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PERMITTEE NAME/ADDRESS (Inrlude Fariliq~ Name/Lnralimr i! Ji!lemml NAME- 41I-~L ~c ~.-~it~--- ADORESSyr D T~ ~-L'r^J-'. `~-S C?N--GR °-E!(- -".-_L.N ~5- - - - - FACILITY - - - - - - - - - - - - - - ---- LOCATION - - - - - - - - - - - - - - - - - - - - - - - A T !1 T VrR NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDtS ) DISCHARGE MONITORING REPORT r DaIR) (]-Inr l17-191 r nr~ Qo n n PERMIT NUMBER M amcH.RCe u y- MONITORING PERIOD YEAR MO DA Y YEAR MO DAY FROM ;~1~ n Vl. TO .3 ~ G5 ~(~ 001 ~: 00~ ^!11AT"~ ~CNrG (0,.7AR GC) Form Approved. ~~.jtlS T S' - F I N A T, OMs No. zoao-oooa M i Y n R Approval expires 10-31-94 :..n •~ NOTE: Read instructions before completing this form. l i Cdrd Onl,r) QUANTITY OR LO (4 Card Onl,r) DUALITY OR CONCENTRATION PREOUENCv S E PARAMETER f4F-5-I1 (S4~M1/) (7S-!!) (46-5)) f~4-61) EX' OF TTPE • AVERAGE MAXIMUM ` TS MINIMUM AVERAGE MAXIMVM UNITS (b ,ill fb4-681 ([; V-JOl PH SAMPLE i:: {s:Y i4 i}{: -~iYAxi~:'': '~: Rit i}'~ ( 1 'i\ / Z MEASUREMENT - s4~.., 1 PEP,MIT tXY,Y i}Qf~4:4 ~t piy L•Zft Fi iii- ~ ... 4~1'j>y1#tl Y4. L IJ r[? IC~/1 ~RAF` ,N I S U. REQUIREMENT ~:Y Ki:k '^ "' II M G.I ~ SOLIDS, TO'[ ~L SAMPLE Ya;l~ iFeY{: Ye 4Yr :': .',[IS `' ( ~ Q) s / ~~ SUSF?HDd~ MEASUREMENT "J, Gto 1 Y 00530 1 ~ ~ PERMIT ~cQ ir'd~h >h 1,4 ¢fi ,>Y . . ~p T~,..~~ .!U ~. d ( PC~Y ~ !~ ~~[' OFF llEnT CROSi Y fl- REQUIREMENT '-,, ,' a ~ Mc, p OIL AND ^,F EASE SAMPLE .. :}iaf#~'.e Q4"'ka$ ( :')~ ?Ri:ON ?xmr;- .R AV .Y r~•l MEASUREMENT 5ro nn nn n 00556 1 J l' PERMIT trt Sk i}fi };': ix Yl#>h#Y) - CC {e Qta~1~1~ .~ ~ ~~>~>f/~~~; ~ +~ " V'. ~ a~ .I~}11T~ l i~11~ F VENT IiR05.5 Y REQUIREMENT ..c .... 4 ~~ ~/ ,. » c.ADr.IUn, SAMPLE MEASUREMENT . ^. .• `ari'::y?: Jh /l ( 1~) pJT F.9TIALLY DIS;OLy O OO loo1 ~.14:Qrf~ 01311 1 7 C PERMIT YidilhY::: ~"Y:#Y::Y~i .. ... OP"IO'iAL .f}_i4 t.Q~R ~ ! NC*./. !R8 F,FFLU r'T C. Y REQUIREMENT *"°~°'° ^P. Y^ 30 V^ ' ' ' "'' G - II~nN, SAMPLE Y.~.w.~w,. fit..{;Yi't ` •!t) 1 PJTF.!7TIALLY DI`St7LV MEASUREMENT h O I 171317 0 •? PERMIT t#9#o# ~~!##rt ~~",- DPTIOYAL 1.3 RBF~IHT :~4;; t "1C.t/ %8;x 8 FFFL!IEHT GROSS YALUF REQUIREMENT «r:r. g 2 Ayr, 30 A AYS LI MG ~.'~ . • , PLOY IY COVDU~ l 04 SAMPLE ( ~) R-Y Y,:': o;[' -.. it it:;:Y ~ • , ATn°NT PLAN, T'ihU TR F MEASUREMENT 'J ~ Z . 50050 I Q ~ PERMIT O.ID1 REPOP,T. *#1k>p>b'1 ~phf[.#0.4 ####~fl i}?. ,4 "t~ ~~~'~~'/. • ~~x PC r 1' I, v. L ],.NT RO55 VALU REQUIREMENT 30 AYG DAILT AIZ „r ^1 ~#~~ -~t ~'~ ~nLIDS, TOTAL SAMPLE *~~#iX4'X Yxi:i~i##r ikiZ~-'I'~i•i p X360 ( 19) DIS'.'OLV~O MEASUREMENT y~ ~ T 7 29i.: 1 . PERMIT i`.Qf:;w~'. ##3~~v'~ vYJh.'v'i4':: ~ ~y .R4!'V•li fDP'!TDNAL ~+• EFFLUENT GRO55 YALU: REQUIREMENT $;~+,- RTF AY; RTR C C 9':/I. NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER oErvALTY of LAW THAT I HAVE PERSOIJALLV ExAMwEp TELEPHONE D A T E qND qnl FAMILIgR WITH THE INFORMATION SUBMITTED HEREIN. AND B4sED / ON MY INQUIRY OF THpSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR _ ~ ' 1 OBTAINING THE WFORMATION I BELIEVE THE SUBAtITTEO INFOFMATIUN 6 V J ~.~T I TR1JE ACCURATE AND fOMPLETE I AM 4WF.RE THAT THERE ARE ' ~ 4 ' $IGNIFICq NT PENALTIES FOR SUBMITTING FALSE INFORM4TION. INCLUDING THE POSS6viY of FINE AND IMRR15oNMENT BEE IB use 4 1tb1 ArvD 51 NATUR PRINCIPAL EXECUTIVE 0~ ~ a3 use § 1319 IPCn.rlric. antler drrm sldmm. mer mdude Gnrs up to ~ TYPED OR PRINTED aW ~ ~nr. r SIt1 n1)O .mJ nr m.nlmum rmon.rnmrnr ni brtwccn A mnnlha OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY COMMENT AND EXPLANATION OF ANY VIOLATIONS (Rt/ercnit /Il allarhmtnl< htrcl ?°2nITTE•: MUS?' 90TIPY YQCD 30 DAYS PprnR TO CnR9INi`i'7 DI?CHA3~'P-FART I.A.4, PG IY. !I'~NT'iLY SA!'PLIf'G Fn°< PH, ?L01i ~ O':G ALLOYED DURIRG PERIODS CF L!'D A.CCP.55: ATiRCH ST4~E,yr^4T i^ Dn?. DCTFC:I09 .,LMT"'S[-SF.P. i.~.2. EP Fb/ PO- R V. P P I I VS fC ~ ~ V 1 LACES ~PA RM - O~tNHfC M T'N Y'BE LSECI:I ,i T -~ j' V - PAVE ~•' OF 00023/950624-042H 1 i