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PERMITTEE NAME/ADDRES$ (/nc/tde Facifiry NamvJLocaticn ifDi$oent) NATIONAL POLLUTANT DISCHARGE ELJMINATON SYSTEM (NPDES) Form Approved.
<br />NAME
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<br />LI7ITF;D OISCMARGE MONITORING REPORT (OMR~
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<br />M O P OMB No. 2040-0004
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<br />ADDRESSEIO Y I r: ti 0. 1 •' ` >: ~ ~ REC ~ --0-0~':--A °
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<br />APProval expires OS-31-
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<br />P.(l. T;~li tii I PERMIT NUMBER DISCHARGE NUMBER - si NA*„ DELTA
<br />FAauTY PAONIA co ata~"za MAR 0
<br />MONITORING PERIOD
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<br />LOCATION{ ~
<br />F R MO DAY YEAR MO DAY
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<br />Rea I ristructlons befor s
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<br /> (3 Cerrl Ony) QUANTITY OR LOADING (4 Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER (46-53) 54-61) 38-45 (46-53) (5461) EX OF TYPE
<br />(32-3n AVERAGE MAXIMUM UNRS MINIMUM AVERAGE MAXIMUM UNITS
<br />(sz-63l auaLYSls
<br />(84-68)
<br />69-70
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<br /> MEASUREMENT
<br />00400 1 0 0 g, P@EiMUr~,' ,t ~
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<br />SU~PENDiD MEASUREMENT
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<br />OU530 1 U 0
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<br />{AS PRf MEASUREMENT
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<br /> MEASUREMENT
<br />U3~82 1 0 0 '`P~ MIT
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WfrH THE INFORM LAW THAT I HAVE PERSONALLY EXAMINED AND
<br />ATION SUBMITTED HEREIN; AND BASED ON MV TELEPHONE DATE
<br /> INQUIRY OF THOSE INDIVIDUAL S IMMEDIATELY RESPONSIBLE FOR OBTAINING J
<br /> THE INFORMATION, I BELIEV E THE SUBMITTED INFORMATION IS TRUE,
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<br />~ ACCURATE AND COMPLETE.
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<br />T I AM AWARE THA
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<br />ISONMENT. SEE 10 U.S.C. § 1OD1 AND 33 U.S.Q
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<br />SIGNATURE OF PRINCIPAL E%ECUTIVE ~ }
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<br />TYPED OR PRINTED § tat 9. (
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<br />maximum impdsorune/rc of beUSea mnrtas may
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<br />n Bmondu end5yeers.) OFFICER OR AUTHORIZED AGENT
<br />NUMBER
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<br />COMMENTS FWD EXPLANATION OF ANY VIOLATIONS (Reference ell attachments here)
<br />`,i!TTLEABLE SOLIi)S LIMIT APFLIF.S ONLY IF G10TR,2'1H9 PRECIP F9 P, `:T IS rLAItiOD. L[ CLgI!+ APFRCYP.D ?Y ;InCD,
<br />'i :i `+ 6 IROM LIf§ITS iItICI. NOT 9E APPLIED TO RE?OR4ED MEA SU R'b'FNTS-SEE I.A•?, P(: S °Tlk 90RDFN OF FROOF
<br />AForm OB- S) Prev ous editioris may t be USed.' • ` • ~(qEP CES' A T C AY .) ^ nn ~ ~ ~ a ~ n 21 '_ • PAGE OF
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