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r_ <br />PERMITTEE NAME/ADDRESS N+re.F«my8«./t.«.non t/Dlpwa,q <br />NAME KEHrt ;;?RL ~D9PR'.y <br />ADDRESS t'I A H .1 !^ I :') 4. <br />k~.U. ~}X 713'1;1 <br />ST3~.^,5~AT ;Pa(N~; ~~ 80'!17 <br />FACILITY <br />LOCATIONaALULE J0 B0{yD <br />AfTh: G..Jrt~E V. ^RTTr"iiOYF !!I!V: tlGR. <br />}*- l,` ;,~ ~ <br />NAnoNAL;6dLEi7fANT IscHMOE [LIMINAnoNSVSrEM ~NP~ES% <br />DISCHARGEpMONITORING REPORT 10MR1 <br />I3 161 I7-191 <br />C)GBS 37 <br />PERMIT NUMBER DISCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR m0 DAY YEAR IYIC DAY <br />FROM i`1 0 TO yy '1L JL <br />!16111 (11-131 (14351 (Z&171 (Z8-Z9) (36311 <br />r~ ,T t: , <br />' ~ ~~~ FDT"m-Approved. <br />~ i <br />POND r/rRIQ ro ~~L&ht~7~Lz0RR4R: <br />(SUER NM) Approve1 C31'P~; i. 9~ <br />F - FI'iAL ~,. ; <br />r,INOa <br />*ft=: 110 DISCifARG° (~( ;<.iG <br />NOTE: Raed InatrucOolr 6elae completlnp iha form. <br />PARAMETER I3 Grd Onryl QUANTITY OR LOADING l~ 6ro OnlP! OUANTITY OR CONCENTRATION ND. FREOUENOY SAMPLE <br /> /34531 l5be11 138-151 346531 l5i61/ E% GF TYPE <br />!31.371 ANALYSIS <br /> AVERAGE MA%IMUM UNITS MINIMUM AVERAGE MA%IMUM UNITS Ie1-esl 154-581 /69-701 <br />L'ti SAMPLE ~ OpROtrR ,4G]SRn. :iC; :5:: ( I2) <br /> MEASUREMENT <br />uOUJU 1 U r, PERMIT aaaR?? xeaaa.Q z~:sa ,.5 ;'~-r.~ ~ 9.0 ESKLY .lISIfU <br />LFFLUc:N~f GRDSS YAL'J5 REQUIREMENT: :: ~ OQQR .'1 <br />IAI!l~UM AAY MU$~~~~ SU <br /> . . ~ <br />:iOLID~, :th'TTLEAaLE SAMPLE LIPOIdPR RRO#tre+ oaaurrs ;:v*s os ( yS) <br /> MEASUREMENT <br />J'JSUS 1 0 0 "'...PERMIT:.' ;:10!AIpI.II.4.91. {: ,..+GE L4##P;0!.'. oaa 0!>,s yY'il Gr¢ LF~O# ~' <br />D:'S <br />I <br />~:kC£/ <br />~ Rl1B <br />'FFLUI;NT GR~55 YALO F. :RE4UIREMENT , bA>fp ' <br />A LY nx <br />nL/ <br />naN ~+ <br />ZL AhD JRSrSE SAMPLE CRFO;YO 04YRG13 aOa~Or uGST tkG ( Iq) <br /> MEASUREMENT <br />)l3yL 2 EI <br />TL <br />~ 0 PERMIT ~ KsPO?7% ^O;kdQr 4 G.'C R/f1C{1L' a~va 4 30 -. ~. D?fTjN iRA9 <br />~ <br />L <br />tFF'LUENT 64y5S YRL'Jr', REQUIREMENT n:sr,-? flAItY HX h~~/L G&H <br />'LJlir I4 r.3lIDUIT J:t SAMPLE ( D3) S<v 4',f ~:~ :y ~}.;: .^4 ,'Y, IC IRO^. ^.! <br />THnU SREA1'pt L+MT PLR:4~ MEASUREMENT <br />7uUSU 1 0 0 PERMIT P?TONAL REPORT aa;AUU~t ~:raG # KEaa4?r #AO r H^[+/ RSTAR <br />;FFLUENTvRD55 V0.LJF REQUIREMENT 3DiiA AV, DAILY t!$ RCD ~ ~ ~ Qrar;G 'fpNTH <br />JiL AND GRH0.5E SAMPLE Q#zcaY ( yl) C3i:t:v;: Yi,; :Y (s -r. a,=;:rc <br />Y L c'+ U A L MEASUREMENT <br />f UJbb 2 0~ 0 PERMIT. ~ 0JR4RQ REP.~BT Y ES=1 x0.~..iK~aa ~ 4:AQd. a.. ~ %'r~~>~IX#.#.~ R:ra .C NEE/ ' ~15;tAL <br />.FFLUENI' ~RJ35 YRLUE REQUIREMENT TNST tl.Rx NO~O ka~4 ^!Oh2R , <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />~ ~ ~ ~~ <br /> ~REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT -~ <br />NAMEJTITLE PRINCIPAL EXECUTIVE OFFICER I eERTIFr uXOeR PENUTY or uw THAT I HAVE PERSONULr ExAMmED AND <br />AM FAMILIM WITH THE INFORMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE <br /> MY INQUIRY OF THO <br />E INDINDUALS IMMEDIATE <br />Y RESPO <br />SIBLE FOR <br /> <br />Riohard A. Munson S <br />L <br />N <br />OBTNNINO TXE INFORMATION, I BELIEVE THE SUBMITTED INFORMATON IS ~ n <br />/ <br /> TRUE, ACCURATE MD COMPLETE. I AM AWARE THAT THERE ME <br />SIGNIFICANT PENKTIES FOR SUBMI7TINO <br />FALSE INFORMATION <br />INCLUDING - 723-47n ^^ Ol ~~ <br /> <br />Y1C~ $enident . <br />, <br />~ ~ I Y vV <br /> THE POSSIBILITY Of RNE AND IMPNSONMENT. SEE tB U.S.C. f 1001 AND 3a SIGNATURE OF PRINCIPAL EXECUTIVE <br /> U.S.C. E rata. IPbuntl.. utl.- Ibs morns m.r NeAd. rw. ~ ro t 10,000 ~ AREA <br />TYPED OR PRINTED .ns «muh,un irwviotnMnr el blwwn a men0ls W 6 ywa./ / OFFICER OR AUTHORIZED AGENT CODE HUMBER YEAR MO DAY <br />COMMENTS AND E%PLANATION OF ANY VIOLATIONS IRe/erence sll sttechments hers/ <br />~tffLEABLE SOLIDS LI!tIf a0.IYiD FOH 10-YRt r4-HR PRETIP eYetir ::u~Jc;:I 'f0 HURDEH OF PROOF REQUIR~.`1P'FTS IH <br />EA::T I.B. L. D, ?. 6. ;TJR!1M0.TtH ".R1iA;°i1E'NT PL0.N DUE 1-1-33. <br />EPA Form 3320-7 105.951 Prevtoue edioona mey be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.1 O 3 3 O / `JY Ci ,'~ - 2 2 S U ~ PAGE 1 OF <br />