Laserfiche WebLink
PERMITTEE NAME/ADDRESS B. v6 frWryN.wL«mIm UDIp....p <br />NAME pOMDEkNCRN CUAL Cp,~PANY <br />ADDRESS ROADSIDE ~'{i~~~• .. Li JA P:I i. c~ <br />P.U. BJt 143;? <br />PALL SAD ;' - , ,;1~,2., <br />FACILITY <br />LOCATION <br />AT1AS JOEIh A. "Cf1 :1 ;:• ~-li~l!E:.i <br />NATIONAL POLLUTM7DISCNMOE ELIMINATION 9YSTEM./Al~j1E$1 , <br />D18CHARGE MONITORING REPORT (OMRI <br />l1-161 l17-197 <br />PERMIT NUMBER DIBCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAV <br />FROM LO U TO CO 12 31 <br />!76711 l71-131 171-751 116-771 115-291 !34311 <br />' - f.GTD1 APProved. <br />eoMe 2 ro cotoseo~''"~'1y°~ oooa e - <br />(SUER iC) PProvala~ i~+~o5-al-9s <br />*' - FINAL 11 s <br />NINOF <br />•'°~+ NC DISC9APGE ~~~ ~<< <br />+ NOTE: Reed Irntruetiorn before eompletln0 this form. <br />PARAMETER !3 Grd Onlrl QUgNTITY OR LOADING !4 Grd Onlrl QUANTITY OR CONCENTRATION NQ FREQUENCY SAMPLE <br /> /46531 !54671 /38-451 146-53I !54671 DF <br />I37-371 EX <br />MALY915 TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 161.63) 164681 169-70I <br />IL ARD :;Kh'AS?. SAMPLE :,#>: #.:~ ~ 94) #Ay Y#>r #-?#A:I L' YLL##ii <br />Y ISUAL MEASUREMENT <br />i4Jtib 1 0 0 PERMIT :;#~k0#>,L RBFs7~2 E5=1 ~'~'~'~'~'~ #~'~~#~ ##9#t4 s:## B8i(LY ISllAL <br />iFFLUEN f GR:1S5 ti,' ~ Lif REQUIREMENT _ ~a4v <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - ~ ~ ~~ <br />~ <br />~ ~ ~ <br />~ <br />~ ~ ~ ~ <br />.. ' <br /> REQUIREMENT ~ :.:..:. <br />~ ~ <br />. ~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT. ~ - <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I c¢Rn Fr UNDER PENUTV GF LAw TNAT I NAVE PERSONULr ExAMINED MD TELEPHONE DATE <br /> M1 FA MILIM WITN THE INFORMATION SUBMITTED HEREIN: MD BASED ON <br /> MY INQUIRY OF TNOBE INDINDUAlS IMMEDIATELY RESPoNBIBLE FOR <br />T 1 <br />J <br />~ <br />Sr0 ~~.r OBTNNINC THE INFORMATION <br />I BELIEVE THE 9VBMITTED INFORMATION 19 <br />~ <br />, <br />, , <br />TRUE <br />ACCUMTE MD COM0.ETE <br />I AM AWME THAT THERE ME <br /> . <br />. <br />SIGNIRCMT PENALTIES FOP SUBMITTING FALSE INFORMATION <br />INCLUDING / <br /> , <br />1 1001 <br />THE POSSIBILITY OF RNE MD <br />MPRIBONMFMT <br />SEE 18 U <br />B <br />C <br />D 33 ~ ~~~ /d / O/ O / ~3 <br /> M <br />. <br />. <br />. <br />. <br />I gIGNATURE OF PRINCIPAL EXECUTIVE <br /> U.S.C. ! t 310. lhwdr• uM•r dw~ mnm• m•r NtlW rw• w ro ! rO,D00 AREA <br />TYPED OR PRINTED •nsnmu•mnr MrplanleN O/M1wwr6mavrNaW6rr'A/ OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference ell atlschments hers/ <br />~cTTLFABLT; 50LID5 LI!!ZT A2PLIE5 ONLY IF <=l0YR,24Hh PnECIF2TATIG9 GVE9T ZS CLAIFF'D. PEiiIYITTFE iIAS <br />BUfiLEN OF PROOF HHEN R~JUF:STItlG BELIEF FHO[1 SETTLEABLE SJLIDS PRIMAF.Y LIMITATICDS. <br />Epp Form 3320-1 (08.95) Previous editions mey be used. IREPLACEb EPA FORM T-40 WHICH MAY NOT BE USED.) 0 0610 /'~ D C 2 2 3-12 5 6 PAGE r OF <br />