Laserfiche WebLink
PERMITTEE NAME/ADDRE55(1.,i,4 Fa~lIlyNa/Ler•ua lJDl~fr.wn) <br />NAME CTPdi'c ""^DA YE.LL''-Y ")AL j7n~ <br />ADDRESS!7~i ..~ it .'rJ -. )llmul .- ..~c.y~N ,T <br />;1'i0 "_+':. ru,-oeI 'T-i ~L= <br />/, <br />FACILITY <br />LOCATION <br />ATP.: '"p3kI`= ~. P.~~'i.°Y. ::'~"'1.11. AT;i '/ <br />NATIONAL POLLUTMT DISCNMOE ELIMINATON SYSTEM INPDESI Forth Approved. <br />DISCHARGE MONITORING REPORT IDMRI y _ 7 „ „ ~ r ~ O1dB.No~ 2040-OOrO,{iF: , <br />17-161 17-191 r <br />A rove! expires 05-31-98 <br />PERMIT NUMBER DISCHMOE NUMBER r r- •~ • r <br />MONITORING PERIOD T <br />YEAR MO DAY YEAR MO DAY <br />FROM `)i TO v. ;) ::. ,. •:1 '~7^.r-..leoi-v I ;: ,:: r: ~~ <br />Iz0-7Il rzz-131 !14151 I26Z71 IYB-191 130-311 •~ NOTE: Read Imtruetlorr baf eo etinp this form. <br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING !I Grd Onlyl GUANTITY OR CONCENTRATION NO FREOUEN(Y SAMPLE <br /> !46531 !5461 !38-05 /46-631 15L61 E µ <br />l31-371 X M <br />y~s TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !eS-e31 !80.581 159-701 <br />l i:')`.r T7TA [. SAMPLE `#::-'- #t#~=« .. t; «..~;.. ( i~) <br />(A, ~=~~ MEASUREMENT <br />~'1J'!S 1 U 1 PERMIT +-v#3#x ##~+##~ #!" ."%?+`+` 3.5 7•^ 'FCF/ ;.;tn <br />vvLU r.NT 3i'J~C ^1 .q 7.9P REQUIREMENT #::+?4 30fli 17^ IfAT LX '^X .`^[;/i, KO'=T°i <br />^i.'?n <br />I5 ~/~")~I° '7 ~ SAMPLE ( 131 L`I%3': ^w ;t r•:>'k •:;}•: ~F ~..«.~r.:: <br />r <br />. <br />". .`. Yi' T'IEA'[""".i'.' i I.lNT MEASUREMENT <br />~~_'tiU 1 n PERMIT RSPJRT ]PTIOXltL ~~'~"'z~ ~*'~~" '•=~BGX-'S + :"=# F,:°LT ;+iSTA" <br />F`LUF.N: C: h'I +5 YALU!' REOUIREMENT 306A AY6 D4ILT ±1X yC,D #~`-•`tr <br />=lt. A;1I1 .; R!'?`i f' SAMPLE ...'-#G-^ ( -14) !I;avt+•;• e4dF qt•`-•~ ... .. <br />;~_~L~AL MEASUREMENT <br />i4'1t,b 1 :` ? PERMIT ,.Yr#-: 1 2 ES=1 v"ykr?r,-: ,t:s:9=X#:: ~'~,".#~:Y,r - r-rt;•y 'ISUIL <br />:'iLUdNT ~R')SS HpLhc REnUIREMENT I35T MAX NO=O '•~"# <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REOUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> ~~PERMIT <br /> REOUIREMENT <br /> SAMPLE <br />- MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> ~REOUIREMENT <br />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER I cmnFV UNDER PENUTr of Lww TNAT I NAVE PERSONALLr ExAMweD MD TELEPHONE DATE <br /> AM FAMILIM WITN THE INFORMATION SUBMITTED HEREIN; MD BASED ON <br /> MY INQUIRY OF TNOSE INDINDUALS IMMEDIATELY RESPoNSIBLE FOR <br />liichard lvlills OBTNNINO THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATON IB <br />/ <br />) <br />~ <br />nl <br />onR~ntal -:anas~ex <br />vi <br />~ TRUE. ACCUMTE MD COMPLETE. I AM AWME TNAT TNERE ME <br />SIONIFCMT PENALTIES FOR SUBMITTING FKSE INFORMATION, INCLUDING / <br />/ <br />I ~'_ ~_ __ <br />_ L3]~J $7~-~7~Z 1 "I <br />_ <br />7C 9~ <br />n <br />r THEPOSSIBIDTY OFRNE MD IMPwSONMENT. SEE 18 U.B.C. ! 1001 MD SB 810NATURE OF P111NCIPAL EXECUTNE <br /> U.S.C. 1 1 Sts. lRNrldr• uww tlwr mM•• m•r ircNnl• rn•• ~ ro t IO,OOD AREA <br />TYPED OR PRINTED .+dwmuirwn iTp'lo.,we ere•n.«n OmmeYl rq eT•va/ OFFICER OR AUTHORIZED AOENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANA nON Or Anr v1uLn I wlvs Irreverence en ertscnmenrs here/ <br />:IL_E~N9^.c LI!TT: r7a m'': ~r Ii'.7M -cTTLT1 ~L'. ")LiC;: ([•„' rl+) '"OL° r?^"IY ?' C= 10-vor ,!l-v-• Du''r~r ..,~u-* <br />IS =LAT_N^U• °_°; .-.A•T O': 1N p~q 7J R:1 r': 7P F , r , n .. .. „_rra r, , <br />~, •r ~ A. O ~>F 7T F'^ ;~ 1TI ^v-'!I^" (1r^: -?'^^ r/r ~• <br />^u7Y E!Uf TU" ] uc Oncm Tor` Ivc nO.r ~+T'~~ro _c~~+url,ur nr <br />EPA Form 3320.1 108-951 Prevloue edlOOne mey be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) ~ „ ~ ~ rl /,t rt ('!) ~ ,~ - ~ T .i „ PAGE T OF <br /> <br />