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PERMRT6E NAMFJADDRESS ((nclude Faci(iry Nmne/Locadon ijDige.enq <br />NAME tlOMI t. q;•"', II^ I t ~I r•, ; <br />ADDRESSgOJIf: ti:~. <br />FACILITY PAU.rIA C`~ ~91U2R <br />LOCATIO <br />our. co sluz=l <br />.. 'C TN: rI LLf 9.1 k. ~~ ~1~ .1-_ vrNS n_~.r <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR~ <br />Tz-16) (1 ]- 9) <br />-~ ( r ~ F r <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM ~? 0 3 0 1 TO ~ ~ O 7 3' <br />(zazf/ (zzs3/ (Pass) (zs-z]/ /z~zB) (3oari <br />Form Approved. <br />~ 140 P OMB No. 2040-0004 <br />pproval expires 05-31-98 <br />(5'194 4C) <br />- - FINAL DSLTa <br />15('Nr ('c eq Tr; L`LFA "'RA??. h[CN <br />NOTE: Readlristructlons before c~orTpleting this form. <br /> (3 Card Ony) QUANTITY OR LOADING (a Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53 (54-61 (38-05) (46-53) (50-61) EX OF TYPE <br />(3z-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />(sz871 Ava-YSIs <br />(64-68) <br />69-70 <br />.iIL AvU ~; t.!? SAMPLE ,-'SL=YRG ( 90) hA,~~~,. .:: r.:~~^- ..,.. „ <br />V ISU A I. MEASUREMENT <br />ilUOtib 1 I. D <br />PERMIY ~ a <br />'~#E~f! g <br />~ 65=1 01 <br />" rz ~# 4#?61N~II~P 7#~ ~~ <br />LPFLUcr?T .ti'l,5 YALU REQUIREMENT P k `'`°' AO=U ~ ' *#-.:r <br /> SAMPLE <br /> MEASUREMENT <br /> ` <br />*k. t <br />,iU!'ItT'~°~, <br />e <br />~ <br />~ <br />4 as <br /> <br />~' r rvy>~ <br />f ++ <br />~ {~~ <br /> <br />a <br />t e1M1 <br /> <br />{ ti ~ ~. u~, <br /> <br />S ' <br />%s <br />li"~ <br />" a <br /> <br />y`' <br />~ <br />i > , <br />t <br />' <br /> <br />;?' <br /> <br />Ge+,R+u„ <br />r <br />'N <br />' <br />T &++~ <br />~s~e r <br />t ;'M. <br />.- . <br />. <br />,~ ~` <br />. `Y^ ~ <br />~ <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> SAMPLE <br />MEASUREM <br />NT I <br />/ <br />` <br /> E l <br />(i )S~ <br />j~r~ ~ <br /> PERMIi'",~~ ~~ - - - - ~ - - - <br /> REQUIREM~N;(' ~,,, <br /> SAMPLE <br /> MEASUREMENT <br /> <br />fRINI ri ~bk.~ <br />~ r,,., F•] " <br /> ENT - *, f ~ ~ a t <br />•~ ' <br /> SAMPLE <br />• MEASUREMENT <br /> ` p MIT 4 <br /> =AEf~U~EMENT <br />v: <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT. ~; <br /> gEQUIREMENT `' ` _t:. <br />NAME/TITLE PRINCIPAL E](ECUTNE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSO <br />ATION SUBMITTED HERE NALLY E7(MAINED AND <br />IN; AND BASED ON MY TELEPHONE DATE <br />~~!/L ~ ~~ ~r ~ E~// ..~r INQUIRY OF THOSE INDNIDUAL <br />I BELIEV <br />THE INFORMATION S IMMEDIATELY REBPONSIBLE FOR OBTAINING <br />E THE SUBMITTED INFORMATION IS TRUE <br /> <br />, <br />ACCURATE AND COMPLETE. <br />BMITTIN <br />, <br />I AM AWARE THAT THERE ARE SIGNIFlCANT <br />G FALSE INF <br />RMAT <br />N <br />D <br />N <br />THE J~~ <br />n <br />. <br />' <br />- <br />' PENALTIES FOR SU <br />AND IMPR IO <br />, INCLU <br />I <br />O <br />G <br />ONMENT <br />EE <br />N <br />(~7 <br />S~ ~ <br />eJ <br />r~ <br />~~ / <br />( <br />[~ <br />~[ <br />/(/~ <br />j/L~//~ j POSSIBILITY OF FINE IS <br />. S <br />1B U.S.C. 41001 A <br />D 33 U.S.C. <br />fi SIGNATURE OF PRINCIPAL EXECUTIVE J • <br />J <br />- (- G~ (~ <br />TYPED OR PRINTED nes up ro Ef0,000 end w <br />mexlmumlmp sonmerrt o/belle nNem~hs ~SUde <br />yews.) OFFICER OR AUTHORIZED AGENT <br />o <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerance all eaacnmenrs Here) <br />ry~dil'LEAf'LL SOLI `S (.i'!I.' 4Pi'f,i~"~ 0'~`L4 LP <13YR~7,UNR PRfCI° F.VFVT IS CLAI"!°`~. T? CLAI11 APPP.OVF_^ 3Y V CG, <br />,l'SS E I3(lh LI"1"t i1(1 ~1T +'' F1'PLf::a °0 RF'POkTEC 'ioA:iUF,S'!ENTS-,4R T. A. 7e ^G 5 PO? 97P.DcN OP PRJOF' <br />EP m 3~§U-1 0~-9 Previous editions may riot be used ~ ' ' ~ ~ e (FIEPIJICES Ay FO 7a I Y O B .) ~ ' ~ ' " ' ' e ~ ' PAGE OF <br />n^nn~io~n~l~-> » > <br />