|
I'ERMI7TEE NAME/ADDRESS (IneYlrAeWryNnr'rx.llu,VOrO 4
<br />NAME q};y.CA C7AL ~Gt.rAnY
<br />ADDRESS .' . l: w H J is ~: 7 ;i
<br />H.4YUt_'N CG 91639
<br />FAatm
<br />LoaT10NHAYJr. ', CG h15.3 :;
<br />ATTX: ~nE:.~ I:ITCitB;. Ji::. :KAY '.6:.aC '!
<br />NAnONAI PDLLUrANT DISCNAgOF ELIMINATDN tY9TEM ((NPOfSJ
<br />DISCHARGE MONITORING REPORT (DAfR)
<br />PERMIT NUMBER .. gseNARDENwBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM U1:: 1V ~(~,}~~ TO Ul 1'i .11
<br />:'z.~~_.
<br />f ',V ~.
<br />F' - FInAL k,:~:r
<br />'_:~^. FORD DSCGH TU GnA55Y Ck!(. '
<br />NOTE: Rrrrrd ImtrueNarr brrlor compNtlnQ lhb form.
<br />PARAMETER QUANTITY OR LOADING
<br />= QUa11 ty Or Concentration NO. uFNCr
<br />FR[o SAMPLE
<br /> i:r< EX c
<br />
<br />AVERAGE
<br />MAXIMUM
<br />UNRS
<br />MINIMUM
<br />AVERAGE
<br />MAXIMUM
<br />UNITS
<br />ANKTRs TYPE
<br />P"i SAMPLE
<br />MEASUREMENT r :; ^:s::u .44p 44?: P~ ~ .:: 4=..:k "
<br />' ~ 1.~ ~+ ~
<br />
<br />~ U
<br />~z
<br />- 1-li~
<br />)U~UG 1 J I ~: ~ PERMIT.. :~.?,:~a~:~~~•x.4 ~
<br />t "
<br />.~:p~.?:~!;~~i
<br />-
<br />~ '.,
<br />:.
<br />. (y~~i:~:~~,~a: r~s~r4.;:;C;:.. ;t .) ..:....;
<br />
<br />~ .~~:$/
<br />SIT
<br />
<br />,: ?I
<br />4 ~ r
<br />cirLU ..tiT G.'0 ;.5 YALUF REi]UIREMENT
<br />: ..
<br />.. .. ~...
<br />....
<br />{I Yr C°:) '?"`
<br />:~I.Y~I!I#,•:.:
<br />.: ~: ..~..::~.
<br />:~. y. n;t 'i);:`..~
<br />rU
<br />~?fi}y ~ti'~
<br />e 1. ~~., It: CDh'/L'I7 J4
<br />~ SAMPLE
<br />MEASUREMENT
<br />~(~-~--
<br />'
<br />-
<br />~ r ( 03r yr}¢D,}~ ar,: ~:.;lp~ .^-:?~k x:tU
<br />T a .: 0 C it ::.4 i" `
<br />6 T PLR 4 j +
<br />~ .
<br />]l/US~J I D i ~ ~ PERMIT ~ ~
<br />_}. 5::'0'T. G ~
<br />tip?u;i:. Etyllk~itk4 ~ •i',4•':"'t:. .~ .::~t:.z:.u~:±, ,:,:::~t
<br />r:N::F:/ c ,,
<br />Cy~fR
<br />LFFLUEAI uf.7~5 Y,1LG pEQUIREMENT ;;)i-;i.'V:: .
<br />tiAiLY :13( riL;a +=~T~ May3:H
<br />JIL 11Ni/ GIiEA;iE SAMPLE .'z.9=.u? ~ .,~) AI?F St O1k+P O{+q?f O?/ .14: ,}K: G':,
<br />y I g tj A L MEASUREMENT ~`'
<br />2f 4 U b v 1 U 1 ~ : .:PERMIT
<br />.. :: 'r C";•~ ;.
<br />:~ .. ~ ~ ,> „ r.:
<br />~ .~{; i~ ~i
<br />:.=1
<br />~ :q.:~e><;:~~...
<br />~
<br />..~_G~,~~,+(.~:~.t.:.
<br />;. t.:,e.,..xs~:.~.:
<br />.ua-x
<br />
<br />~
<br />Nt:.E/
<br />R
<br />L
<br />I . -. I
<br />-,FF'..UEN. GI:OSG YALU. REQUIREMENT
<br />.. ..
<br />;~
<br />.; ,:.:.. K. ;, ~.
<br />_
<br />\1'-U ~"~':~.. ~: ~~~ :.. ~ ,°~:xu : L;1.4'
<br />R:H
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIT .. ~ ... .: :.. .. .. ..
<br />~
<br /> REQUIREMENT ~ ~ ~ ~ ~ ~ ~
<br />~•~~
<br /> SAMPLE
<br /> MEASUREMENT
<br /> ~~:.~.~PERMIT'. .. ~ .~. ~~. ~ :. . ~ .:
<br />~ .~
<br /> :REQUIREMENT ..... : ~ .. ~ ~ .:..
<br />:....
<br />...
<br />.
<br />...:
<br />
<br />~.: ...... .
<br /> SAMPLE
<br /> MEASUREMENT
<br /> ~~ : ~ PERMIT ~ .. ... ..:..
<br />~..... ..
<br />..
<br />
<br />..::.
<br /> REQUIREMENT
<br /> SAMPLE
<br /> MEASUREMENT
<br /> ~~PERNIIT~... ...
<br />~ .. 't~...:
<br /> ~REaUIREMENf
<br />.. ~ . ~ ~ ~ ~ ~ . ~ ~ ~. ~
<br />.. :.. ~ . . ~
<br />~ ..
<br />~
<br />. .
<br />
<br />~~ .
<br />NAME/EIttE PRINCIPAL EXECUi1VE OFFICER 1°^"r° "r`"•Iro 1•"'^•"hh ~in1n1 in°i°•n.ch".^u .°^
<br />pny,M una.r m, aln<nen er,up.nlaoe In .rmra.nae wlln . ,nr.m aal[n,a -~
<br />, TELEPNONE DATE
<br /> m.w,. Iha qu.nnea Kroeea pmgar prnn.na r..wa. manrorm.nen / /
<br />~
<br /> mbmllrM. En¢d e" mr Inqulr, NNe Aron w pnpu .he mnn.[e IM ,Plelr~ /
<br />` `
<br />
<br />er Ihw perom alncnr mpe,.LNe fa plhean[ Ihr Infemullen. Ihanfmmnaen ~4
<br />\
<br />L_ \\
<br />'
<br /> arbmlllaa LL le the nvr er mT ArowYa[,.rla Mllrr, rme, n[tvnlt. and °emp4N.
<br />I.m.w.r. ua men.n aranrm
<br />n.me ro
<br />n
<br />lul
<br />Ntr mro /
<br />1
<br />N U ~ D I I
<br /> p
<br />r,u
<br />m
<br />n[
<br />ro.uen,
<br />I 8
<br />0
<br />ATURE OF -RINCIPAL E7fELYfrIVE
<br />TYPED OR PRINTED mlualry the pmaullllr or nn. nna Impan,nmenl rm Ln°.In[ aa.uola OFFICER OR AUfHOR12ED AGENT CODE NUMBER YEAR MO OAY
<br />..vmmu.,.a ..nv ..., .......,..... -. ..... -....,-..,vn~ rn.rvmw wr .nscnmm,a n.rq
<br />TES E IB~Iv LICIT +,ZLL ~: ~A1Y .= 4';,^. ;::".,~;,? L'~ ~CILID:~ LI°LT' APPLii;L ?OH <=1~YR,24t;1t ERECIP EVEtIT~ TAG ::
<br />IRUN LIl1IT5 rAZYED FUii >I:,Yh,-L~ih:+ t'l.`.CI'r 1Vc"17 SJi~,lr.'C: '".0 ~UiiDE:Y C)F FdJOF I!i I. r1.::. OIL E GRtASi:-SF.E
<br />EPA Fwm`J320-1 (]may 3/99) Prevlous'edlllons may lie used ~ ~~ ~ Tllis is a 4, an-form. PncE OF
<br />00104/Giv~l•1 iaS.. 1
<br />
|