Laserfiche WebLink
RERMITTEE NAME/ADDRESS pM~4irmry Na/ranrm pD~.rmq <br />NAME .pQNU1:Rti'J Kh IUhL i:~1Ma'eNY <br />ADDRESS BOA~OSZaE riINE, N ,~, S PORTALS <br />P.U. HOI 1430 <br />FACILITY <br />LOCATION <br />ATTNi JOHti A. r.~:~AnF F~sL'S1LEAi <br />NATIONAL POLLUTMT DISCHMOE ELIMINATION SYBTEM (NPDES! Form ApprOVed. it ~ <br />DISCHARGE MONRORINO REPORT (OMR! 1 • <br />!?-, 51 - __ ,7T91; -- . _. RoAns.~rE e3!1 3o c --- <br />0000 714 {5UBfi YC) """~~ .~)t°~ '+ <br />PERMIT NUMBER DISCHMGE NUMBER F- F I~ A L <br />~'::-, <br />MONITORING PERIOD MI1+CR ' <br />YEAR MO DAY YEAR MO DAV ~ ~~1 <br />FROM TO #t°•`• HO CISCHAY.GE 1__4 ##r <br />!16?U r11-131 ,14151 r?6171 l18-291 l363n NOTE: Read inetruetirNle be1OlB completing this form. <br />RARAMETEIir <br />- ' - -- -- l3 Grd Onyl QUANTITY OR LOADING <br />- - !1 Grd On/rl QUANTITY OR CONCENTRATION <br />~ <br />~ -NOr ~nyT <br />- AM <br />r3?-371 1~6-531 /54671 138-151 MB•53 154-61) : EX OF TYPE ~~~: <br /> AVERAGE MAXIMUM -. -UNITS- - ~fA1NIMUM--- ---AVERAGE- - - -MAXIMUM-- UNI_TS~ mz•e.T Murss <br />!54581 Y59=7o1 <br />PH SAMPLE <br />ME <br />MENT .-. .-. .:F###;r# ;t#4S#9 <br />{ I2) <br />1/ .` - <br /> ASURE / ~ / / l <br />U40U L 0 U PERMIT -'k>~:~t0::k 'k3L~>7A010: ##:! (e.$' .' >aL1CII~$a0t' ~eQ <br />: ~; .BEJ[LY IWSIT.U <br />bFPLUENT L:k045 VALU REQUIREMENT :':`. '. ;: ###• li2.llY itlll::. '' c' : :. :,. .. <br />::::~ Y. 3f. ~'<.: 0 .i. ' <br />30L USY 'f UTAL SAMPLE .- ..-, ###### <br />~ <br />~ ####i# <br />'~ ~~ <br />~ s <br />4 ~9' <br />' <br />l/ <br />>U-iPEADEO MEASUREMENT ' <br />- ~ -CJ <br />; 3U I,_ <br />UUD30 1 Q .0 ::~.' PERMIT '?:~: L*#3, :~ .x ir+.'S~~M)7pS:~ ri#C G7L><t71~61'A:: :.~.: , '. .•:, ,.. . <br /> <br />LPE-LUEN'T Gpp$5 YLLU <br />:REQUIREMENT <br />~';... :::. ' <br />" ;; <br />,}8 /.°~~tG <br />:+aiil:~Y':!S :: <br />11G L' <br />',.." <br />$:: <br />:...:.. <br />itONF OT11: SAMPLE ''~4t. ;: t: YS#### ###### 19 <br />{ 3 <br />f <br />' <br />{pS F'E) MEASUREMENT ~ ,3 ~- 5 ,~ <br />~ / /! <br />~ <br />1J4S I 0 0 PERMIT #;„c~n •'::#~#'++# ##~ #s7A0A? j:$' 7xQ .N. ~$AB <br />FF'LUENT GR055 VALU_ REnl11REMENT #fiY7 <br />3'd~t .:A1fG <br />•DAI I: 'tfi <br />!16/L <br />- <br />:lidN'tN <br />:1 G$EA.$E SAMPLE :~+=#Y~-`~3 #-~+^•### #'-dL'### <br />~ 19) <br /> MEASUREMENT / <br />jsal L o U PERMIT '-•~=3L"i<#3 . ~~fF#~# #mu a~L>'iaw~+ asFO~x 2~?: .t " o>~~,IR ;ke6 <br />FrLUENT GROSS YALUE REnuiREN1ENT ###A 30D! ;d:1''G' ~.aS:t' ll.Ai. NG/L <br />68N2 <br />. <br />'LU a IN CONGO iT OR SAMPLE ( O3) #b#^•#+ #:##fit Rtr### <br />THRU TREAThERT PLAN MEASUREMENT ~!``L~ I I + ~ ~ .~ T <br />0050 1 0 4 ' PERMIT Ri:?ORT REPGRS #.#0##IIr #?p4*~AL: : ;::$..#..IPA~P>M ~ ##: <br />L.X <br />.R- N <br />,,TA <br />'FFLUEN? GROSS 9ALU REQUIREMENT <br />3oaA :'AVE. <br />O.ALLi lr:x': <br />ncD <br />:.. .: <br />>". ':..:.; : <br />:r:,`,'..:::..' :..' ', <br />*### <br />~ <br />' <br />.i a ?O A SAMPLE :#~?## ##?##O ###### - jy <br />{ ) <br />ISSOLYEO MEASUREMENT ~ ~ Q ~/JC ~J~~ <br />70295 I 0 U PERMIT %Y°.L##~'."' :fIR7:t irr#'# ##ti: #IpC+',7-~"-lt N FQ~'T $B ~C$'¢.. ?RL.~ :j1AB <br />'E'FLUL'NT Gk0$S 'iALU REQUIREMENT. ##'Y-# CRTS~ AYCT QR:?F lIAY. tiG/L <br /> SAMPLE - tF#i'.it-# { 94) ###### ~+P4o~~fi - ed#>}p+Y - <br />1S U A L MEASUREMENT ~ ~- ~/ 7 ~/, <br />4 J66 1 O 0 <br />,,.... <br />::. PERMIT...: :. ~. aGC:plgc... ::. <br /> <br />~ :...:, Q,R $$'~ ~~ <br /> <br />. ES=1 .~.. .;k ~#•!.#t#+0~.. _...ilA 4' iF#'... ~-:: 1QIi1.+/0+B?M° - ~~# -- ~:~.'~ L7 TSUA~L <br />'.FrLUEN7 6RUS5 VALU .REQUIREMENT ~ : ~~ ~. I857'~~.:_tl;l.~..:: M0=0 ~ ~ ~ ~ #### ~ ' <br />NAME/i1TLE PRINCIPAL EXECUTNE OFFICER I CERTI <br />AM FA FY UNDER PENALTY OF <br />MILIM WITH THE INFO uW THAT I HAVE PERSONALLY EXAMINED MD <br />RMATION SVBMITTED HEREIN: MD BASED ON TELEPHONE DATE <br /> <br />E, (.1 ~ C V P ~ MY INQUIRY OF THOBE INDIVIDUALS IMMEDIATELY RESPON98LE FOR <br />OBTNNIMO TXE INFORMATON, I BELIEVE THE SUBMITTED INFORMATION IS <br /> TRUE, ACCURATE MD COM0.ETE. I AM AWME THAT THERE ME <br />INCLUDING <br />SIGNIFICMT PENALTIES FOR SUBMITTING FALBE INFOMIATION <br />'I <br />1 <br />A . <br />T <br />E POSSIBI <br />TY <br />1 MD 3 <br />E <br />T <br />E y <br />u <br />/ ~ l~s y~~,~ n~ <br />' ~~' /) <br />~ <br />` ' r H <br />LI <br />OF RN <br />MD IMPNBONMEN <br />. B <br />E 1B U.S.C. ! 100 <br />J 610NATURE OF MIINCIPAI EXECUTIVE I L L <br /> U.B.C. 1 1 ] 1 B. IlylraY. I~W.r eLw .bNh..vY ~.~. rwA Ip ro t 10,000 AREA <br />~- TYPED OR PRINTED A,s or m.rilNm inpiawmrrrWArrwwnemmeu rwelwal OFFICER OR AUTHORIZED AGENT LODE NUMEIER YEAR MO DAV <br />:- <br />`-~ <br />COMMENTS ANU EXPLANA nun yr ant YtULA I Iona ,nererencs err e[reenmenv octal , <br />CHI:i UU'CFALL IS NOT ELIGIBLE FOR EIEtlPTI0N5 F$OM TOTAL SUSPENCEC 50LIC5 {T55)F 70TAL (RUN AND/OR <br />~E'i1'LEAHLti SOLIDS LIRI?ATIONS - SSE I.A.2. <br />EPA Form 3320-1 108.951 Pravlous ed10ons may be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.1 0 v 3 2 2 / 9 H L 2 2 3-12 $ 6 PACE lOF <br /> <br />