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PERMITTEE NAME/ADDRESS lrnclude Fuciltry NamrlLoeatmn ;i/DfBerem) <br />NAME SEKECA CCAL CClFAhT <br />ADDRESSD I(A ri E h D <br />HAID,:N co al~3y <br />FACILITY <br />LOCATION A = U E N <br />ATTN: (:. tlUD HAUYk, <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) F~)rm Approved. <br />DI$CHARGE MONITORING REPORT (DMR1 OMB No. 2040-0004: <br />(zas) rn-f 91 C7 F~ ` Approval expires 05-31-98 <br />~JULn 9fr) <br />RMITNUMBER DI$CH,RGENUMBER p - . ; (, ~ L ''~UUTT <br />unutlrn61un_ecelnn ACUIL 11fT TE°T]AG fCb (ItA <br />CO 81E~U FROM <br />GFh£HAL M,AtiAGFH <br />TCrirl MV UHT <br />7 LS )L ~+~~ 6G II`_CHAECF ~~ ~ CA! <br />/zs vJ 120-Y9J (3tr31J NOTE: Read Instructions befom Completing lhls Corm. <br /> (3 Card Ony) QUANTITY OR LOADING ard Only) QUANTITY OR CONCENTRATION Nd, FREOUENC SAMPLE <br />PARAMETER (4653) (54-61J (38-45) (46-53) (54-61J ~(t OF TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS '~ <br />is263) ANALYSIS <br />/64-6a/ <br />69-70 <br />LC 3 A HF: Y HA A U SAMPLE Vn>0 ~~ CA~OCO :~:yot}y ^~.. ' ay) <br />CEHIOUAPHNIA MEASUREMENT <br /> <br />Ttll'f!b I 0 U ..PERMIT ~`~ iiF Cl >p O FF- I1 BA:E~ <br />BFPLU°NT :.ROSS YALE ~M=<1UfiEMENT ~,,, ~ pN tILQ£ CF17 - <br /> SAMPLE <br /> MEASUREMENT <br /> `PERMIT:-: - i"--'I` a, .,u' qT `; } ~;."- <br /> - - y - , <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> ~~ <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> f ~~ <br /> FiEf~JIR~MEtJ€ - -~ - - - ...~ r„ ' <br /> SAMPLE <br /> MEASUREMENT <br /> PflRMN' - ~ - <br />. A~.E(,~~I~_3_fi61ENi <br />~ _ - t <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMILIAR WITH THE INFORM LAW THAT 1 HAVE PERSONALLY E%AMINED AND <br />ATION SUBMITTED HEREIN <br />AND BASED ON MV TELEPHONE DATE <br /> INQUIRY OF THOSE INDIVIDUAL ; <br />S IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> THE INFORMATIDN, 1 BELIEV E THE SUBMITTED INFORMATION IS TRUE. <br /> ACCURATE AND COMPLETE. <br />PENALTIES FOR SUBMITTIN I AM AWARE THAT THERE ARE SIGNIFICANT <br />G FALSE INFORMATION <br />INCLUDING THE <br /> , <br />POSSIBILRY OF FINE AND IMPRISONMENT. SEE 18 U.S.C. § 1001 AND 33 U S.C. <br />SIGNATURE OF PRI IPAL EXECUTIVE ~,^ <br />V I <br /> <br />TYPED OR PRINTED § tat 0. (PeneRies under these srenrtes mey include Inres up to Et0,000 end oT <br />menmum ~mpnsonmem c/behvBen6monMS end S <br />eers <br />J OFFICER OR A HORIZED AGENT A <br />NUMBER <br />YEAR <br />MO <br />DAY <br /> y <br />. C E <br />COMMENTS AND EXPL4NATION OF ANY VIOLATIONS (Reference all attachments here) <br />S'r'i PAkT I.A.4 FOR CE7AILS OE T85T PHOCF.DUHE. HfiCAT LGYEST DILU4IGN ('~ £PPLUS6T) iIHICd I9 IfItAI TC `UA <br />GF TEST OBV,AhI5115 (1C5U) AND ATTACH ACUTE 7CYICITI TEST AEFGAT FCAf 2C CtlF. <br />EPA Form 3320-7 (08-95) Rlevious editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) OOle 61r y 9 O E i ~ -IFS Y13 PAGE ~ OF <br />