br />DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (RelBrence ell attachments here) - . - `_, = • " ` ~.°
<br />'CIiS G FE LIMITS rILI EE I:AIVEU G SETTLCAHLE SOLIDI LIMIT AFFL1'ED FCF <~lUYR,2YtlA F6k'GIF lYPLTs,Ctll: 11E5-
<br />RUNOFF CONciTITU7E5 E.A.;OAITY OF 10AL'-SEE I.A.1 (CI), !~ V, FCH Fet;U76EEEdTS. DETEC7lC6 II!]7_~Sl~ ,I:F:7.
<br />P orm 33 1 ) reWOUS`edi Ions mey not a used. ~ r (R CES A F -40 H S ,. OF
<br />
|