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PERMITTEE NAME/ADDRESS O..~Id. FSWryNaWlxeum UDl~w..p <br />NAME r n ... M .. ~ .. _ .. - - <br />- -. _ <br />' rflr L "~- n^ i'll ~j <br />FACILITY <br />LocAnoN <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT IDMRI <br />11-161 lI7-191 <br />V PERMIT NUMBER DISCMMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAV <br />FROM TO ~'" <br />120-1 // lT1-13/ !1415/ I16-I7/ /TB-19/ 1363// <br />Form Approved. <br />--~ - i ~~~ - -nOMB•Noa 2040 ;0004.,, <br />r .) Approval expir~ a OS-31-98 <br />rr_ 7r 1 <br />• T.1- <br />NOTE: Reed Irntructlau balora completlnp this Corm. <br />PARAMETER 13 Grd onlrl QUANTTY OR LOADING I~ Grd On/yl QUANTITY OR CONCENTRATION NQ FREQUENCY SAMPLE <br /> (46-531 !54671 139-<51 !<6-53 I546I1 EX TYPE <br />131-371 ANµYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS /FT-6]1 /5466/ 169-701 <br />i.~',':F TOTRL SAMPLE <br />E <br />RE ~r4 r.y `.`y..:n~ -.,, .:fi._.:-'`' )f <br />~ <br />~ <br />r" u <br />~Q <br />~ ( 1T) <br />~ <br />/3 ~ <br />G~~! <br />(A~ p?) M <br />ASU <br />MENT r <br />1 / <br />J104S 1 0 w PERMIT :srwCRx ~4rRx'r ;#? ~#tr,:nw 7.5 ~.(' NCF/ :RA° <br />.F[LU dNT u!?O':2 !'~T. IJ, REQUIREMENT :A r:,}# ~(J ~, 4nr. }ITT.Y M)( MG/1, RT Tr( <br />~~,t.. IN CAN n"r nsl <br />' <br />~ <br />+ SAMPLE <br />SUREM <br />E <br />~lO~~ <br />(' .72 <br />Q <br />2~ ( )3( Ls al rlt3# #=k~;#•: <br />~ -~ <br />O <br />`~ <br />(L~rA <br />i <br />. `. <br />! <br />'.: R ° A C M F 9 f ~ i. `i'~ M <br />A <br />ENT . / LJ ` <br />7CO.iV 1 0 l) PERMIT R°P~N.° PTIO!fAL .`-aR#'p°-",] #A}Gv%kt:: '%+ Z"-~r•A ~'•'~ .F,.°.1CI,Y :.NSTAY <br />"'.U,;NT GRASS YAL7e REQUIREMENT 39p,x 9V~ 'DAILY '1X !7~~ ~'"`~' <br />:lii "->{ii :Y,EA~F SAMPLE :~C#4~ ( ~'J) ,..: rZ J..:.. w?.,: ~t~ .-;: 4'_:/-~r:'s <br />~/ <br />fT ;1; h i MEASUREMENT ~ ~/ 3j VISU~1 <br />J4(:~:. 1 Ct 't PERMIT ~~:R x~C ) Y ES=1 ~'?:x:~:;::t ,t •.;««.; ;«.., y; R?YI,y rTSt"' <br />I:vPi,U;.^ 6RC.SC 4AL'JF REQUIREMENT :~'.~m. I*15Y %AY, ;10=0 ~~~ <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 EXECUTNE OFFICER I CERTI FY UNDER PENALTY Of L AW THAT I HAVE PERSONALLY ExAMINED AND TELEPHONE DATE <br /> AM FA MILIAR WITH THE INFO RMATION SUBMITTED HEREIN; AND BASFD ON <br /> <br />MY INQUIRY OF THOSE INDIVIDUALS IMM WIATELY RESPONSIBLE FOR ~ <br />/ <br /> fin <br />~ <br />Richard M(Ils OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS !fir <br /> <br /> <br />' TRUE. ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE <br />SIGNIFCAHT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INClUO1NG //( <br /> <br />(970~87U-277 <br /> <br />~ <br /> <br />) <br /> <br />~8 <br />.4anager <br />Env(ronmental I , <br /> THE POSSIBILITY OF FINE AND IMPRISONMENT. SEE IB U.S.C.r 1001 AND 33 SIGNATURE OF PRINCIPAL EXECUrnE <br /> U.S.C. E 1]fe. fMnBlr. Wr dwr mnma AI.Y hchW 6rI„ w N 510.000 AREA <br />TYPED OR PRINTED rMe-m.rimnr inPHaumwlrWNnvwn FnNntlrs rW6rwA/ OFFlCER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY vwLA I wns Irrerennce an eTrsenmenrs oars! <br />HL`"~YNA7E: LI`T" F;)° I; :, Iu~fs .. ..4rTic19T ~~LT.n; (~~^ Fir) enFT,y .ic~.v rr. %_ 'r_vpr 7r;_:~? •~ur.-;r :rccn <br />~J. ,-.iAl :if). S'''~' T. 4. ~, ~ , c,^,° °7?9-•.I ~•. nc'1^,r Fc. ''JI°'.!~`Tr;~ ,.TT r'-rq'--rp .nrl^•I'1 ~_^ r~r -I^_ ~~ <br />[.TOt V -'eYb' T.1 Oc•Tln, T+•'/' TN ~ t^-.r^/•tT ^-~~~.~ nTr n• <br />EPA Form 3320.1 108.95) Previous editions may be used. T (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.( r n n r ,) / T ^ f ~ ,s 7 _ t ~ T C PAGE ~ OF <br />