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PERMITTEE NAME/ADDRESS (1.d~4 Facs~yNw/laanm dDlQfrn.p NAME K::HH C7''.L ~J"P1`IY ADDRESS R A H ci N• I 'J "'- P.o. 1:1K 1774't7 Si.`.'A:1£JA" 3?H',4:5~J'.J'J17 FACILITY LOCATIONM (L LJL11 -~J t)J'J J.J nI"f ;v: L'LJ~GF: Y. VAtCL'itiiJM, yIVr. ^1; 3. _ _ ., _ _ _ NATIONAL POLLVTMT DISCHMOEELIMINATON SYSTEAE'//Y~DE3)" - ~ I'Onn ApprOVed. DISCHARGE MONfTORING~REPORT lOMRI o 040-0 4 r2-r61 r7-r91 POND H/2RTH YO CAaMA~A~t 1 .~'.R C7G 35 D037 @GZ A- (SDHR VY) Approvele)rJ~i~~05-31.98 PERMIT NUMBER DISCNMGE NUMBER F_ F I :J A L MONITORING PERIOD `i I ~ O R YEAR MO DAY YEAR MO DAY FROM JU l JL TO U U3 J •`•r !1'J DI SCfi AF':R ~-~_~ .^.}~' I162/I l12-231 !14251 126-271 118-191 !363/1 Y NOTE: Rasd Inetruetione before compbtinq thu form. PARAMETER l3 Grd Onryl QUANTITY OR LOADING 14 Gid On/rl OUAN7ITY OR CONCENTRATION N0, FREQUENCY SAMPLE !05-531 !548!1 138-451 !46-53 154511 EX GF 132-371 MALrsls TYPE AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS Is2-esl 164681 169-701 1'!1 SAMPLE .kx~ka xk::x;: .-.-, #`: ( 12) MEASUREMENT i/CJJO 1 U U PERMIT ~~. .::~~tk:xCxt~ ~ rfC>~00d1 :<:x:: b.5 ~ CI.Tt.:. O r3eG ~ .E~t'6Y ;wSI~IO :,FPLUf:NT JHUSS YAL'J£ ~~REQUIREMENT; : ~~ ~ ~ ~ ~ L t-; ~~M I.K JIN ~ l4AY I""ElDtS~:~ 5U ~.I Lillj, ~GTTLEARLE SAMPLE ~x YR?6' C#.644iF ~%YRpn3 fi..^-# #;' ( 25) MEASUREMENT . .; 'J :,4~ 1 0 U - ::~"::PERMIT ~ K~II i!lSt~C~": ": ~~... iY~~C.791"~ 3 G ~ 4ff L!k#-0t~ ~ 41?C~F# i~ 9-.5 :~: -. -( f. ((G;~~~ ~ ~ ;.R~,fl i;l. ' aFFL7T: R u T-`R75 5-PAZ'J3 REQUIREMENT- - : - ~.~::.,, u~z-es= ~I- - .. •) ~i [, _ JIL hYD .~H£ASE SAMPLE .%:YGC. x:3`..•`. 4C{-if?+ ~+?4 3Sk ( 1~~ MEASUREMENT 'J3ijl 1 D 0 PERMIT . ~.-~xrx #x~Frtr2 O Xt`G Ruxr~tO #•:1.R '» 1Q ~ ( OM~FIN :'~B ~FFLUEHT CR+O55 VALUE REQUIREMENT Oar.x DAILY "18 'R~;/L Sl;KY f Ur, N CONDUCT JR SAMPLE ( 'l J) ,-.. p~fc ~ -A ~r'F Y:C 1 tf kG TBEATREN I' ?LAt:T MEASUREMENT 7 J')5U I D :J PERMIT JP 1'I~YAL iJEP7iiT p?hr>f iX -a: '-.l # '".Cfi~YO .,- ( N.: t;/ :HST"~. FF'LUhNT :rRJSS YAL3r: REQUIREMENT ;jJnA AVM BAILY AY CGS .:-{: Hn;Tp 1 ND GREAiP. SAMPLE :`5:: .`-;: ( 97) kRrk;F:: .~. #= .rt~"~ D U A L MEASUREMENT ;JUbb 1 0 U PERMIT :; ;:xt-k ;: R3P:7R! Y FS=1 -x•V;ta~tAGG ~ ~ 'AFis:Y O.. ~ `k~.~?Ot%# - S; '.: .( YCP/ 'T_GUAL ~FFLUEtlT GH7.°i5 YAL.1f' .AEOVIREMENT IYST :TAX NC=U ~ ~ ~ '~'-# lJi7NT! SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT - ~ ~ - NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I cERTI AM FA FV UNDER PENALTY aF MILIM WITH THE INFO LAw THAT I NAVE PERSONALLr EXAMINED MD RMATION SUBMITTED HEREIN; MD BARED ON / . TELEPHONE DATE MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR RSchard A. I~fUIIBOn OBTNNINO THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS \_ ~~ TRUE, ACCUMTE MD COMRETE. I AM AWME THAT THERE ME SIGNIFICMT PENALTIES FOR SUBMITTING FALSE INFORMATION INCLUDING . V1D8 President , THE POSSIBIl1TY OF RNE MD IMPRISONMENT. SEE 1B U.S.C. f 1001 AND 07 1 /610NATURE OF PRINCIPAL EXECUTIVE G ]7 724121 @G G4 D7 TYPED OR PRINTED U.S.C. f 13ta. lPerleY. utlA- Flrr mroro. mry NcN.O. bwr w ro JI0,000 . rq armuimnr Mpiaonwnr ol4rwwm emnlnu rq eY.MA/ OFFICER OR AUTHORIZED AGENT AREA CODE NUMBER YEAR MO DAY `COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRaterence e// ettechments hare) :,r:TTLEAUL£ 5'DLIDS LI'fIS rAIV~U PDR LJ-YH, to-HR PR°CIP EYEnP :,UoJc~i IO 9UBC~F JF' rH;J.~F RStiUI~ENCN"_ Ie PArtT I. 9. 1. D. P. 5. :,TJRMYATEA rA.VA36,'7°9? ?LA:Y GU£ 1-L-3?. e EPA Form 3320.1 108.951 Previous editions may be used. /REPLACES EPA FORM T40 WHICH MAY NOT BE UbED.I r7 2 ~~ 1 / y 7 ~7 B 19-1 2 5 4 PAGE ) OF