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PERMITTEE NAME/ADDRESS (IweLL FrWryNr/fau+s l/D~ew)
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<br />ADDRESS DRAPER D
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<br />co ese7r-
<br />FACam
<br />LOC/nONYeYDEr CD E11630
<br />eTYY: G. EsUO BRDYY, GErERAL lSArAGER
<br />NATIONAL POLLUTMT DISCHMOE EDMINATION SYSTEM NPDESI
<br />DISCHARGE MONRORING REPORT /D R/
<br />11-161 17-191
<br />r 'n » n+
<br />°~ PERMIT NUMBER D13cNMOE NurAeER
<br />? MONITORING'PERIOD
<br />YEAR ~ NIO DAY, YEAR MO DAV
<br />FROM _~. O1 02 ~TO. ~A9 03 ~ 31. .
<br />110'1'11 !II-131 114151 ;,,.t., , 116-171 118-191 !36311 .
<br />Forrn Approved.
<br />MB No 2040-00D4
<br />SE.D. POYD DSCGH T~+ '~+~~K.~IFrQYY
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<br />(5UDR rY) 1234'S ~,~'`,~
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<br />NOTE: Rsed IrutTUetlom bslw Oln Ietlnp thM form.
<br />41
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<br />PARAMETER l3 Grd Onlyl QUANTITY ORkOADIN O . ~-'-~~±`~ '!i and Onhl- QUANTITY~OR CONCENTRATION ~ NO, FREOUweY SAMPLE
<br />131
<br />37 ~ 146-531 1546 _'.T: ' 138-151 !46-53 l6L61/ EX
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<br />/
<br />AVERAGE
<br />MAXIMUIN'~
<br />UNITS`
<br />MINIMUM
<br />AVERAGE,
<br />MAXIMUM
<br />UNIT&,. S
<br />1e1-sal MN.Y619
<br />151-681 TYPE
<br />159-701
<br />SOLIDS, TOTAL SAMPLE +dtrtraatr aatrtra,x atras#~ t.l~) '
<br />5U$PErDED MEASUREMENT
<br />00530 1 0 D PERMIr tr4«+aalx: .'.~a~,•:xr..>l aaa
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<br />EFFLUeili GROSS rALUE REQUIREMENT
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<br />NAMElTITLE PRINCIPAL EXECUTNE OFFICER I OERTI
<br />AM FA FY UNDFR PFNN.TY OF L
<br />MILIM WITH THE INFO AW THAT I HAVE PERSO
<br />RMATION BUBMITTED H NALLY E%AMINED MD
<br />E
<br />E TELEPHONE DATE
<br /> R
<br />IN; MD eMED ON
<br />MY INQUIRY OF TH09E INDINDUN.S IMMEDIATELY RESPONSIBLE FOR
<br /> OBTNNING THE INFORMATION, I BEl1EVE THE SUBMITTED INFORMATION 19
<br /> TRUE, ACCUMTE MD COMRETE. I AM AWME TNAT THERE ME
<br />SIGNIRCANT PENN.TIES FOR SUBMITTNG FN
<br />SE INFORMATION
<br />INCLUDING
<br />~~
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<br />!
<br /> .
<br />,
<br />THE POSSIBILITY OF RNE AND IMMOSO _
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<br /> NMFNT. SEE 18 U.S.C. 1 1001 MD 3]
<br />BIONATURE OF PRI pP
<br />E V
<br /> us.c. f t]te. /AII.WeYF uMw tlua mnma n+.r inchdF rss ~ ro 110,000 AL
<br />XECUENE AREA
<br />TYPED OR PRINTED .,re.,.~.,.:.w,,:~al>a.,,,,rtaan...,, en~a,.we r..~l OFFICER OR A oR¢ED AOENf ODE .NUMBER YEAR . MO DAY
<br />D ArvU CArLq RAI I I V N V h NN T V IULA I I V NS /Refs/BOCe e// BtfeCnmeefS AB/6/
<br />TSS G IQ01t LIdITS PILL BE YeIfED ANU SETTLEABLE SOLIDS LInIT APPLIED FOR <=IOYR,24RA P.1~'CSP E-EIFT; T55 F.
<br />IROY LiNI1S YeIYED FOR >lOxR,2uMR PB£CIP EYErf SUBJECT TO SUROEr OF PROOF Ir L 1.2. p 8.6RLASL=SEE
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<br />EPA Fwm 33 O-1 108-961 Previous editions msybe us` - IRFPLACES EPA FORM T40 WHICH MAY NOT BE USED:I ~ PAGE OF
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