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PERMITTEE NAME/ADDRESS p~Jrislll0'Nr"La.nar UDIBE.sr) NAME TkA PPO'R MIMI N!;~ TNT. ADDRESSTHAYPF.R !IIN^ P.O. RDK 1:+7 L CFAI;, ~') R".626 ((~ FACILITY q' LOCATION ATTH: d. CORD y P'TEA.Sr PRF3/I~°"t N`:R PARAMETER !3 Grd Onlyl f97-371 10653 AVERAGE - STSPft F. Nub AC SAMPLE ~ :`CA7 NATIONAL POLLUTMT DISCNMOE ELIMIMATON SYSTEM /NPDESI Form Approved. DISCHARGE MONRORING REPORT (DMR1 r T R n P OMB No. 2040-0004 1.161 17-/9) •~ 7 ~ Z D 1 i ~ ~ r• {) q p h N) Approval expires 05-31-98 PERMIT NUMBER DISCNMDE NUMBER P _ p~ ry A T M ~ ~"' MONITORING PERIOD A' n~° V FT T ° ;"II:G FOR 011 ~ YEAR MO DAY YEAR MO DAY ~_} ' FROM - TO - .. fifi= Ni DTSCHA°!: P, ' j~~ #t~ I7411J 172.131 /7A-I¢1 ~ {16-Y71 179491 /343// NOTE: Reed InetruetlaFr befaereo-mpletln0 ~V form. TY OR LOADING /I Grd only! QUANTITY OR CONCENTRATION N0. FREQUENCY SAMPLE I5(-61/ 138-~51 /,653 (5461 OF EX ANALYSIS TYPE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS res-esl /e~-691 /69-70/ CskIO~~A?kNIA - MEASUREMENT TAgJb 7 U !) ;...:::~FERMIT.: ~.: •:c .. :#?X.L'k11k#. ~~~:~~ ~ r°.r. ... #~~.!. _O:~A1 0#R :::;::;.:~.. ~:.: '::~ ~~~ ~ .~ ~:Iltr:#IIIfS##~.: #fx~m:p#a.0.~:~ F.R- .::- .r.'i~LY _,.: ~R 3 ; EYFLUF.F'P ::455 't.U. ~REQULFiEM.E.Nt` ......:.. .: ~ : .......~. .- .:..:. ...~.~ .:...~ ~... ##33 .. . . ; . . . . .. L:: 0 :i i IT4F. 9f." ACI SAMPLE +FCO#fifi ##fiG^'# ~ . +tr#t x''400# ( ~7~ PTMF.PiIAL S MEASUREMENT ~ - ' 7 A N L C I. 0 9 ....: ... ° ERM~7; : i:.:.: :..`.i 43 : s;O C#~# .:: 003 ..r....fpy ::F.::.: ~. ::; 5'z s ` : ,:: ;r-##.Or# `i:~1!l:iR:::: V A - T R C. Y x:~1CiI1 Q::. Ln cPFLU£HT :;ROSS : ~,;, . .: REQUIREMENT' .. ~ *„; . 0043 . :... .. •: (~yF 1'~[Yii~P : kw3 r-FVT . . . , SAMPLE MEASUREMENT ' • :PER f,,«:;~: ... EN ' O ~ :.. .: ' ~ ~ ;.::.. sa>.: ~ ~,; :.: ~" U~.;~.~( c : : ;?;I"~;~, i.,:.; . I fiE UIREM .~ :. ~::. ... ; :. ..: s;.:. SAMPLE ~ ~ ~- ti MEASUREMENT ~'/ s 1^~ ~:.: PERMIT ~: :... . .:.... ... ~ •~ ..... ~ .: :. :. REQUIREMENT ..~~~ .. <:..... ~..~. ~. ~: SAMPLE MEASUREMENT ~ ' ,.. -. ;:,:.:< : i? ' , .: ........:.... :: ..HL . .:....... ....... .. .,..... ... . .... ..... ...:. ~,: ..r~~ : ..:......... :,.' SAMP41r MEASUREMENT ~ ~ - ` :PERMIS':~r: .:~ii~' ::.:... .. .. :: .......:.: .~:. .. ::;':..:. : ~`.; ::'~~ ; rs;:.. ^;. ::s i::, r s'.'~S ~`~~ ~ ~ . : . n, REQUIREMENT. . ' . . . . ~ ~ - , .- . . . , .. ,.. .. : . .. SAMPLE MEASUREMENT ::.;.,REFIMIT: ::. .... . ~ .:. ~. ~ .. :. .. :. ,:y.:::.. ~.....:.. .,. :fIEQUI.REMENT~ : .. :::. :. .... .. .. ..:... :::.~:: ~. ~:.~ .... .,. :.... . I NAMERITLE PRI CIPAL EXECUTIVE OFFICER I cERTIFr uFlow P NALrr G L^w NA AVE v ALL AM FAMILIM WITH THE INFORMATION SUBMITTED HEREIN; MD B ARED ON TELEPHONE GATE W. Gordon>PdC@IS My INQUIRY OF TXOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTNNINO THE INFORMATION. 1 BELIEVE THE Sl1BMITTED INFORMATION Is T E ~ ~ 970-u24-4401 60 01 27 1 M ) TNER ME TRUE, ACCUMTE MD COMPLETE. I AM AWME TNA SIGNIFICMT PENALTIES FOR SUBMITTING FKBE INFORMATION INCLUDING 8II8gd>• ~GeII@I8 Prd 9144171; , THE PoSSIBIUTV OF RNE MD IMPRISONMENT. SEE re U.B.C. E 1001 MD 31 eIONATURE Of PRINCNAL EXECUTIVE ~ U.S.C. f t GtS. r9eomn ludw• eNS mnma nvr heA.~1. r.I.a w ro s IO,aGO AREA ED OR PItINt'~ ..~>nrrYnun lgn'onlrN a/bnrrremanNS rM 6Ywa1 OFFICER OR AUTHORRED AOENi CODE NUMBER YEAR MO DAY COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Reference ell sffschmen[s here) PP I-QF FCR. D°TA[LS OF TEST PROCF.DU4E. R6P~R4 L SE° I.A.`L ^SO - STATT>TT'11. P)iNT °~T7^'7°" vsTl!'y IS E ST ~RGANISRS L6YHAL 1'ry 50'. ~F TP AND ATTACH ACUTE T~KICITT ~n^L°' TEST REPORT lr04!! TO T,Mi! np Sf L . , . . INPQB'1A1'FLIN RUST Rtt SPNT TO EPA. YRt'N YFT TP57iNf. BDT RV-O _ OfIT O/1 (1t RFf10iR ED-SnRF SCF R"+gn^r ~ ~yT r• ~p ,G I`. EPA Form 3920.1 108.961 Pravloue editions may be used. (REPLACES EPA FORM T-40 MYHICH MAY NOT 8E USED,! o 00105/9angzl-103 PAGE OF t ~ T I N easox r ExAMINED MD E F T 1