|
FERMITIEE NAMFJAODRESS rtd•A~ r4wru~ [~~.: :.. ; .,Wa.,,..
<br />NAME
<br />ADORE88.: : n ! .- N~ 1 S qi1 I HEST g'.i ~~'$
<br />. .. TUX 1U'3U
<br />FACam "~ ' : ~ C3 91 a 28
<br />LocATION. ' 1 A CJ a F u 2~
<br />' tfFY RcIC ~D n n nc nDC
<br />`~"DiS Ciro PC.E MONITOFd l::i REPpRT :}!~.69i
<br />--PERMIT NVMBER _-- ~au:,AAOF «vuNR
<br />MONITORING PERIOD
<br />Y AR MO DAY vEARi MO DAY
<br />~RDM T~ ;,
<br />L.~,:
<br />C
<br />I-
<br />NOTE: R..d knWOdorr MiNi >"L7npMdnp If11. form.
<br />
<br />
<br />PARAMETER
<br />QVANTITY OR LOADING
<br />QVALITY OR CONCENTRATION NO,
<br />E "Azov(«cr
<br />ut SAMPLE
<br />
<br />AVERAGE
<br />MAXIMUM
<br />UNITS
<br />MINIMUM
<br />AVERAGE
<br />MAXIMUM
<br />UNITS X
<br />AnAt•ps TYPE
<br /> SAMPLE - .. - ~
<br />~
<br /> MEASUREMENT
<br />.IJ~ 1 - U
<br />• Y r ^ C RE UIREMEHT
<br />__ ~r~p}~ ::Rn~c3 t r ~. .`_~
<br />y~ k ^" ~' ).'~
<br />M « c ~cP:LT RSIT
<br />
<br />;, s
<br />- ~' - ,•~`
<br />SAMPLE
<br />MEASVREMENT
<br />..
<br />-..
<br />~
<br />• ' }
<br />~ e _
<br />
<br /> PERMIT '
<br />- ,
<br />REQUIREMENT -~~..o t': sC
<br />IoO trc ~- - VeCC-,: 35 7,1
<br />
<br />' k['£f +'!:1
<br /> _ 3ahi 14' Y 1
<br />_ u; .'rR _
<br />_ L ,.' ; ~ -~ ~ SAMPLE _ - -
<br />~~
<br />! ~}
<br /> MEASVREMENT 'I i
<br />I
<br />
<br />- i ~ :1 PERMIT
<br />I
<br />M ,tD ev.:, o~~c., . - _*. ,. Fran: - ~ PIJ~fiL l.:/ G~: ~'/ _
<br /> REQV
<br />RE
<br />ENT
<br />v
<br />
<br />y" I~TAL SAMPLE
<br />MEASUREMENT 7
<br />I ~ }
<br />(A3 Y::}
<br />~
<br />. _:7 L J ~ f'ERMIT .^c'~4}~0 ~ :.ory• 9i~a ~.. ieG I:il .>~ .a'
<br />.[:t REQUIREMENT .. - ~ ,
<br />_i
<br />... ntiU uILE1~[_ SAMPLE
<br />MEASVREMENT - ' :)
<br />'
<br />' )v2 ~ ~. PERMIT =:31_I; 'YFL^~ ~ .''-..a 7,•-. ~SJV-' ~ ~ __-~ ]'+ i~A-'
<br />-
<br />-, I _, _ . , ~ RWUIREMENT _ . n s ___ _
<br />_.~+~ I•: _.::~:1 :;i' SAMPLE .)
<br />
<br />,.~ ~ T3L, ...7 ._
<br />•'
<br />_ MEASUREMENT
<br /> PERMIT
<br />:
<br />'., :;;)S; I
<br />L;
<br />RE
<br />IREME
<br />T rtr!-- Ns. s~L[HF cca moo.- o.oa.~~ aa~Fic t. +.LI
<br />, - li 3?t
<br />- r'r ' U S'; 7 QU
<br />N
<br />_ __
<br />rLIU~" ?':•iAL SAMPLE ~. - ( 1
<br />MEASVREMENT
<br />•
<br />PERMr7 jyFp r, .Y>b rtrb~~ t:Obu^ }i~Pc042 i' tIPTIOiGAL
<br />REQUIREMENT "''T ,i~A$
<br />1
<br />
<br />MAMEITITLE PRINCIPAL EXECUTIVE OFFlCER "' '°`" 1 Mi Pi'""r""""""""""""«""•^" ~
<br />~
<br />' TELEPHONE
<br />.•
<br />a...
<br /><e,
<br />.~
<br />.•.w
<br />i
<br />e ......~
<br />a
<br />DATE
<br />N
<br />,
<br />p.'
<br />.
<br />.
<br />" «,
<br />.
<br />«~
<br />r
<br />" «...
<br />.....i,..,rn..
<br />[
<br />ow
<br />sA
<br />«.
<br />v
<br />d
<br />r
<br />W
<br />.
<br />1
<br />N
<br />w
<br />V
<br />l
<br />~
<br />4ti•
<br />_
<br />n
<br />.n
<br />f
<br />.
<br />,
<br />r
<br />4
<br />u
<br />w,. ,
<br />p.s"
<br />! t
<br />..
<br />,wtvw.l
<br />pn
<br />P
<br />' «M,euw.~,e a Tr ,+aa,r d Uw T•d « Iwrne« .«e «r,•""r w ,rx,n, i
<br />a f«or M•w ei.rr!+r m.r,1p« f« i«Mnwt W I"Arr,uW4 w «J",~,Waw
<br />~ ~ -
<br />.IMIIwI I. Y In. 4f1 e! •+t t~f..«ij. w,1 MYL Irv., 4•.n4 u•E m,NMI. ~
<br />-.
<br />- ,
<br />:
<br />~ ~ x
<br />,
<br />1 «w ,.«. d4 o.,n «..trnrw y.w"b. M w.«.w.wM I.b ,nnr„..er." BgNA TURF Oi FRnIC~AL EXCGtlTIVF ~
<br />~
<br />TYPED OR -RWTED ~+~e~wpr..mi~Kn,...~a l"y.w.«I«.,, a...•.«,t •w.osa OtsICER OR AVTHOR[jFD AUFM CoIA NVMDER YEAR MO OAY
<br />COMMtN 1 S ANU [ AYIAnn nvn Vr nq . ..Vrn „VnJ 1^NNMCI IN InN(MIM4 0NI/
<br />> i.:__ L:".Ii J,~il. :: .:I :," ~ ~'] i %_. •'? PdECI~' EVEdT IS ~LF.IHED. IP CLATC 1tPPY,09E.0 AT ~~CD,
<br />_..._ ::Ii+. ~.,, .... Lri :.?'! '12ASU$E!!£y?':-SH'e I.A.2• P%:+ 3" FDH S43D£8 UP PROUF
<br />
|