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F[RMITTLE NAM!/ADO R[f! ~/n[(ude <br />Facility NLMrlLomrbn iJdiJfnenfl <br />NAM[_ MTUDrtP r~Ur~_____-___- <br />ADOR[tf~C--F!-T<i`f-z '? ^r!'~°'~-~M` . -C~-E-L~' !~~-C-~-M r- <br />~--- <br />PwcluTv <br />-------------- -- ---- <br />LOCATION <br />n c~ <br />Nwn oN wL rouurw Nr msnN wwG[ [uMmwnoN srsreM (NPDESI <br />D ISCNARGE MONITORING REPORT IOMRI <br />116 1719 <br />PERMIT NUMBER D1icNARG[nuMf[R <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM ~ DU D TO 9D O6 3O <br />(1 ~ !) /1113/ 11473/ 1161]/ /Z8~19) 130- 1/ <br />~. I N U ti Form Approved. <br />(s U B tl a ~)oMB~NoY2o~0-oooa. <br />F - YI YALApproval expires 6-30-91. <br />FOST-.:1`IING RUNOFF ccU.[ PLi:+D <br />~I'=x• !+C uISCHAAGF J~ overt <br />NOTE: Rsad insvuetions before fi leting this form. <br /> (3 Card Only) QUANTITY OR L IN G (d;CRrd Only) OU ALITY OR CONCENTRATION FR [OUENCY <br />PARAMETER (I6-J3) (7161) 178-IJ) (4663) (Jill) ~ NO. DF 9AMPLE i <br />TYPE <br />(37-37) E% •NwLrsls <br /> AVERAGE MA%IM UM ITS MINIMUM AVERAGE MA%IMUM ~1NITe 6163) (646%) 169-]0) <br />Fd MEABUREMENT #tl diOC~? 4•}..A## = 1• O#(f ~JOO ( IZ) <br /> ~I <br />GDuGG 1 ~ (] « PERM1.: .~~:{ <br /> <br />WHgU <br />REM E1vT <br />T" e",° a ,Ir,# <br />t <br />.~ <br />~ <br />~ ; el ,.[ <br />>k i]# ~+rr en <br />~° <br />° °s° ..•A' <br />Z~ <br />' <br />ltP~i <br />~aa <br />s <br />° <br />w' ~ <br />14'~,M~ffib <br />~ ° x <br />~ ~. <br />`..;rs <br />~R ...~, <br />°ya~ ~s <br />[ <br />Y ~ <br />u <br />~ <br />C IP f f 1 <br />- ° <br />s (:',"e <br />°'-.`, ~ Ia",yp ~ <br />go~ i;. a > <br />,r`° ° * ilY.~d tl <br />.J4 a <br />s <br />~ <br />E <br />~ <br />.,a ~ ~'f° <br />'«w~°~t tm 1 e,~ <br />„W, .r +w<< q <br />a e. [ <br />, <br />«. <br />•m <br />SOLIDS, SETTLEABLE MEAal1REMENT °°°°~° 00°°*~ ( 25) <br /> <br />ODSaS 1 0 D ~~I=Pea~orII" " <br />REOU1R MHNT °~ °~C!AA~A.". <br />~~ ,'~yy f~~Y°" <br />7~ <br />~~e Gi= <br /># ' t <br />~ ,,y <br />~#i~(IFs~ta $>v. <br />~ <br />~ <br />a .~i,~:sys~ r sµr <br />°~ <br />° <br />[ <br />`° o~,•' , W <br />f 'm <br />~ <br /> <br />a <br />, <br />° <br />e. <br />,`, <br />® + <br />: <br />w <br />°'+ <br />~s <br />t <br />~° <br />i ' <br />D e I w ~ <br />OIL AND GREASE 9AMPLE <br />MEABUREMENT L~<JgVa~# OOV#O# aI;PeMOSSr O#Oa~a <br />( 19) <br />FA <br />EO <br />N E7(TA-GRAY MF <br />T <br />. <br />c <br />c <br />G0556 1 D Q <br />'-~«~lERMIT~~ <br />R <br />4UIRE <br />H' <br />ffi .~~g~ ~ ffi~ <br />! ~ ~! ~ g, <br />f~. °~qq~~~y, ate, 1' <br />!Q,i#~JFi' <br /> <br />rf iYV <br />gzXV <br />' <br />~ a ,s 4t <br />~ <br />' <br />'~ <br />4, '~~gy~,<~~)°,~~ <br />~ <br />~ <br />~ <br />'" <br />y.~~$ <br />ff~ ~ ' <br />~}S ~~Y <br />~T i[ <br />4 A C T rl , <br />E <br />M E <br />J; <br />~ : ' ~ x,« . m"cx s9T~,r {E Yah ~ <br />, <br />m'aa' s. <br />p. <br />n~~aY °~~~: "'"o <br />,t <br />a. a <br />.°. <br />eV8"' Yffi. la ~ rr 8~f ~~ 1 v]-8 fii[~ic A~ <br />FLOP, IN CONDUIT OR <br /> <br />THAU TfiEATHENT PLAN SAMPLE <br />MEABUREMENT A' O <br />1M D) C ~ <br />J A3 <br />/1 ~ „yy* y#>a0#4 c#~E~o-~lo <br />50050 1 0 0 ~.-° « <br />°REG REM ENT• <br />U -r" n?~.!!~~° <br />ff~~ •J <br />^R~D~WJJ <br />, n~q~nsw_ ', <br />3 kt7 ~" <br />; <br />R <br />~ ^ g..." y,.. <br />Ny}~ <br />°1G.11 <br />eT <br />°-d <br />~ .. , <br /> <br />` <br />°# h s>~.•,~~, <br />`~rx ~~yq,A,~~~y <br /><., <br />' <br />~.4~ <br />rsa. <br />• <br /> <br />if SK; s <br /> <br />e`~m ~«~ ;~ <br />y, <br />~' « e-,~:, <br />vys F <br />1 <br />'~ <br />' <br />' <br /> <br />r <br />°~.. + . <br />, <br />, <br />a a, <br />, <br />a <br />s ~ «s a ,l t's'° gTb <br />n a <br />~ ffi ~ .afl.n~ ~ <br />. <br />7 <br />, <br />;,4 <br />xiA°~~~: .ea.a°° <br />,., V:i <br />a{" < <br />Y~ <br />I~ <br />`IR <br />~ < <br />,~' . <br /> <br />SOLIDS, DOTAL SAMPLE ##xt#{::} ~,+~~;Y ~T ;x ~; /. {;;y +, ~} / ~(3) <br />1 <br />DISSOLVED MEABUREMENT <br />70295 1 0 0 ~°`PERMIT`" <br />RHpU1R EM ENT. ;~t!Y#!k l~;'< <br />g. °A~4O4 <br />~e9, ;,#;I ;1tm~` <br />IF~~~n^^ ° ~ <br />x <br />'a <br />'° Fwy~kf~fa~a,_a° <br />~ <br />4 <br />'~ of eny ..Eg:~Q~,a. <br />x <br />° ter, f~,n,e <br /> . ' <br />~ ,~ g <br />o <br />'e s a <• ° <br />:i ~~ }}.. g <br />l~' <br /> y ° A <br />GIL AHD GREASE SAMPLE I; IR#4tl# ( 94) #'~O; f~ 4G4#~0 >r 47.'1## <br />Y ISUAL MEABUREMENT <br />84066 1 0 0 ~' ~ ~ <br />g <br />MT~ ":~~~~Y~° <br />+ ~;~~~,~~~,.~ <br />~"~'~° ' <br />: ~ <br />E.1=I <br />;>~$~Y~16~~~°..a Q,y= Y ~ <br />. <br />~ <br />~ ~~"~4'~ *` ~~ <br />~e n r, <br /># ?:..° <br />f a x <br />~ <br />° ~m <br />f <br />~' <br /> <br />' ' <br />EGO1RlME :«s <br />'n <br />' <br />s .j <br />s` <br />'s" <br />° <br />° <br />' ~.° <br />.. <br />'~"' <br />' <br />' <br />~ <br />° w• <br />d° a <br />' <br />e <br />` s,~y :.t <br /> <br />` '~ " <br />,, <br />'" <br />~ <br />° <br />PC R <br />p r AG ~ ~ xza <br />4 <br />"- In_ a <br />a <br />s~• <br />$ <br />.. a <br />; <br />_ <br />a fiie es°.x .;.Y a~s <br />'e. aw+[° <br />K <br />, ¢~L°I $ .c~ <br />,'huk <br />W <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> ~f"AERM <br />Y 7T~ # <br />~ s~ ~ ~. a,~ v <br />~ <br />~ la r~k„ atl a~$a <br />~, eg e ~@V~"~ <br />`<" <br />~°~ n°pv~~"'e~~°~'°~a n.i~ '6.. <br />~~r ~µ ~ ppti~ <br />Z , a. o-,.o <br />~ <br /> R[t <br />W RE M,~NT <br />~) . <br />ti*'e @ <br />b _ <br />S 9 s <br />kn <br />6 Ycx <br />4 y <br />~6"° <br />q ~ <br />~ <br />~ ¢ <br />& i <br />A k <br />.~ <br />~ <br />` <br /> i 4` ° <br />. n` .. ~.= <br />R ~".. s <br />° rY <br />• r i A V ° _ <br />y ° <br />~ y <br />~ <br />'h. <br />., «.;A y <br />„ k <br />^ a <br />c <br /><a <br />w~. <br />NAME/TITLE PRINCIPAL E%[C UTIVE OFFICER I CERTIFr unDER PENALrv OF LAw THAT I NAVE FERSONALLV EzwMInED <br />•ND AM FAMILIIIP WITH THE INlORMATION SUBMITTED HEREIN wND MSED TELEPHONE D A T E <br />_ <br />S"~ //I <br />V ON MY INDl11RY OF THOSE INpVIDWIS IMYEpATELY RESPONSIBLE FOR <br />OBThINING TN[ INFCRMATIOY I BELIEVE THE SUBMITTED INFORMwT1ON <br />•~ <br />A IS TRUE wCCURwTE wND COMPLETE I AM AWARE TNwT THERE ARE SIG <br />NIIIUNT PEN6LTIE5 FOR SUBMITTING FALSC INFORMITION MCLUbNG <br />~J <br />~ <br /> <br />Yes <br />J <br />TrvE POSSIBRrtr O< FmE wND IMPRISONMENT 5[E IB USC f IDDI wNO . <br />~ <br />J <br />~ qdt ~/~ <br />O <br />E oR <br />~ <br />1 <br />IDEE- <br />]]USC f 1]19 rPrnulhr. undn 1A,v uaml+r n nrldr /In+ u <br />m Jln nn <br />rar I n 51 NATURE OF PRINCIPAL E%ECUTIVE /- / <br />T <br />`T J /~/ U <br />TYPED OR PRINTED R <br />aid... nnu~nlum ln~P.r.•.rlnl+nr.,/A+lu.vnJmnnlM1rand i.n.., OFFICER OR AUTHORIZED AGENT ARA NUMBER YEAR MO DAY <br />COMMENT ANO E%PLANATIOH OF ANY VIOLATIONS' IHe/ornre ull Wma'hmenu hne) <br />SRTTLEABLE SOLIDS LIMIT WILL BE ~AIVCD FO;t >1J-f R, 24-dk FRECIP EVENT-SEE I.A.2, PG IY, POA REQUIkEM°VTS. <br />(=RTRLY SACIFLING INSTRUCTIONS-I.C.9, PG i%. 3G DAY AYG IS RIGNEST !lONTHLC AYG LURING PERIOD REPOF.TED. <br />3320.7 (Rev. g-De) PJSwbus editions may <br />(fl EPLAC E! CPA PO RM T-40 WNICN MAY NOT fE YfED.) <br />0010+}/940412-1838 <br />FAG! OF <br />1 <br />