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PERMITTEE NAME/ADDRESS pnc(ude PnN!!ry Namdlncneon 1fD ffu.ny <br />NAME <br />YF:STERN F'UPLS-CCLOFADO, LLC <br />ADDRESSiiEY NUkI'LU!i G]DE <br />P.U. UOY 61ii <br />FACILITY tjUC LA CO ti142u <br />LOCATION <br />ATTN[ H_ LA Ii C'F YAf:F- ~TNC N6Nl.^.CG <br />NATIONAL POLLUTANT DISCHARGE EUMINATON SYSTEM MPDESJ FOIRI Approvetl. <br />DISC~iARGE MONRORINO REPORT (D~R~oI OMB NO. 2010-0004 <br />~')1 r. I N a H ,4pPrDVaI ezplr.B~o6,91.99 <br />PERMIT NUMBER DISCHARGE NUMBER (S U F F i C) ~ , <br />F - PIi1I lNTFS <br />MONITORING PERIOD ~ POND F U I C E P .C N L Y -TUT 7I E ~ 61 i <br />YEAR MO DAY YEAR MO DAY ' <br />FROM OC C7 +)1 TO OC CS 30 905Y NG j]_`CNABGE .'~i09 ' <br />rzazl( (zz-za( na-zs( (zs-z7) Raze) (3oar) NOTE: Resd lnatructlons befor~rR-Pleting tftls M(m. <br /> (3 Cent Ony) QUANTITY OR LOADING p Care Ony) QUANTITY OR CONCENTRATION NO,~ FRC-0UEN SAMPLE <br />PARAMETER x6-53 SIAf 38<5 IB-53 5r-er EX OF' TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS •' ~ 5g;70 <br />H SAMPLE 009000 .9900+:0 ~ 090000 ( Ii) .. rc-.. <br /> MEASUREMENT scAj <br />-0400 1 U G PERMIT. q»68091 4000c9-q ;r,;: .5. ~ gogaaa ;-r ,iQ'~,~~i,;=-;p :., <br />FF U'N KOSS Y LU REQUIREMENT r,t:iv r N R0h <br />"U LIDS, :iETTLEAeCF SAMPLE 0091r};r0 Od9.'#Yi ~ i`_} • <br /> MEASUREMENT ~ ~ ~ ~~~ <br />U54U 1 0 0 PERMIT 840000 A06g0a K90 P4IO~NA1 EEF017 '+ - .:• ~ <br />CFF ENT GNUSS YA REQUIREMENT ~ ;~;:q F .A G ';,{,:. :a`, <br />.. <br />IL AND GkEASE SAMPLE 0909A)0 0609610 096999 669g00~ r ( 75}~ ~.~ = <br /> MEASUREMENT ~ ~ ~ ~ <br />_ ~ ~ <br />'35d2 I 0 0 PERMIT.. 'Oagq~ri ag6gq9 Kt'v g0gqqq q.10~1/416 <br />~ ~~ r,.Y - <br />P <br />c LU NT GftOSfi YALL'E REQUIREMENT K 9 {,0 <br />~ ~ <br />'- . L ~'- , <br />LOM, IN CON QUIT CF sAMPLE ( CJ) 9999L„ 099060 9A q;it9 - = xa; <br /> <br />HiIU TP.EATtt F;NT PLA N3 <br />MEASUREMENT <br />- x <br />- _ ~~ <br />SUii50 1 U 0 i'FfiMlt' HEtQRT AB6Cf2 906094 9gt~aa:G ';,' =.a o66 , r: ' <br />F: F F L U E N G' S VALUE RFAUIREMEiNT 0 G 0 I t C U - -•' '~r ` 6 g C 6' <br />;GL1U5, TOTAL SAMPLE 9r9A:9K: 460009 0909L0 ( I~) - _ ~=.;s <br />GISSOLYcD MEASUREMENT - - <br />02`JS 1 0 0 PF,AMIT 8000170 90g99C 9 ;t ~ g6g99A 6EFQ~'I .. P - .iL, :~r' <br />F'F' UP. t1 GHU ~ YALU REQUIREMENT tr,:SO 'y` i. <br />[L ANU GiiEA:iE SAMPLE Oa0040 ( ;4) 9GOOOa 960860 g9,Q+tS9 <br />VISUAL MEASUREMENT <br />` - - <br />` <br />94U66 1 0 0 PERMR 009040 ]<_=1 OA6g00 6iQ4004 ~ q .tt6"~L ~ OLC ~ (}, '~ <br />EFFLUE6 Gfi05S YAL REQUIREMENT I 5 !( FC=C ~ '-" ~'o0Y ~' <br /> SAMPLE .. I - <br /> MEASUREMENT ~ - <br /> RERMIT ~ <br />• <br />~ <br />~ ~ i ~ <br />~ <br />c <br />~ Q. <br /> REQUIREMENT <br />- . <br />' - :: _ - - <br />NAMERRLE PRINCIPAL EXECUTNE OFFICER I CERTI <br />AM FA FY UNDER PENALTY OF <br />MILIAR WRH THE INFORM LAW THAT I HAVE PERS <br />ATION SUBMTITED HER ONALLY EXAMINED AND <br />EIN <br />AND BASED ON MY ~ / TELEPHONE ~ - ~ . DATE <br /> 'INQUIRY OF THOSE INDNIDUAL B IMMEDIATELY RESPO ; <br />NSIBLE FOR OBTAINING ~ ' ~ ' <br />~~ ~ 1\ /~ Y ~~ ` <br />JJ THE INFORMATION I BELIEV <br />ACCUMTE AND CbMPLETE. E THE SUBMITTED IN <br />I AM AWME THAT TH FORMATION IS TRUE, <br />ERE ARE SIGNIFlCANT -: ' ,' r( - .rJ ~'. <br />~ 1 ;'f (E <br />LS l <br />' <br />' <br />• ~ <br />(~ ), 1 <br />"'t <br /> <br />' PENALTIES FOR SUBMnTIN O FALSE INFORMMTION, INCWDING THE t <br />t <br />j <br />W <br />2 <br />• _ <br />~/~{ ~IJ G ~/~t <br />z R. POSSISILRY OF FlNE MID IMPR ISONMEM. SEE 1B U.S.C. S 1001 AND 33 U.S.C. 610NATURE OF PRINCIPAL ET(ECUi1VE ' <br />- ~~ <br />TYPED OR PRINTED. ~t~(PeMNea IIrIeY Blere <br />pM1rmnreabeA,e arNe(at IMy /nc/uer 6neA up m fr0,000 ar1d a <br />arempnWaneSysere.) OFFICER OR ADTHORD~D AGENT <br />NUMBER ~ <br />~YEAR. <br />MO <br />DAY <br />COMMENTS AND EXYLANAI TUN UY ANY VIULAI IONS (MBlB/BnCB el16I03COl/1Bn6 TIB/BJ - ~ ~. y J. <br />ScTTLEABLP SOLIDS lJttli -ILL B£ 11A7VEU FUF ~lOYF,:41~H PFECIF lYEDT-SEE I. A.1~D), FG Y,.E.CI fiEC.U3N'fAE61T5. <br />;~LITkLY SAMPLING IHSTFGCTIUNS-I.C.Y;, PU 1(I. 3G f.Al AYG IS HIGHL•ST CCNSHLY AYG DCF,IIG FEF,ICC 6EFfF7EE, <br />EPA Form 3320.1 (OS-95) Pravlous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NO7 BE USED.) .. r . PAGE OF <br />