~^ _ ___
<br />PERMIT LEE NAMEIADDRESSIInrl~dry NATIONAL POLLUTANT DISCHARGE ELIMINATIOII SYSTEM INPDESI
<br />In.nn..vn,l,r1 ~~„roan,lap/..rnu /r p~ DISCHARGE MONITORING REPORT /OMRI
<br />~AM.E__~I.AiA~~', Sr~'~H1L.(.Cl~.~i~~fJ.__ 17-161 /f7-191
<br />ADDRESS(;1,'trtc~IIC115T1TETILy1~'~'pASpTq~G[~~,pQUCyj.__ COG950023 005 9
<br />--_[c2jt yp yy",_LE{y pyva.yy~~EET ~_~t- _'v -- PERMITNUMBER _'~., Ip o DISCHAROENUMBER
<br />,, .~ ,, MONITORING.PERIOD
<br />FACILITY __ '~ ~ ~ ;~ ~' = YEAR' MO 'DAYi ~- YEAR MO DAY.
<br />LOCATION _ _ _ _ _ _ ~ ? -' ~, FROM TO -
<br />rl [ [ N : l;A'! ID 3. MAC DO UGALL ESQ. --~'' ~~ ~~ -? nav>; 177.zJ1 iu7J1-' ~; -rzA.7n rzA.zm IrnJ»
<br />F - FINAL
<br />PIT f5 DSCdBG TO GAASSY CAEE6
<br />7 ( -~ .
<br />MINOR (SUHB =N4)~' ' AOUTT
<br />NOTE: Read Instructlone before comoletlnp this form.
<br />'
<br />...
<br />" lJ Card Only) -; pUANTITY OR LOADING yy~~' ~
<br />M ?'
<br />~
<br />` ~
<br />fi
<br />I IY Card Only/-. QUALITY OR CONCENTRATION -
<br />p '
<br />~ FREOUENCV SAMPLE
<br />
<br />PARAMETER
<br />1~6J31
<br />(Jl
<br />l) -:
<br />H
<br />- •. ~ _
<br />_
<br />IJ8JJ1= rybJJl ~ lJI-6!/
<br />~
<br />EX
<br />OF
<br />(TYPE
<br />13737/ >r w. AVERAGE i _ .t MAXIMUM' cr GNITS: ~ . ~ MINIMUM AVERAGE MAXIMUM EUNITS ~
<br />(67th ANALYSIS
<br />' (6468/
<br />/69-79)
<br />.~ .I '-' SAMPLE =1
<br />~
<br />~ ::##+~}#?~#'
<br />%
<br />: M I~~qv~#~!~
<br />q
<br />: ~ LET'
<br />~
<br />^ ~~ L~t L ##~##'~
<br />-' 1
<br />~ 9 ~. .T =
<br />'
<br />A ,
<br />fl~
<br /> MEASUREMENT
<br />~
<br />. •
<br />? ~
<br />~
<br />e
<br />,' a RRRiii - r
<br />~
<br />r_
<br />r., - ri;
<br />.
<br />r rr
<br />.r i
<br />- ] - _
<br />_ ~ ~
<br />U `
<br />/}
<br />(, ~ li C i. 1 O O .- PERMIT ,~~,. ~##~##
<br />"~ r~~~#~ , [
<br />~
<br />#0!,r O ~ p
<br />~/1' ~.1~,
<br />~ ~ ~~ ~ .O ' f ~ f P ^_-' ~ .~• "- R ~'I HAB
<br />'•FiLU;:NT GROSS YALU ~pEGUIREMENT~. cr ####' b ~ '~.%' `'ll,yI !1 SU t ~ 'IIOBT t
<br />~I:LIU,~, ::iTT'LEAHLE - "SAMPLE ~
<br />A ~#v###J!" •~;'#~~#?F#~ g a ~ ~#_ O##~#
<br />L~ ~ ###### '
<br />~ -
<br />~
<br /> MEASUREMENT =.
<br />'I
<br />' - T. ' +~ k7 I "i ~?- ' «A D ~ '1
<br />~/
<br /> ~ ,t ~' _
<br />L
<br />, ' .. /
<br />I. ~ `U ~ 1 O O ~ .: PERMIt ~>
<br />/ ~
<br />IRJi#~I ~ _.er,II~####
<br />' ### O i #
<br />'~~
<br />" #~IO'O~I#'r
<br />' 0 ~. ?:' I G ~ Y S/tom'. HAB
<br />. f F LU i:NT GROSS YALU REOUIRE~IENTJ}; Y~r
<br />l5t !;m,r~p
<br />lY. I]r
<br />~ - ~
<br />J 7
<br />#1Q##~ v
<br />'9 •~ /, , G ,,
<br />C11 AtID GAEASE SAMPLE
<br />NT
<br />ME
<br />URE .IO###4#,
<br />- :3 ~JpID,####'
<br />+ - `I a
<br />'~ ~ ~ ~''#~4L!#4,
<br />'•
<br />s ~=
<br />~ -: ~#####
<br />[• ~•' I'
<br />
<br />~
<br />" n
<br />
<br />~
<br />tn~CS Ek1fi-GRAY I7ET AS
<br />ME ~~ -
<br />,_ Tr _. 3 ~ i
<br />' ~ NON" D (~ !)
<br />~9~
<br />li ~ `_~ ~ 6 1 O U ' PERNAt
<br />~~ ###I~ODb i>~
<br />'
<br />' i01R#:
<br />~~~ ### ~ I ;.- #~A..0' #'~~} #~# 014,;,
<br />~ j/~..s~, - ~ . -ii
<br />`~?
<br />-~ -, a` ~TIX ~A B
<br />1 ffL rN~[ O S Y FEOUIREI~iENT ~s; -
<br />~.~.
<br />~ `" i4~', #~##r ~d ~' AB '' .~T,"i' tl
<br />k`
<br />" L'*. ,~,
<br />H 0 N - ~ ' SAMPLE ~
<br />MEASUREMENT t######: ,i # ~#+##' C" ~. ~ t, '.#t##~#?D~
<br />, #'~,AI### f,`
<br />5 L U a~~ ~ ~
<br />1C'IaL hhCCYEHABLE ~ ; ~ , ~ ~~
<br />~ J •) ii C 1 O O '. ~% PERMp ~
<br />T
<br />I ~Ol 0:#4# ~
<br />"
<br />~ ":09?##L ~ ### r ~ # ~$1tr r-;
<br />T OHTdOM L TI'R HAB
<br /> .
<br />^EOUI,REI~EN ::: 1 ~ ,~x
<br />i~"' ~
<br />.I j,,, ~ 4«- ~
<br />F LGN, IN CONDUIT CR' ~. SAMPLE - :1,~#####. ~'W p~p ,~~] ,A
<br />~ ^ ~
<br />~
<br />J ~ ^ 1###~#~i
<br />L ~
<br />###### .;~###~#~ - t nL
<br />
<br />1'IC:U 'iFiEA78ENT'PLAN MEASUREMENT --r ~ YY t\] d i ~
<br />..
<br />i c :
<br />It V ~~ O
<br />9- ~ n.T -
<br />~ !~ ~~ r~/ FJ
<br />_
<br />:; 1, r~ J li ~ O O '
<br />~ y
<br />IR##
<br />4?0~1
<br />.'t F.OH~ ~' ~ ~# ~
<br />;
<br />~
<br />~
<br />~ .
<br />'~
<br />'}~ 4
<br />;y, ;, 't#014# ri,+;, ### ~ -B%` ~ISTAN
<br /> .
<br />iREOUIREIAENT T
<br />, I ~
<br />~,a
<br />f
<br />y .
<br />,
<br />p
<br />Jt;LIG:i, TOTAL
<br />' ~ SAMPLE w
<br />MEASUREMENT: .z t###$##'
<br />~ ., ._. _i r~.'F-'rk#.~#.
<br />eT
<br />, F ,
<br />P ~ ~ ; 9 '###~I#
<br />:? '_. .i'
<br />• x .~?R?Q4+P#
<br />C> > ..
<br />'
<br />.~/~ T 1'
<br />.. ~
<br />V '
<br />~ ~O
<br />V~I"1 L'
<br />~ ~~vs ~ o a ~ PEPMII ' w ~#:
<br />~ ~ '~ #0# ~ * n "
<br />'~ ~'" r:
<br /> '
<br />:REOU
<br />REMENT ~ ~
<br />o
<br />n #
<br />a
<br />~
<br />~ H8P0 Y n
<br />x ~ Y.]Y I~AB
<br /> M
<br />~
<br />~' n j. . r. ?y ; ~ ,Y
<br />%S ~
<br />
<br />Y
<br />..
<br />
<br />-
<br />M p i
<br />I;LI AND •;fiEASE - sAMPiE
<br />MEASUREMENT' .a?p#J}###"
<br />~ ~ u' '+'r '~ ,y
<br />- ~. +^• ,
<br />U' ;~ ~##~~#~'
<br />~ S~
<br />' Ir ###### ###### /J
<br />~
<br />~~
<br />J
<br /> _ ^
<br />, ~
<br />'?
<br />• -r .
<br />.J
<br />!I i4l:b 1 O U PERMIT ~
<br />~~ i# #.( "'I
<br />~
<br />'
<br />'~'l O~` a `~~ c"
<br />r'
<br />1 E$= ~ '
<br />Ir [~
<br />O:ay >~¢#~
<br />'4 }, # =~.
<br />~ ~}~
<br />~ ####
<br />~ #.. ###
<br />B/
<br />tSUAL
<br />
<br />V REOUIREMENT~ >
<br />'.
<br />.~ry
<br />~. • i
<br />-
<br />_ ~.
<br />-.i" dt rA 4?
<br />R
<br />~.
<br />/ ~
<br />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY'OF LAW'THAT I HAVE P ERSONALLY EXAMINED J
<br />~
<br />, TELEPHONE GATE
<br /> AND AM FAMILIAR WITH THE INFORMATION SUBMITT ~ 1
<br />EO HEREIN; AND BASED r'
<br /> ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
<br />~'
<br />Karla Rabuck OBTAINING THE INFORMATION. 1: BELIEVE THE SUBMITTED INFORMATION
<br />'
<br />J
<br />Utce Pre$tUent IS TRUE, ACCURATE
<br />AND COMPLETE: I AM AWARE THAT THERE^p RE SIG'
<br />NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING
<br />,
<br /> ~
<br />THE POSSIBILITY OF FINE AND IMPRISONMENT SEE 1S U.S.C.- 1 110D1 AND gTURE OF P INCIPAL EXECUTIVE
<br />33 U
<br />S
<br />G
<br />1319
<br />• 6O8 754-2291 92 07 30
<br />
<br />TYPED OR PRINTED .
<br />.
<br />. J
<br />(J4nalNrx under Ihar rrarurer may /nNudt,
<br />Jlb uP;ro J/9,p79
<br />d ormui
<br />m
<br />A
<br />L
<br />M
<br />d J
<br />IL'OFFICER OR AUTHORIZED AGENT A
<br /> an
<br />mu
<br />rmP.uonmrnr o/
<br />errnn
<br />monr
<br />On
<br />r,vn./ O NUMBER YEAR MO DAY
<br />~v~.~~r. ~,. i i,i.v cn~l.,~,n~ IV I• V~ /.~~ r YIVL/,IIV IYJ (R[J~R/IR nrr prlUCllTlnlS n[I[/
<br />(.il f Gti%aSE: SEE FOOTNOTE F/, PAGE 3 IH THE PEAMIT. FOAtlEALY DISCHARGED UNDER CO-0035b53.
<br />EPA Forln 3~2[I-t(Rev.9-0t1)P/eYIOUS BdIlIOn3Tney DB UBBd. IREPLACESEPAFORM T~ID WHICH MAY NOT REUSED.) PADE lF
<br />00030/510123-1657 1
<br />
|