Laserfiche WebLink
PERMITTEE NAME/ADDRESS (1, Y6 isWryN~/locn,m lJDl~Grwq <br />NAME TNAi'PP.3 ~"LSIiJGF :r,C. <br />ADDRESS T k A F' e' E rc ." I t. ~' <br />>:'.o. r:ox lr7 <br />CiiAli: r_O blb2e, <br />FACarrv <br />LOCATION <br />„i1'.f: w. :;OFIUV+' C..°eF. ~~ i!NL;,/Gf:.. "'R <br />Form Approved. <br />L^ ~: ' E `_ T O V 0 h A n(~MB~q.L~9A0-0004 <br />(i U F F• K'A) Approvelle.>~rgg05-31.98 <br />F - FInA1 <br />"I`1CF <br />NOTE: Read InalructitNr belon eompletinp thin form. <br />NATIONAL PoLLUTMT DISCNMOE ELIMINATION SYSTEM /NPDESI <br />DISCHARGE MONITORING REPORT lOMR1 <br />1-15! 17-191 <br />Ci)OJ3?115 C0: A <br />PERMIT NUMBER DISCHMOE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM '. .. iJ TO ;. <br />114111 111-13/ 111.151 !16171 !IB-19/ 136311 <br />PARAMETER !3 Grd Ontyl QUANTITY OR LOADING !1 Grd Ontyl QUANTITY OR CONCENTRATION ND fREOUENCY SAMPLE <br /> !!6531 1545! (38-151 !0653 !51-61 OF <br />131-371 EX <br />MALYSs TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS lit~e3 (51-591 169-701 <br />' n SAMPLE ~:.Y r..y t S: ... .. ; : 0 # : n <br />~ 1 2) <br /> MEASUREMENT ` / d? G /, ~" ii1h <br />:.Oa()0 1 1 0 PERMIT ~+:74L?~ :,-•.x:Y>r;t a,.^..C 6.S Ot•eE#ri 9.5 E~Ky I,~iSTTi <br />•.ir"LUtNT i;ROSS YAL'J ;REQUIREMENT .;,};,t7t ~~.h~I:DI.I!!$t1 ~ : ~ ,. ~~ ~ta:fl.3>aU>f:.~~ SU <br /> SAMPLE <br /> MEASUREMENT <br /> -. PERMIT .:.:.. ... ~. <br /> <br />:... . .. ~ ., ..... .. <br /> <br /> <br />. <br />.. ~ <br /> <br />. <br />, <br /> .REQUIREMENT ~ <br /> <br /> <br />1 _. . <br />,. .. <br />... . <br /> <br />. <br />,. <br />. . .. . <br /> SAMPLE <br /> MEASUREMENT <br /> ' PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERM17 ' <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 />~ <br />NAMElTfTLE PRINCIPAL EXECUTIVE OFFICER I ceRTI <br />AM FA fY UNDER PENN.TV of <br />MIUM WITN THE INfg uw TNAT I NAVE PERSONAUr EI(AMINED MD <br />IMAT10N SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE <br /> MY INOURY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br />OBTNNINO THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS ~~ ~ ~ L~-- <br />W. GordOa Peters TRUE. ACCIAUTE MD COMPLETE. I AM AWME THAT TNERE ME <br />INCLUDING <br />TIES FOR SUBMITTING FKSE INFORMATION <br />SIGNIFICANT PENN 970-$24-4401 90 7 27 <br />President /General Efaaager , <br />. <br />THE POSSIBILITY OF RNE MD IMPIIISONMENi. SEE 1B U.S.C. S 1001 MD 33 BIONATURE OF IYIINCIPAL EXECUTNE <br /> U.S.C. f 131 a. !/V Wary. u!r d,.w wwM/ ,rrY M,nY.W rn.F W m t 10,000 <br />TYPED OR PRINTED .ndn mvim.n ino"LA+nrnr olNnrwv,enane,. nde N,ra.l OFFICER OR AUTHORIZED AGENT CODE HUMBER YEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IRataran0e alr amenmanrs noel <br />L55 G TUI1.L IRI)'% LI"'~IT.:i ',aILL PE dAIViO• A:dG SF..TT,LEA?LE 37LIC°_ LINT AFFCI`'D !'LF <=l0YR.211f!R DR2CIG Fy};AT- <br />:•k.L kU.n'Udf+ i1F I'300F RF.VUIr3F:`;EN'TS UNilt3 1. A. ]. PER"ITTF.E "!U.`7 'flKE ACI A::45CNFFlL• !^'A,SiIi<ES TO REi,UC£ ?F! <br />108-95) Prsvioua aditiona may he used. (REPLACES EPA FORM T30 <br />00022/°71211-1gu6 <br /> <br />