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PERMITTEE NAME/ADDRESS p•~N Fs=IIryNa/Loc•uol =/D,p...nq <br />NAME ',YPRI!" v, ~•. .,.• y '. .?At. '.'7D~ <br />ADDRESS rtIl1 ,j .'y t~ )Cv t .i U'I°,~~ ^av>i ~, nv( <br />4"LUil Ei;'' 'T1pRP'.. ~;~'Lt. <br />FACILITY <br />LOCATION <br />.~-'7 i7 !'fj it !'T_S J. '<"'; {.:°~ ..°V''"R1•L A"7'i <br />NATIONAL POLLUTANT DIBCHAROE ELIMINATION SyBTEM lIYPOE$1 <br />DISCHARGE MONITORING REPORT (OMRI <br />lI-161 17-191 <br />"~~)~/1~4 Ct'17 a <br />PERMIT NUMBER DIBCHARDE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAV <br />FROM ~ .' ,: TO `_ ° I I i <br />116111 l11-131 !14151 /16-171 !IB-191 !34311 <br />Form Approved. <br />* ~~ r ' c T„)OMB1No:, 2040-0009-- <br />F Approvey exp~{ea 05-31-98 <br />v _ r.cET <br />« ~. T ry <br />NOTE: Reed instructions befor com latinp this Corm. <br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING !I Grd Onlyl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE <br /> !46531 !54611 l38J51 !4653 154611 DF <br />l3I-371 <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS EX <br /> <br />Is]-s31 <br />ANALVSIs <br />!54581 TYPE <br /> <br />169-701 <br />,U :i UCi:lITY SAMPLE .. ". t:.°rre .~: •: ~~n:~y ~; ~ i.) <br /> MEASUREMENT <br />,`~1,~14 1 D ~ PERMIT '.; :t ^:: k4 ',; r#OyA>r <br />~ ^'c`. S'O h. 4"k N. r,T <br />51 <br />. D., t <br />~PQ ~".' ~nui / <br />I <br />" <br />H dE P <br />/ '7 <br />A"r. <br />, <br />9E'{. 1J=.,' ;n~;S Y~f.=IF REQUIREMENT ny.k~ . <br />w . <br />., . ~ <br />r~l SAMPLE .,-r':Ck 4GRF~',t '~','-*x'=~s' ~ <br />1 ~) <br /> MEASUREMENT <br />'O~F'IO 1 D U PERMIT ~F :=~LOAfF ~DAr¢4'-F {=rk <br />':~r LU`: ~ JRU55 YALCI , REQUIREMENT k";t„ qT. !IIT*Oh' «PX «fl'." c{, <br />~JLIDS~ T7YAL SAMPLE ;Fkkk„;= S-X^+:',::<~:; ~~f:~t-4,:: ( tr)) <br />3U4PBNDP.'i MEASUREMENT <br />'JU~30 0 0 !1 PERMIT O.tf.t:;%~ `,~-^. k;;< ;atk ks'"=«y,. R'"^~nr n^rr)om u~T.~;J :RAY. <br />i:~. CL)"!Y'?NTS ~"L14/ REQUIREMENT rrk0 70p,{ A.Y^ ~nk ", ~LY MX "";/L ^f 7t!'!"'% <br />i0LIU5~ TOTP„ SAMPLE ui=7kk;: ..r'k'~-=A :"t{"::;'_^: ( 10~ <br />~ :: ? F.:V D 3 i) MEASUREMENT <br />JLi~30 I ;1 J PERMIT 4F'z~k7 ~4#tr:`fi .'t-'kt `-t>tiri,.4t,: fir, 7{t EIa.E'/ :RPM; <br />~; F? L J S N T G 4 U+' '! 8 L"'~ REQUIREMENT <br />4?kC <br />Z()116 `JU <br />DRT I,Y wy <br />"':/?. <br />.'d 7' T" <br />iJLIDS, Jc7T[.P1 'LE' SAMPLE ~.rkC blk7tc?: ~'r'•`##-'+ ( -5) <br /> MEASUREMENT <br /> <br />.~i5U5 U D 'J ~. PERMIT :s:'S :qk :: .r"-.=•i-r`~ -. r'=.= :s~°##+S~t Qf, Al j7T r.~c {_•rG I :i.'.AA <br />i i.:' CUM?S 6'"~". ~ L'1, REQUIREMENT r,::".3 af!D4 4~a!`, AP-t~ MX «L/L `1ry';T`r <br />_`UL DSr J.•.;,7'. "- ; SAMPLE . rRvac #ax~r,• ..,, ... ( %n`) <br /> MEASUREMENT <br />QS45 1 ! -' PERMIT tk::t kRR ~C#?C>` : ;:,zt :fi#-g*•s;c 4u D{}j?T {/o cry=,-, uTr v/ :?, E1 <br />"?LUBNT G°~~S :Pt."° REQUIREMENT 3'cCk ?C1DA RY^ ;1'TIY 9X •r/t. +~,>."4 <br />., a y. SAMPLE .. :c ~:='. ^. {: r,.; ','::x :~..-~ ~ x~.. . <br />( 1 v) <br />'?i04 E1(Td-%'~"" "'~`'." <br />I MEASUREMENT <br /> <br />:C)S56 1 ^ ~ PERMIT »n~7;=0 #n'T ~;x r.: f .~.. ~ :?~'=fi .. 7fiv try <br />l <br />ry`'°;~ <br />.4.1q <br />'F'rLUEHT ^,4"'S' '/"6, REQUIREMENT y, « <br />NAMEf{ITLE PRINCIPAL El(ECUTR/E OFFICER I cERnFr UNDER PENUTr DF uw THAT I HAVE PERSONAUY ExAMINEO AND <br />AM FAMILIAR WITH THE INFORMATION BUBMITTED HEREIN; AND 9ABED ON TELEPHONE DATE <br />Richard Mllls OBTNN MO THE NFORMATI MDINBE EVBE THE SUBMETTED EINORMATION~B , <br /> <br />Environmental P+4a^ager TRUE. ACCURATE AND COMRETF. I AM AWARE THAT THERE ARE <br />9GNIHCANT PENALTIES FOR aUBMITTING FN <br />SE INFORMATION <br />INCLUDING .~' <br />97D g7D-~7~Z <br />S ~ <br />~FJ <br />96 <br /> . <br />, <br />THE POSBIBIUTr DF RNE AND IMPRISONMENT. BEE to U.B.C. t toot AND 73 <br />U <br />1 tJle <br />B <br />C <br />K SIGNATURE OF PRINgPAL E%ECUTIVE <br /> <br />, TYPED OR PRINTED . <br />. <br />. <br />. I <br />,rIAn w•r d.•r mnm• my NcAd• rinr. w ro SIO,OW <br />•ndnmuinun inprls+vttRrr we.n...,anN.:n,.,es y..r.! <br />OFFICER OR AUTHORRED AGENT AREA <br />CODE <br />NUMBER <br />YEAR <br />MO <br />DAV <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS !Reference ell ettschmsn(s here) <br />~.LIrRNAT':: LIMIT; Fn'' -S °;:^iL?A3LC _~LT.^5 (L'"1C '?'I °^'LY '~'~{.Y r~ r. T _v- <br />,q_a•. r;:,_In t.,l,.;r r~- <br />J <br />~ <br />F7? R'!RryF'! lF ?rt~ryr ~cIIJTRF:N:'D rq. I`TL. c ^n rj,~c_~r.c snn~-.. ._ / <br />CLF~IM}'D., 5r'F ..A•~e ~~ 1.'ir <br />'.' ^• <br />r <br />• <br />EPA Form 3320-1 108.951 Previous editions mey be used. (REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.( ,. / <br />" <br />~ <br />, <br />, <br />r , „ PAGE <br />OF <br />~ 1 <br />/ <br />I <br />II ~ ~ _ <br />~ <br />~ <br />