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PERMITTEE NAME/ADDRESS pwd~L FrYrry Na./l.ocaua I/DIC rr.P)
<br />NAME CYPI:Ii.' '+•.- n "I,L'" =~4L "7'.A.
<br />ADDRES"y .'4:N?~ TF--T _,11t...IF a c.G•.,q~ ,./
<br />.i-.. F
<br />FACILITY
<br />LOCATION
<br />NATIONK POLLUTANT DISCHMGF ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (OMR)
<br />1Z-151 /17-191
<br />C~0~271~4 ~n7
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAV
<br />FROM ~ ~ TO " 1
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<br />.I. Trr ..
<br />Form Approved.
<br />~onAB,No:, zoao-oooa- ..
<br />APProvel nx{lires 06-31-98
<br />NOTE: Raed Inetruetlorw bolo oompletinp thu form.
<br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING 14 Grd On/yl QUANTITY OR CONCENTRATION NQ FREQUENCY SAMPLE
<br /> 145-531 154571 138-451 14653 !54571 DF
<br />I3I-371
<br />AVERAGE
<br />MAXIMUM
<br />UNITS
<br />MINIMUM
<br />AVERAGE
<br />MAXIMUM
<br />UNITS EX
<br />
<br />Ib'3-63!
<br />ANALYSIS
<br />1545$1 TYPE
<br />
<br />159.701
<br />!I+J Y.A TD?:,L SAMPLE +k r:r{: ,`-;I ~,'t .,.t r,y..,.a ~. ( 7Q)
<br />(g ; F?I MEASUREMENT
<br />'ll r)u_ 1 D ^ PERMIT "yF x'FC #RG4C~ i ..... FQ#fi;.-'"~- 3.5 7.7 i 'ri ;: -% :f:,?r'.
<br />%vF?.fI FNT :;4'755 Va j, T7 REQUIREMENT ~ :4^F 3DDA Ar:: DdTLt 1`:X `: C,/T. :]:,?T'!
<br />FLL/+/ IV C:7u'7JI" n''. SAMPLE ( U3j #rA:}',`•'.- ##?:>r' 't ..^#"
<br />:n^Il TJr59T.`•~L'T PL''1 MEASUREMENT
<br />'TUGyO 1 ') PERMIT REP~R1' )PYIOMAL F#1SyiY-4 ##t##^ #~:v'-
<br />:.FFLUEV'P GR'1S i VAT.'I? REQUIREMENT 3rJDA AP. GAILY !1E `7G9 #{:^~
<br />JIL AHp n$°.AS~ SAMPLE rF .•'k F~J ( j[~) t.:;r:•:!c±c ;: ., ~ ~ -, .
<br />+rISUAL MEASUREMENT
<br />:.'~!lUhS l U '! PERMIT {t r; +,F ~. r-:~ Z E`%=1 `Lt#:`-#r :;e+; i;',F ~::!; r,::k##t~;? v ,,,Ly. rl[rl tT.
<br />~t'FLUENT SR?5^. '1AL71• REQUIREMENT IKi"' !1 AX qp=U #~;t;:
<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 CERTI
<br />AM FA FY UNDER PENALTY OF lAW THAT I NAVE PERSONALLY EAAMINED AND
<br />MILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND BASED ON
<br />~ TELEPHONE DATE
<br /> MY INOUIRV OF THOSE INDIVIDUAl9 IMMEDIATELY RESPONSIBLE FOR
<br />OBTAINING THE INF011MATION
<br />I BELIEVE THE SUBMITTED INFORMATION IS /
<br />A
<br />~
<br />I;icllard hAills ,
<br />TRUE
<br />ACCUMTE AND
<br />MRETE /
<br />,
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<br />^
<br />' ,
<br />CO
<br />. I AM AWAflE THAT THERE APE
<br />SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION
<br />INCLUDING
<br />'~
<br />/
<br />970 E7C-2712
<br />11
<br />2~
<br />9
<br />0.'1II1B fTtB~ ~-~1]!16 QI
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<br />THE POSSIBILITY OF FNE AND IMPflISONMENT
<br />SEE le
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<br />001 AND 73
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<br />/ SIGNATURE OF PRINCIPAL EXECUTNE
<br />
<br />TYPED OR PRINTED .
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<br />S mruna wlry
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<br />rsa-mvinun hprianrlrrr a/Nnr.xlemandraw6y.v:l
<br />OFFICER OR AUfNORRED AGENT AREA
<br />CODE
<br />NUMBER
<br />YEAR
<br />MO
<br />DAV
<br />Gumm[n I D nnv cnrlnnn I %vn Vr nn r nvLn ::v:w rnermVnGa en elmrnmenls nal9/
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<br />EPA Form 3320-1 (08.961 Pravloue edrtlone mey be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.1 ~ r ~ L, ~ O I r PAGE ~ OF
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