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PERMITTEE NAME/ADDRESS (lnc(udc Facilifv Nnmr/Cxorion i/'D~creng <br />NAME <br />TKAPPE;H lIIKI~G, 7NC. <br />ADURESSLw AFFtH CIIIt <br />Y.C. SOA IE1 <br />FACIUTYGEAIG CG b1i1: <br />LOCATION <br />r\::N: n. GL`hDL:h FE'tEF_- E•nE_i/Ghh P.Gr. <br />NATIONAL POU-VTANT DISCHARGE ELIMINATION SYSTEM (NPDES) FOrm AppfOVed. <br />DISCHARGE MONITORING REPORT (DMR; OMB No. 2040.0004 <br />(zas) pr- el f. I k C A Approval expires OS-31-98 <br />PERMI-NUMBER DISCHARGE NUMBER (S U E~H h Y) <br />F -rI~}.L CFA2 <br />MONITORING PERIOD L I S C H A C 1 C F L L[ E C L L C F <br />YEAR MO DAV YEAR MO DAY _ <br />FROM C C G1 TO O '~%= NG LI_CNAFGk 1~~ ~== <br />(zo.zr) (zz~z3) (24-25) (zs~zr) (zess) (3031) NOTE: Read Instructions befor -cD plehng this form. <br /> (3 Cerd Onry) QUANTITY OR LOADING (4 Card Onry) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-6 f) (38-45) (46-53) (54-67) E7( OF TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />(62-63) ANALYSIS <br />(64-68) <br />69-70 <br />. iL AND GHi:ASE SAMPLE +~="~'<" ) 9+1) 09Ktto L~7~h+~+ AC~~C: <br />Y L i U 61 MEASUREMENT <br />4066 I U 0 ~ ~ tFri00spr7 <br />" '`118Y - ~,~ ES=1 - <br />~~O~It~~ x^~ „?~~ls " <br />r ~~~~~Ii-: A~ ;'~' ~ftY. '+~011L' <br />tFLUENT GR S Y L' LTMENT <br />~". . 5~ - ~ <br />f , <br />r ~~ ~ F ~ fi ~-- A+'~ ~ ( t, <br /> SAMPLE <br /> M~1ixUREMENT <br /> i <br />" s <br />+ # , <br /> <br />RCaIyENj <br />. <br />~ <br />~ tip: ~ r <br />,~ .a ;. <br />'i~.: <br />- <br />- <br /> <br /> <br />" SAMPLE <br />~ <br />~ "1'-' <br /> MEASUREMENT .V , _ <br />~~. <br />5Y„ip. <br />Iw <br />PJ.~ ~..' <br />'.Q <br />9 .ry r <br />r <br />i . <br />~+~ "i <br /> Eh7E~ ~; ~ ~ ~ . <br /> SAMPLE <br />1, MEASUREMENT <br />y <br />~~ ;, ; <br />:- <br />.t. ~ <br />_. <br />~ _ <br /> EY~tT <br />H~G1 . f <br /> SAMPLE <br /> MEASUREMENT <br /> ~~ , <br /> Nr. <br />R <br /> SAMPLE <br /> MEASUREMENT <br /> k~ _ _ <br />}, `, r4 t <br />t rr'x_ <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTI <br />A FY DNDER PENALTY OF <br />AR WITH THE INFORM <br />I UW THAT I HAVE PERSO <br />ATION SUBMITTED HER NALLY E%AMINED AND TELEPHONE <br />EIN <br />AND BASED ON MV DATE <br /> AM F <br />M <br />LI <br />" INQUIRY. OF T~OSE INDIVID~~IIAL <br />THE INFORMA ION, i BEl1EV ; <br />S IMMEDIATELY RESPONSIBLE FOR OBTAINING <br />E THE SUBMITTE[T INFORMATION 15 TRUE. ~~~ ~~ <br />Gordon Peters <br />td ACCURATE ANN COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT <br />D 70-824-4401 00 04 27 <br />. PENALTES fOR SUBMITTIN ING THE <br />G FALSE INFORMATION, INCLU <br />Prea ' d eD.eL FEaIiH a POSSIBILRY OF FINE AND IMPR <br />' ISONMENT. SEE 1B U.S.C. § 1001 AND 33 LLS.C. SIGNATURE OF PRINCIPAL EXECUTIVE <br /> <br />TYPED Op PRINTED es under These s <br />§ 1319. (Penelb <br />maxmumimpdsonmenl of betw6e tatutes mey include lines up la E10,000 and or <br />n6monlhs end5yeers.) OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />1 <br />~,~ <br />!, <br />I'~~ E TG16L IAGN LIQ775 MILL BE MAIVEDa ANC SET7IEaeLE SGLIC~ LIlIT AFELIEU FCP. <=1CYF.i4FF FFfCIF EYE6T- <br />~ik• bUHDEh OF PACGE FFQUIHFr2kT5 UNDER I.A.3. iC,E i!CkI7Cl.ING - I.E.3. CIL E GFEASE - °_FE I. E.I.IL). <br />P%1 0 33 -1 0- ) Prevlous'e i Ions m n t ~ LAS 0 I A USED.) C C 10 5/ C G G I I l -1 E i 4 PAGE ` OF~ <br />