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PERMITTEE NAME/ADDRESS prre. irdiryNw/lacanan ypI>f...+q <br />NAME .'..Y P,J_ .~ L .., ,._ - _. <br />ADDRESS KI(i".5 1+' ; i $nf• n..~ ";:~: <br />. 9d i•PU 'P~_ "I`J r'Rt1 ^i •(`r... <br />FACILITY <br />LOCATION <br />NATIONAL POLLUTANT DISCHMOE ELIMINATION SYSTEM (NPOES) <br />-~ - DISCHARGE MONfYORINO REPORT IOMRI <br />• 11-I61 17-191 <br />. _ _ .70!12715'1 ^%n <br />PERMIT NUMBER DISCHMGE NUMBER <br />~ ' ~ 1 ~ ~ MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM .1 TO I <br />0.L 4 T ~' V I]0] Il !]L231 !24751 l26-771 /78-191 !30311 <br />.. _ .. _ , F ... _ _ .. <br />l~•r-IO •;1 <br />c _ c - 4 T. <br />.., -.-~ <br />Form Approved. <br />~. r)OMBINo~ 2040-0004c n <br />Approval expires 05-31-98 <br />1 1 <br />NOTE: Reed instruetiane betor c~etinq thu form. <br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING !I Grd Onlyl QUANTITY OR CONCENTRATION NO- FREQUENCY SAMPLE <br /> !06631 1566/1 136-15I !46-53 150-6/! <br />EX OF <br />TYPE <br />l37-37/ ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !61.691 !66661 169-701 <br />:ir0`:+ ".'~,..-. SAMPLE ~}C:'tr #,'-!`C;:.^ ;:#'a'Rf• ( '7\ <br />1 E ~ :~:.) MEASUREMENT <br />J1JLS - f ~ M PERMIT C':Y~L`rYr v'~i;R#~: ~ ': ,k. }rtTd?tc 3.5 : IR~?I ;RAfI <br />-r:'i,U i I-'. 7`.i .° YALUE REQUIREMENT - to-^,t '= 7!1 ?lb AY° "~;TLY NY "IG/I. I'17N i <br />,'i:11;, I~~' C:'1; n'1 _Tr ()1: SAMPLE ( )1) G3.-•~^t: .. Y..Y ~#... ;f.. Y..,.. <br />~'! u U T '. '.: ~i"" ? N ° ?LAN MEASUREMENT <br />iJ:)j(: L C ') PERMIT 'JF;~OT{p ]PTIOAd.L 'X~#X"a# ~~~~~` 'kLz=pY,~r. -.r t F!?RL° 'NS°~" <br />"t'LUr.+-~[' ~N?5" VALUE REQUIREMENT aU;)A xV ~ p.lILf *!X 0CJ ~ ~ i=4'•= <br />J.L AY: ;ic'.0~' SAMPLE '.Y:~^•;e ;: ;: ( ~l) '.:': •;. •:yf ..: r: i,!#Ot=: t+.w~.... t: <br />+' I ~ :I .~ L MEASUREMENT <br />.i J: LT ,L L U 0 PERMIT ##RR#R I F.,=1 :r.:"'r,~;: •: ..`-'':-F,t:~:! #"~t'~"~'-c <br />' .. S cs^L"" i5';FT. <br />':, 7~::'i: GRJSS V1L'J: REQUIREMENT IY$T •AR :JQ=O ~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ' <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTI <br />MA FA FY UNDER PENN.TY OF L <br />MILIAA NATN THE INFO AW THAT 1 HAVE PERSONN.LV E%AMINED AND <br />RMATION SUBMITTED HEREIN; NVD BASED ON TELEPHONE DATE <br /> <br />MY INQUIRY OF THOSE INDIVIOUN.S IMMEDIATELY RESPONSIBLE FOR ~ <br />Richard ivlllls OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS <br />T ~ //I~`' <br />~~ <br /> <br />l <br />l R <br />E <br />i <br />IIICLUD MG <br />SIGNIFICANT iENALT11E3 FOR SUBM TING FN SE NFORMATIbON vl/' <br />(970) B70-2712 <br />f3 <br />21 <br />98 <br />anager <br />ronnnenta <br />! <br />nv , <br />THE POSSIBILITY OF RNE AND IMPRISONMENT. SEE 18 U.S.C. 1 1001 AND 37 _ <br />610NATURE OF PRINCIPAL EXECUTIVE <br /> U.S.C. 1 1316. IArWtl.. r+Ww IArw mM++ m.r ~+ ixw+ ~ ro S IO,OW AREA <br />TYPED OR PRINTED +nsnmulla+n YnA+le+wwnr or Mnrwnem+nN+W6y+val OFFICER OR AUTHORRED AGENT CODE NUMBER YEAR MO DAy <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IReterence ell et(schments here/ <br />,', T.^FRNAfF. L'"TrS =^3 T~C', 74'J17 S°TLi.?lOT.° ~JLIn° (Li.^. ')t) -T,v n„Tv T~ :- '^-°'. ~q_n. ,.n;C7D <br />r <br />IS CLA Z:1 EG. -. I.3+' r '' J r - ?fir: -+c~r ~v~-n'^c~ '1T• ~ F•^v q.- _F nr~~r ri my f•/ n~- ~• <br />-amD}V b M'fr T~' ~ O: f`/". nT.)- T~': r'>'I~nTnu ^,~r-~n~~vnm: n. <br />EPA Form 3320-1 108.95) -Previous editions may be used. (REPLACES EPA FORM T~0 WNICH MAY NOT BE USED.) PAGE OF <br /> <br />