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PERMIITEE NAME/ADDRESS pnc(ude Fariliry Namellaran^n if 0,$ertmt/ <br />NAME r-Y Phi}i "vp.P: ^r•~,lnq rr~, <br />ADDRESSp{C[.F. !!I~'.° 'O"'7!.F'! <br />P.{l. R7T FR <br />FAauiv <br />LOCATION <br />dT iG: b,: .,Y"'P ; -• R.P. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCNAR GE MONITORING REPORT (DMR~ <br />(!(- 9) <br />N I <br />RMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO ~~ '~ <br />(za2n ru-zsl /21-251. - (2F2n (2&291 (3631) <br />Form Approved. <br />OMB No. 2040-0004 <br />' ~ ~ ~ ~- Approval expires OS-31-98 <br />!'•~I''~ ~~~) <br />NOTE: Read Instructions befo) o I letlng this form. <br /> (3 Card Ony) QUANTITY OR LOADING Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (4653 (54.67 3845) 48-53 (54-61) EX OF TYPE <br />(32)7) <br />AVERAGE <br />MAXIMUM <br />UNI <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNRS <br /> <br />(8160 ANALYSIS <br /> <br />64-68 <br /> <br />69-70 <br />:;. L_';I ±. f.; !' SAMPLE .aa sa .. :Y.. ': ,Ar$^•r ( 1'1) <br />C'TSc•OL'1:,'' MEASUREMENT <br /> <br />!li ,.'vy 1 n 7 :-" PERMIT k>k# ~.y ,. 111FP.~'Og'S' 7'~'•'Y.S ~fIL ~'- 7"~[~.-~ ~1 - <br />$~ <br />EF~i.I]F:T ,N0S5 V4r,n #1~OUIREMENT ;i~`a <br />_~ >at.^.* ^., : <br />t"~"s ~± <br />g~ rope fe1 °G ~` € . <br />. <br /> ~, , • ~, ~ { /1 <br /> SAMPLE <br /> MEASUREMENT <br /> -`PERMIT <br />E - <br />~ ~ ~`° <br />`= <br />- a ."~ .~-~ <br />-" - <br />°- <br />-u <br /> f{~QUIFiEM <br />NT , <br />>ir _ ,(~. ! <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> q r, <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT a '- "' ~ <br />T ~~ <br />' - - <br />~~ fix` <br />~" - "' <br />` ~ ~)' <br />- <br /> REQUIREMENT =~-~ ' ~ '~ <br />E <br /> SAMPLE <br /> MEASUREMENT <br /> HERMIT ~ '~' '~g--' I <br />- <br /> REQUIREMENT _ . ~ - ~ ~ ~ ~ ~' <br />' - <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ "* r' . <br /> REQUIREMENT `~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT " `' <br />~ -- - <br /> <br />REQUIREMENT <br />~ <br />~ ,'f <br />~ <br />~ <br />= _ <br />- <br />NAME/TITLE PRINCIPAL EXECUTVE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSO <br />TTED HERE <br />ATION SUBM NALLY EXAMINED AND <br />IN <br />AND BARED ON MY TELEPHONE DATE <br /> INQUIRY OF THOSE INDIVIDUAL ; <br />I <br />S IMMEDIATELY RESPONBIBLE FOR OBTAINING i ~4 1 <br />Richard Mills THE INFORMATION, I BELIEV <br />ACCURATE AND COMPLETE. E THE SUBMITTED INFORMATION IS TRUE, <br />I AM AWARE THAT THERE ARE SIGNIFlCANI <br />I <br />~ i~ ~ . ~ ~ <br /> <br />970-87D-2712 <br />' ('-.. <br />-~ rj 4^ <br />` <br />FnvirOrlTn9ntai fL~8f10gPr PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUD <br />NG THE ~ lJ ( 1 l <br />I <br /> POSSIBILRY OF FINE AND MIPRI SONMENT. SEE le U.S.C. 4 1001 AND 33 U.S.C. SIGNATURE OF PRINCIPAL EXECUTIVE <br />TYPED OR PRINTED meximum~p~anmen~o ~tweenemorrch^~i enld5u~nes upro510,o0a ends OFFICER OR AUTHORRED AGENT NUMBER YFAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all eTlachments here) <br />Ii F. T'T L:'A NT. ~~ ;'11.1^,- LT"71' .:crC;'D cnu ?LAY°„?'1 '~1 `.t n?f'CID 'Vr`1T-~F^ *.4. ~, ~ 'v~ ,moo ;. onnTnr. MCrq~, :.ATT. , <br />~Hi•:r1SF, ~>'aH Sq~~Lf p,~:P-I.'!SI` rr~~'![c~.~ v yTgTo c eucr nerra;o ~^•r <br />I. L N [~ O q, or7 ~r.~~.TuP TAFSrpgrrrr'yi-i.-.ne <br />u.- <br />EPA Form 3320-1 (08.95) Previous editions may nol be used. (REPLACES FPA FOfiM T~0 WHICH MAY NOT BE USED.) PAGE OF <br />- - - - - - - -- --- - -- - - -- - - - - _~_- QR741f/i9~0+112-1523 t <br />