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_ Y .- _ - <br />FERMITTEE NAME/AbORE55 (/ryir4 FrdlryNa.dL•[•Ilen Jn16...•p <br />NAME ICt:B$~CrDAL .".OhPA(If <br />ADDRESS '1 A N N M I N t' <br />P.U. R]K 173U57 <br /> <br />90U l7 <br />FACILITY <br />LocpnoNr,ALG~N ~J y0J•1`J <br />,Tr•.. .iJa ; . :. a:,rre1: ;J'i. ,IS,e -~: <br />NATIONAL POLLUYANT bISCHMOE ELIMINAYION SYSTEM (NPDESI <br />DISCHARGE MONITORING REPORT (OMRI <br />!1-/61 117-191 <br />~JG850077 G07 <br />PERMIT NUMBER DISCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAV <br />FROM '• U U J L TO U J U J J <br />114111 122-131 !14751 116-171 /I9-191 !34311 <br /> <br />POND G/TRIR TO CA~~{BJ~°{~ioao-oooaR <br />(5 U R R N G) APProve expiroe 0531-98 <br />F - FZ':AL <br />'IIaOR <br />NOTE: Reed Inetructlate before oomplatin9 this form. <br />PARAMETER (3 Grd Onlyl QUANTITY OR LOADING !~ Grd OdlYl QUANTITY OR CONCENTRATION NQ FREQUENCY SAMPLE <br /> 146-531 154611 138-461 14G53 15b611 EX TYPE <br />131-371 MALY515 <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS lF1~691 !6468/ 169-701 <br />I-d SAMPLE ., ~.-.. ... .., _;:«^ ( t ~) <br /> MEASUREMENT <br />J~i:J ~ J .` PERMIT Kt>k#.#•: r##k Xv ., j,j ~ -F.R~ . V•tI F^;C!.Y ?7SIfi <br />Pt.a ,.n?J3 ;L :.: REQUIREMENT. L"Y'?# .'; Iiil$VP1 ~ F.A X1~?l U~N $it <br />J.. ... .;r - .. iLF •.. SAMPLE ,##?~,. k+?#k7•Ct kkk, ~, 4t?~ ( zrj~ <br /> MEASUREMENT <br />U.: ~ . ~ J PERMIT ,•=FR 7~;%. t;4k a~C:+l! . <br />~ a3: ~ #+3#k3M >rkk~' ~ 0~~5 -.I N~v F'/ : R113 <br />-Pr ..'1;SV'~ :,liJ:i:: V?Llr REQUIREMENT ~ ~ ~ <br />~ ~ 40.? ~ DAILY MY ML/L ~ MO~Nrp ~_ <br />JLL hhU ,r.EA3B SAMPLE ,...:## ,{:#FK~;~ L::F#:?s`.=: ,-,. kd ( Ig) <br /> MEASUREMENT <br />137tS1 I D 7 PERMIT r~t •:3## k{rr>#~k Y:k;- #x#;F;s# r~~s [+ O 10 t 'ONI'IIY ~R~!' <br />.:F'FL'JdNT .ii75:i YAL I° REQUIREMENT O'.~7 DAILY Nii( r!;/L uL!~T <br />F L_t.r IN v0,'; 7JIi l+l SAMPLE ( ~I~ r'#k.-~ `%~-'`' +'• +-•~~~ - <br />(rt tit 1' R .~. n T'! r. 'i T { L 4 .i ? MEASUREMENT <br />~~J~J 1 0 ) PERMIT PTIOYpL (iEe^3HT R~X{sik4 :r•:'.#Y"f # ~:<vIRiXL~~ = .,- f ~N~E/ tiiTA`1 <br />Fr'L'JN_NT. 'GRAS; VAL 1;: REQUIREMENT 30DA Atl; DAILY N:K MGG ^; f ~Jpr;i <br />~IL ANG GR~A~'_ SAMPLE ....., ( ?U) ..r,,.. s:~s'= ;.#'::`~;: <br />V I [i G .4 L MEASUREMENT <br />J'v Jrsb 1 J .) PERMIT • ,-. #r R#:?0RT Y E:i=1 #f g(. L~~ +~=~: 't L` :u#~': }: ::r f; :` ~N"E/ II5!I4L <br />..(FLJr Ni GRJS$ VAI-'JF .HEQUIREMENT ~INST MAY NO=J -~,^-G# - !7Jt1 T'H ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TRLE PRINCIPAL EXECUTNE OFFICER I CERTFY UNDER PENALTY OF <br />AM FAMILIM MATH THE INFO UW THAT I HAVE PERSONALLY E%AMINED MD <br />RMATION SUBMITTED HEREIN; MD BARED ON ..~ ~ TELEPHONE DATE <br /> MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR ~ <br />I BELIEVE THE SUBMITTED INFORMATON IS <br />NING TXE INFORMATON <br />T 7 <br />~ ~~`, <br />Richard A. Munson , <br />OB <br />N ` <br />~ <br />a. TRUE, ACCUMTE MD COMPLETE. I AM AWME THAT THERE ME <br />INCLUDING <br />T PENALTIES FOfl SUBMITTING FALSE INFORMATION <br />F ~ _ .- <br />~~ <br />~ <br />~ r~ <br />E <br />VSCO c1 e61dQBt , <br />SIGNI <br />ICM ~ ~7O r23~~,Z1 ~~ D~ D7 <br /> THE POSSIBILITY OF RNE MD IMPRISONMENT. BEE to U.S.C. 1 t001 AND 37 ~tB10NATURE OF PIIINCIPAL EXECUTIVE <br /> <br />TYPED OR PRINTED U.B.C. f tste. IA.wU.• uNlr Nrr mnm• nl•y AtcA.d• IGIra uP ro FfO,000 <br />.ndwm•xnx•n Mpiotntrrr •rbMrnencnN••M6Yrrs! i <br />OFFICER OR AUTHORIZED AGENT AREA <br />CODE <br />.HUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rs/erence ell sttecnmsnts Hero/ <br />L-: 'r.TTLEAdLtl SDLLOS L[AIP NAIYLU Fa3 LJ-Y4, tIi-It$ ?fi~~IP [:VPAL' ~JE.Ji~i ;O HUIDEY OF PRf_~F RSI;UI9'•:~e.`:f IN <br /> <br />i,AKT I. d. L. D, P. 5• SfGf:'14ATE'itANAGr'.P4ENP ?L4.'7 DUE 1-L-7,. <br />Epp Fam 3320-1 108.951 Previous editions may be used. /REPLACES EPA FORM T~0 WNICN MAY NOT BE USED.) 0 3 i 1 / ~ 7 0 d l q -1) ,.+ II PAGE L OF <br />