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PERMITTEE NAME/ADDRESS!/rirdrfacdiryNrWfocanm I/D,p....p <br />NAyIE TESHJk CHEER ~JN?ANY <br />ADDRESS?ERdON CHEEK LOADOUT <br />1 1840 HIJHMRY 133 - <br />PAONIA CO BlUl9 <br />FACILITY <br />LocAnoN <br />AT?N: KELLY PkL~ZL'R, ~PE~iATIONS !1,P. <br />ELIMINATION SYSTEM (NPOE$l Forth Approved. <br />iING REPORT IOMRI ~; 1 ~ OJT t' U !71 1 0 §I o. O 004 <br />n-19~ ~ TJ h M.,~ ~.~~~~ ON <br />° U 6 k .~ C ~ Approvd e~~l~i0~31-98 <br />DISCHMGE NUMBED F- F I N n L 1 <br />ZING PERIOD NIN~R <br />YEAR MO DAV <br />To ~ , ao#:°MD DI SCRABGP.' ~yy~ r4;` <br />116-171 l18-191 l3P3 ~ Reed 8rehvcdaru 6e Eon cromplefinp thb form. <br />PARAMETER l36rd Onlyl QUANTITY UR A <br />~~ ~ l1 Grd Only) QUANTITY OR~rtQd iFJ1T10N NG FAEOUENCY SAMPLE <br /> <br />131-371 1I6-531 (5461 - 136-I51 146-53) 15b61 <br />- <br />EX of <br />Y3 <br />TYPE <br /> AVF,/,iAGE MAXIMUM ITS MINIMUM AVERAGE MAXIMUM UNITS let-6s1 MAL <br />15 <br />(64681 !69701 <br />a EASE SAMPLE #71 >:3:# ~ ~l) ;74Gc: rC 4tit,.. ¢# ,-:~4Y## <br />I S U A L MEASUREMENT <br />4U66 1 U is PERMIT :-1r%f OCt4 REP~H7 L E5=1 !~:~~Oi~: <br />~~ <br />~ a#gttx. ±4 ~4`R',r; t~ '.E4 yf y:..r," <br />;, <br />FF4UEN'T 'ROSS VALUE REQUIREMENT <br />- <br />ENST NAY <br />R <br />=0 ~~'~ <br />'°~~ ~ ~~ <br />+~#~~ <br />~ <br /> G .. <br />' . <br /> SAMPLE <br />-- <br /> MEASUREMENT ~ ~ <br />~~r . <br />' <br /> PERMIT . ~ ~ ~ ~' <br />~~~~ <br />~ ~' ~~ ~ ~~ <br />~ ~ <br />~~ <br /> .REQUIREMENT ~ ~ <br />~ <br />~" <br />,: ~~ <br />.. <br /> SAMPLE <br /> MEASUREMENT <br /> .PERMIT ~ ~ ~ K <br /> ~REQUIFtEMENT~ . <br />~ ::n <br />-: p: .. <br />~~y :. <br /> . .. .,. . ;:. <br />. . <br /> SAMPLE <br /> MEASUREMENT y -~~ <br /> PERMIT <br />~ <br /> ~REQUIREMENT ~ . <br /> SAMPLE <br /> MEASUREMENT <br /> ~:: ~. ~ PERMIT .i:. ~. <br />~ <br />~ ,. .~ :,; ~ .. <br />~ ~ ~~ :~ <br />~ <br /> REQUIREMENT ~ ~ ~ ~ . <br /> SAMPLE <br /> MEASUREMENT ~ ' <br /> PER.MIT.~ : ~ ~~ <br /> REQUIREMENT ~ ~ ~ f~ '' <br /> SAMPLE <br /> MEASUREMENT <br />~ <br /> "' <br />. <br />. PERMIT ~ ~ .. .. .. .. .. <br /> <br />s <br />4::~ <br />' <br />~' <br /> . <br />. <br />:REQUtR.EMENT. <br />...:~. ... <br />.~ ~~ <br />.. ~.'. ~::..~,.. ~. <br /> <br />v° <br />.~ <br />~ : <br />:; iw. f <br />~:~ <br />NAME/TIYLE PRINCIPAL EXECUTIVE OFFICER 1 CERTIFY UNDER PENALTY OF l <br />AM FAMILIM WITH THE INFO AW THAT 1 HAVE PERSO <br />RMATION SUBMITTED H NALLY EXAMI <br />EREIN; MD e NED MD <br />ASED ON TELEPHON E ~~ OATE <br /> MY INQUIRY OF .THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br /> OBTAINING THE INFORMATION, 1 eEL1EVE THE SUBMITTED INFORMATION IS .-% <br /> TRUE, ACCUMTE AND COMRETE. I AM AWME THAT THERE ARE <br />SIGNIFICMT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING ~% ~ i,~ <br />KELLY FR I TZLER , <br />THE POSSIBILITY OF RNE MD IMPRISONMENT. SEE 18 U.S.C. 1 1001 MD 7] / <br />R <br />INCIP <br />ECUT <br />E 7(1 ~ - <br />' ~ T <br />TYPED OR PRINTED U.S.C. f 1310. BMWfiF InOr IMr mNha ,nFY NcANN (NHS W ro F 10.000 <br />AMwnM,inwninprimlrrwlr FlWwwl6 mrndla rld6YrrA1 61GDIATU <br />E <br />AL EX <br />IV <br />~OFFlCER Oq AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />wmmtn I s AHU tArLANA I lun yr ANY v1uLA I Ions lFrererence sn ettscnmenrs here! <br />:;ETTLEABLE 57LIU5 LI!SIT APPLIES ONLY IP C= LJ-YR, 2U-H3 PRtCLP $YL'NT IS CLAIMED. IF CLAIM APPROYEO HY <br />YQCD, TSS CRDN LI!7LP5 .TILL KOT BC APPLIZD T7 REP08Tr~ '7 EAiUkL~!{Eai~--5 ° I.B,1A, PG 5 AND I.H.1D, PG 6. <br />STDRNYITRR MAOi :RM RMT DEAN nnlP 1-1 _aa. <br />EPA Form 3320.1 108-951 Previous editions may be used, (REPLACES EPA FORM T40 WHICH MAV NOT BE USED.( ~ PAGE OF <br />0160/970819-1254 Z <br />e.aH.yjr..... - -- _-- - _......I~:.~.;.IS.,.~wa!-;_ _~a~: -'~~-v,~ s~ _ ~~+1~-~-i..RM.. _ .- -- -- ~ - <br />