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PERMRTEE NAMElADDRESS Mr-r lr~ryMr<tr.pw /D{}..~.c <br />NAME <br />AOOAESS ~ .: ~. <br />. nix a~u <br />rAClLrrr <br />LOGTXW <br />MAT)p{At rOtSVfAIIT OI9CMN10! RIMwAI50M 11YfTW /INPOfSI <br />O18CHAROE MONITORWA REPORT (OAiR1 <br />PERMIT HUNKER asaAno[wwa <br />MONITORING PERM)0 <br />R MO DAV YEAR MO Y <br />FROM TO i <br />roan Apprme0 <br />AIRS NO : WG•W O{ <br />(:rJ yy .il) <br />~' - F:~h[ <br />r _, ~ <br />i <br />NOTE: R~~d MtrueUar Ntot~ oortpMNn9 thM lam. <br />PARAMETER OUA.NTITY OR LOADING pUALIiY OR CONCENTRATION NO. <br /> <br />EX rA[OUnln <br />Of SAMPLE <br /> <br />TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNTTS u{ALVye <br />_. ~ SAMPLE <br />MEASUREMENT <br />~/ t ~ <br />~ ~- <br />_ i <br />_ PERMIT <br />REQUIREMENT i L:.FL•F.7 <br />i _ ~~ ~ r ~ ~ <br />~ _ v( .rt:q rr~ . - `.~.~ Y._~~ j+! <br /> SAMPLE <br />MEASUAFMCNT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br />MEASUREMENT <br /> PERMIT <br />REQUIREMENT. <br /> SAMPLE <br />MEASUREMENT <br />~ <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br />MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> <br />~_~ - <br /> SAMPLE <br />MEASVREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br />MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br />NAME/TITLE PRINGPAL EXECUTIVE OFFICER "'"t' r""" "a"'" <br />OwMM.n!<. rnr A~Nw r fur• "s"'""""'i°'°I"d """' <br />r1r1w ~e v<aNwKr •~rT . m.w b{u! TELEPHON E DATE <br /> rs.wr. ITw pMMd A•rn~1 rryerlp {uM . V r•Mrr. tY InNw.r.rlee <br />w9Mt W. t~l w of iyuin M w Prrw w rww+..l.s rwM W tt+r<rw <br />w I.w< R~u'u O'[r<Ur rvptiOY f.r (LLrt1w{ p. {da<r.is~ W ud.ullm \ <br />\,~ <br />_ . ~ - <br /> <br />`T <br /> rMlttd 1L u tM fwt Mm. \q~Yty<wr{ MML Vw. r.ww. W rorylrY. <br />..rku. <br />I <br />w <br />n 4r wn.n+ <br />wJb M <br />~wra <br />t <br />b <br />V•t. <br />{ <br />/IONATIM[Of rRq/VAl [)[(CVTTVT / <br />TYPED~p~O .w. <br />. <br />{ <br />r <br />.i <br />.{ <br />. <br />. <br />nn, <br />r<r <br />u.ray rr pram. wnr....{uy«.r br w.r.{.fe4uer. OFnC[A OA AViNOR12E0 AOFNT A A NUM!!ER YEAR MO OAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS fA~/~r~ncr w~T ~h~chmm7~ Mr~l <br />:. . _. -., <br />EPA Pam 3770-t (R~v 1901 Preswv{ ednwrf may Do u{+a , .. .' ~ TIIISi 5_A,'(.~f(~plrtt PAGE OF <br />