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,9R..,. <br />PERMITTEE NAME/ADDRESS (/ndude Facility Name/Lomtian ifDi$ereml <br />NAME <br />TnAfFEh tIblbt:, INC. <br />ADDRESSC 9 n F F E ti "! I A <br />F.C, b~R 17 <br />FACILITY C h A I ~ ~~ e l t l is <br />LOCATION <br />r l'PNV W. GUnI]G,\ 4F'. bk5- Ur F~/:.Fk HGL <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDEB) Form Approved. <br />DISCHARGE MONITORING REPORT (OMR; OM8 N0. 2040-0004 <br />(~-tfil 111- 9) 1! I NC F Approval expires 05.31-98 <br />PERMIT NUMBER DISCHARGE NUMBER (5 U E? F A F) ' <br />F - FIA11 PCFA1( <br />MONITORING PERIOD C I S C h A F C f 'I C f L L f f C L I C K <br />YEAR MO DAY YEAR MO DAY <br />FROM f,.( (' v TO ( (~ ~ [tc AG CI`ChAFCF ~ ~ ~'~~ ! <br />(zazn (zz-zs) Ra-2s/ /zs-z1) (2629) (soap NOTE: Read Instructions befor IImpleting this form.- <br /> (3 Cerd Ony) OUANTIIY OR LOADING (4 Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-67) (38-45) (46-53) (54-61) EX OF TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />(6z-as) ANALYSIS <br />I64-sa) <br />69-70 <br />~I.L AND Gk::ASf SAMPLE Afi~~'~~' ( 94) 4gEL~t L;;LbD# ~Cit4V <br />I S U A L MEASUREMENT <br />~4U66 1 U C ,-'E.:~aM1T ~7 ~~` ,, ` .~~ 4~3 r~ E_=1 lR~" {;.. ~?~ <br />~: <br />F '~ ~ t~ <br />° <br />~'~- 4L ~ ~,- ~~~' '~ ~, <br />, <br />`r E'L'u ENT Gk055 YALLE iiEQlYlpt?K}pNT~ ~ - AC=C ~ °+,-'~^, " ""^; <br />'° ~-`.~ XS'~ts <br />. <br />' Cii ~1 i. c. <br /> SAMPLE <br /> MEASUREMENT <br /> peC-' P[ERp QM~ ITS,` y" <br />v - - ' -~ <br />t <br />~ ~ „~iy. " <br />~ ~ <br />~ s r~'= ~ <br /><`'i <br />I <br />`^ <br />~'~` ~~ <br />- <br />' P <br /> '14~~f If1hM4N\. ' <br />~ <br />' ~ S t ^4 .. <br />t < <br />v )la. T~ . ~\ _i <br />. 2r <br />. <br />- - t <br /> SAMPLE // ~ 1' <br /> MEASUREMENT J~ ~Jf <br /> i .t~~dhlR' ~ t ~' ~" t ' ,,•, <br />' . i . <br /> H {~IAGfifETiT- <br />~ ; <br />~~ <br />,- " <br /> , ~ <br /> SAMPLE <br /> MEASUREMENT <br /> ~~RN11r ~ - ~ , <br />i~ <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> P yI1T-~~ - ~ - <br />~ ~ -,$ ~ <br /> v}GV~NV ~ryt ~ ~ <br /> SAMPLE <br /> UREMENT <br />MEA <br />S <br /> pp <br />~~ <br />` <br />~ . I <br /> ;p~ <br />QC~1 t <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> ~F.1w~w"" ~x:: ~ <br />~. ti <br />? i-~- .. <br />~- ~~ } .. <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSO <br />ATION SUBMITTED HER NALLY E%AMI <br />EIN <br />AND BASE NED AND <br />D ON MY TELEPHONE DATE <br />INQUIRY OF THOSE INDIVIpUAL <br />I BELIEV <br />THE INFORMATION S IMMEDIATELLY RESPON <br />E THE SUBFfITTE6 IN ; <br />SIBLE FOR OB <br />FORMATION I TAINING <br />S TRUE ~/ <br />~ <br />~ C <br />, <br />W• ('iO rdOR PeC6rB ACCURATE AND COMP7~TE. <br />I AM AWARE THAT TH <br />I <br />ERE ARE SIGN , <br />IFICAN7 /~ <br />+--~~ <br />J 70-824-4401 00 04 27 <br />PENALTIES FOR SUBMITTIN <br />PreEtdent/General Manager POSSIBILITY OF FINE AND IMPR ON, INCLUDING THE <br />G FALSE INFORMAT <br />ISONMENT. SEE I6 U.S.C.§1001 AND33US.C. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />§ 1319, (Penehies Under these s <br />TYPED OR PRINTED mtuimum tmpnsonment olbaMee tatutes may include hoes up ro Efa,000 end or <br />n6months end5yeers.) OFFICER OR AIJTHOR12ED AGENT <br />O <br />NUMBER <br />YEAR <br />MO <br />DAY <br />d <br />i4Q <br />(!~ <br /> <br />COMMENTS AND EXPLANATION OF ANY vIULA HUNS (Reverence all aaacnmen[s Here) <br />._~ is 'tGTAL IRON L1tI15 PILL HE MAIYdD, AAL SETTLEAF.LE SCLIDS lIRI1 AFFlIEU FCN C~1CYA~i4hN'FFEGII EYEA1- <br />~t.t. bUdLEN OF PRCCF FEC~DIAEC£.ltTS GNDER I.A.3. kFFlITYEE Mli°_T TAFE All FFRSUNALLE CfA'_EfF_ 4t EfDLCE Fh '- <br />P r` 32 -1 (0 - wo s e i tfi m y e s (REP SEA dRMsT30 IC D.) D 011 1/ C C C 11 l -1 E i 4 PAGE L OF <br />~,,: <br />