|
PERMITTEE NAME/ADDRESS (/riidr FrelryNw/Loranen 1/Dlp .nq
<br />NAME ., ,~ P a U ~ ~ ~ ~ `' l L T ~ ~ '
<br />ADDRESS '!O1 S$ L/c'. ~ ±'311''"'F [ ~.. .:•. ]•.
<br />FgCILITY `~-'
<br />LOCATION
<br />., .'i Ti7 v; l)„hT~ '• .'CL^4 ^`'qc?.L ~ 'JT
<br />r
<br />NATIONAL POLLUTANT D19CHAROE ELIMINATION SY9TEM INPOES)
<br />DISCHARGE MONITORING REPORT IDMRI
<br />11-761 117-191
<br />^)027]]4 In9
<br />PERMIT NUMBER DI9CHARGE NUMBER
<br />MONITORING PERIOD
<br />VEAR MO DAY YEAR MO DAV
<br />FROM I ".' 1 TO 9 ~ I. I
<br />!16111 l12-23I 111-751 116-171 178-191 !36311
<br />Form Approved.
<br />-~.~~ -„-IOF,QB•No.,2040-0004 -
<br />V _ -~ ~' • r ) APProvel ezPiree OS-31-98
<br />(l...l ,. r n.., L i 1 .
<br />Tr~~
<br />NOTE: Raad Inetructloru befor eorhQlatinp this form.
<br />PARAMETER l3 GrO OnIY! QUANTITY OR LOADING I/ Grd OnNI QUANTITY OR CONCENTRATION NG FREQUENCY SAMPLE
<br /> 146-531 !548/1 !38451 146-531 15b571 GF
<br />/3I-371 EX
<br />ANMY915 7YPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !e1-eel !54581 !63701
<br />v :'. SAMPLE ...'-IX:'Y :.`•'k ;:Y-`.:,X :: i,::t .'.:.',x'- ( T ]~
<br /> MEASUREMENT '
<br />::7=1v^, i 'J ? y. PERMIT r~?ff4;tR tr##tr-# : #~: ,*, rr.5 :,. d=•'.+#-` n.^ 4 ~I?SKf.Y 'RAr?
<br />.'LU~~; is GR:';° VAL'7~ REQUIREMENT ~ trr,.;:.
<br />'~ M+M
<br />7C RZ, .i,
<br />N11Y Trnn
<br />SL1
<br />OLLL_F _".)."P~. SAMPLE `",=T^-d: 2#4C'-1:# tr#~?;b# ( 1R)
<br />~ [J ~ ;; ;~~ ~ = ~ MEASUREMENT
<br />
<br />~C~iU 'J C PERMIT :##?Rtr '~##tr## fi :=~1 tr#rk$bss R°~ngT RkPORT ~ NC~?>' '8A°
<br />--~ CD'"'.:YT3 1"[~'~' REQUIREMENT ~ ~ !:#tr# ~rl^A AO'^ 9AT :T r'Y "..^/L MOPTH
<br />ALL: )$F °7T- iL SAMPLE Strw~Y.. ;:r:rt : +~..;~....~. ! 1?)
<br />,; U,, u ", 4 ~ ~ ~ MEASUREMENT
<br />:05317 ~ 0 '1 PERMIT t:: ~$.k fi•:t#r:;x .. ,;: r'Y:+: -fc ~A f .'7^+°/ ;.~Fa
<br />FFa.UniT '~R:`i=' :Fi Lx!„ REQUIREMENT :7 a,:;x{: ?Ilnp aV~ Tt51';y Ea n';/7. '90r: "1°
<br />:UL•IDS/ .. :(T`f."l.'~' SAMPLE .. ::'k ~;. o.x ^.-K. xr.. t.;r;p ;a~, ~ '
<br />>)
<br /> MEASUREMENT .
<br />L :1+45 D I 0 PERMIT .~`•R':.@I .C#Til1l#IR :T •: •: 7#'->v,;:'ar 'i ~nQ o... I^.~ W.;;%/ 'n.l ':
<br />_..;p ~13M hE r-~.~ any
<br />- REQUIREMENT
<br />
<br />~.:
<br />
<br />.. ~-
<br />
<br />..: ::k# ~ ^
<br />3-na eV:
<br />A4''TV !tY
<br />v'./L
<br />,. ~•. r.
<br />'.;LfDS/ ~:':'t.`.(,F SAMPLE .;: :r##M R#[:rtr;: t,#ix,e;:,` ( ';1
<br /> MEASUREMENT
<br />]l.`:iJS 1 U '` PERMIT R#4~R ~Y Cx t,•;:'x Y.•w-:: t,;A. ,. ;`-;t^M; r': nr{71~nm ~ nr; p7FT _'/ 77"l
<br />1
<br />~' Fi'6U : "_' :,RJS : 1 L0r REQUIREMENT tr~t=# ?pI? 1 AP^ DAILY Mg y? /L '1 ?'~'"'i
<br />7 .. iS ., l:A ;[; SAMPLE .. ~r:rv fir.: r.trr-r; :G -..; ~.-.7 a##....;.,. ( 1,~)
<br />~'t?~" _Xf3-;,~AV °"T"= MEASUREMENT
<br />~I115~5 1 0 0 PERMIT ... r:`-~ ..--::;;;_fi- .+x :.. ht: ^.a+:'t #r#',t,:r ti0 fl'iT?3 ;7A`a
<br />PP:.Jci:'~ vROSS YIL'! REQUIREMENT Y~i:~r,: I"^^~ '*4Y 'i-/[ '7vT
<br /> ,
<br />raU.' / t. . A SAMPLE -r F;x.^^-F~',`:: f~:;:;:rr is ( 1 p)
<br />(A~ PEI MEASUREMENT
<br />iIOaS 0 D 1 PERMIT ,-?~Y ~k~ 5: :x iA#. trG •' +: ^r: p;,c..,~~.., nf'T`n 0'r' ~rrr1.,..~ I l; f'L/ ''?`~.
<br />i;.': ::OwMEKTS .. !, :1. REQUIREMENT 3~7R3 L.V.: 7tAi LY' ?'~)` °'/[. !'.l!;T':
<br />NAME7TITLE PRINCIPAL EXECUTNE OFFICER I OERTIFY UNDER PENN.TY OF L
<br />AM FAMILIAR WITH THE INFOR AW THAT I HAVE PER90NMLY EXAMINED AND
<br />MATION 9UBMITTED HEREIN
<br />AND eA9ED ON TELEPHONE DATE
<br /> ;
<br />MY INOUIIfV OF TH09E INDIVIDUAL9 IMMEDIATELY RE9PON9BLE FOR '
<br />
<br />2lchard Mllls OBTNNING THE INFORMADON, I e0.1EVE THE 9UBMITTED INFORMATION 19
<br />TRUE
<br />ACDUMTE MID COMRETE
<br />I AM
<br />ME THAT THERE
<br /> ,
<br />.
<br />AW
<br />ME
<br />SIGNIFICANT PENALTIE9 FOR 9UBMITTINO FM9E INFORMATION
<br />INCLUDING
<br />Environmental I~1Dnager ,
<br />THE P09SIBILITV OF RNE AND IMPNSONMENT. SEE 19 U.S.C. f 1001 MID 39 ~ 970 ~ 070-27~ 2 8 2 ~ 9$
<br /> U
<br />E 1G1B
<br />9
<br />C
<br />P
<br />Wtl
<br />d
<br />'
<br />I
<br />l
<br />S
<br />O gIONATURE OF PRINCIPAL E%ECUmE
<br />
<br />T .
<br />. l
<br />.
<br />.
<br />Yr
<br />a u
<br />r e
<br />wr .sruroa m.r
<br />vlr.W ro
<br />rAW
<br />I
<br />,OW AREA
<br />YPED OR PRINTED Anarmuirwn Ynpianwlt or Mrwwnemanrhs r,ds rrnl OFFlCER OR AUTHORIZED AGENT CODE NUMBER VEAR MO DAY
<br />COMMENTS AND EJCPLANA710N @ ANY VIULAIIVN5 !Hale/BRCS a//etteCOmen[s /late!
<br />eLi`:R94T? LI''I°5 ;Ov 'x';'9r ._TP04 6 rRPI'L=49L i7LC6~ (:.''- 'Jr) Dn~v .-I ., T, ''• 'v ~- 1(T_yT. ]i~-,;• ^,PP^Tn -q~..
<br />Iv .:LA L'fED• ]r: °'T..A.~/ 'r' IR. 5'04 IJ~7`"I .~.F i'RJ?P .'~'1CT^o vr,,.r~~ 'T +c'r ~? - P't'~^" ~•r: v/
<br />-., .'.
<br />
<br />,•
<br />I V T~ I y <' l ar D f T l~ 7^ n n :; T T. T r' ~',+ +• T 1 v ~' ^. n ,• ~ n w v n/ / .
<br />EPA Form 3320-1 108-951 Prevloue edlUOne may be used. (REPLACES EPA FORM TAO WHICH MAY NOT BE USED.) - PAGE
<br />OF
<br /> n ~ t -
<br />7 / ~ . r• r ^ -, _ • ~ ] ~ 1
<br />
<br />
|