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PERMIT7EE NAME/ADDRESS p..>ra. Eacmy Nrrluanm 1/Drp...np NAME TflAPV.:C RT#i•>~. ]'•°. ADDRESS tRAPE F'!i H!Yv P.O. N~lx ~ ~ CRALL+ 7 y]h2', FACILITY LOCATION A 'T i:it M• GDi'.D1Y P•'S e. E'"~. PRA-.5/:;f •~ IM ;~ NATIONAL POLLUTANT pSCHMOE EDMIMATON eVSTEM /NPOESI DISCHARGE MONITORING REPORT /OMR) 17-16! 17-19 PERMIT NUMBER DISCNMGE NUMBER MONITORING PERIOD YEAR MO DAV YEAR MO DAY FROM I TO 0 T 11x111 /7I-131 174961 116-7J1 178-791 /3Q31/ Form Approved. ' Fr T g O P OMB No. 2040-0004 i Approve! expirae OS-31-98 ~ (SLxPR t+r) r - rl•+tL *~PAT D'1911 inn T'? In5R40 !1 f.OLrN aa~ +a~ nTSCHARf,g ~ ~ ar:: NOTE: Reed IrrtrueHorte 6efon LrdfnpAttnp thM form. PARAMETER !3 Ord On/yl OUANTRY OR LOADING !I Grd gory! QUANTITY OR CONCENTRATION NO- FREOUENCV SAMPLE l~6531 !51-61 138x51 - X6-53 15I-61/ EX of TYPE 137-371 AVERAGE MAXIMUM -UNITS MINIMUM AVERAGE MAXIMUM UNITS e9-es MALV95 154-661 !64701 /lIL AlrD CkE0.5c SAMPLE CC4tr C# ( 941 pmpRtF# 44;t±t•a tr#O##R / / Y I i U A L MEASUREMENT ~ ~ D ' YIhAIL °4066 1 Q 0 ";; PERMIT trDY++kCtr ~ RE?"7rtT ES=1 ~ >x~Y'OE4rArp€.:~: :~-..A~~3:9t4~Q:'~~. ':;~'::;O~~Di.4(#!4r•'IVi::~~~ #Ct~ ;3SER~! ...... ~=~CF~i ; /. c FYLUF.k1 ~RJS4 YIL 9 ~Enl1~IREMENT _.:.. ~ R a ~... ;:...,;:...:" ..:: ... .. :.:::.:.........:':. ..:.. .::...~ _:.:.. , .,.,..:: sx sus<! .,. . :., SAMPLE - MEASUREMENT - - - . PERMIT REQUIREMENT - ~ ~~ ~ -~~ ~~~ ' ~~ . e,:: :::iiE':P' ..: ,. ` 'e 3;' '~'~`. ~C i ' : ~ . ... :.:... ~<.::.:. ....: : •~<:..:~:,. <,:...: ......., ;. ~'i' ~:. SAMPLE ' '~''~ ! ~ - ' MEASUREMENT - ~ .. ~ :;s PERMIT ~ ~ ~ ~ ~ ' ~:a'~:%; ~;":o , EQUI ~EMEFIT R R - ?:.~ SAMPLE MEASUREMENT PERMIT. ..::...: . .... . :: . ... .REQUIREMENT ~ ~ ~ . ~~ ~ ~ ~ ~~~~ SAMPLE - MEASUREMENT .. ~:~... PERMIT ~ . ~ .. . ..... .. .. .: .. . ~ :.: .... ..:..... .. ::.:: e.:... . ; ~ . . : ...... :. .: ,:. ..: ... ., .. REQUIREMENT ~ .. . . :: .:... . . . . .... :.~~...,.: ,....:~..~:: :. .. SAMPLE MEASUREMENT F~ERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT -pEQVIREMENT - NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIfV UNDER PENALTY OF AM FAMILIM WITH THE INFO LAW THAT I NAVE PERSONALLY EXAMINED MD RMATION SUBMITTED NFREIN; MD BASED ON TELEPHONE DATE /6/ ~r~~ ~ J J~~~,~ [JAM ~1Nr /-'tcFrS MY 1NOUIRY DF THOSE INDIVIDUALS IMMEDI/ITFLY_RESPQNABLE f09 I BELIEVE THE SUBMITTED INFORMATION IS OBTAINING THE INFORMATION ~~// /~J_-.-+ L ,(/.f ' , TRUE, ACCWIATE AND COMPLETE. I AM AWARE. 7NAi THERE ME TIES fOR SLIBMITTIMG FKSE INfORMATION INCLUDING NA T ~ ` /,v N~~~O/, !/ a~ -~/ ! ~'+ V _'/ ..t //~~ ~~ . ~ ~!~/,K (/~/Ar~/~ r , SIGNIFICM PE L THE POSSIBILITY OF FINE MD IMPRISONMENT. SEE iB U.S.C. ! 1001 MD 33 BIONATIINE OF MIINCIFAL EXECUTfVE J ~ TYPED OR DRINTED U.S.C. f i41B. nMYerr uWr rMr mltma rnrY MrCAM rAra y ro f1O,000 uMUmurRUn Mpnsml,nt oL brnrrn 6 monMr.ne 6 yrrw/ OfFICER OR AUTHORREO AGENT AREA CODE NUMBER YEAR MO DAY 4: til ~, ~~ .~ f(~r f; ' ,F :~ 'f COMMENTS AND EXPLANATION OF ANY VIOLATIONS !Reference sl/ errecnments Oerel G TO'Pl1L IRJR LT!ITTS NILL r•F' W4IYP.9, 0.bD SF,TT'LF'A'tLE S~LI~S LT~TT IIDpLTFn vryp <s1~TR,74Hg AA°-f.iP i'Y"V*- •'`, `iDRDEN pP L•N.'1nP RY3UTIiF.'i'y'-, 11YBV_R L.0..]. DT:AnITT';.r Pft57 TAR? 0.L.[. PT!1750.~Lr KCJSU?A.S Tf) 4.°,DF!CP rN arrr,u-.^N^P uTru nr~* - ..pA fmm 737 D-1 108 ^51 PrnviOUS edlunne mnv he ure - 1 LACE F WHI A N D.I^ PAGE ~OF Z 7J?~?/ngnC?1-Lnl~