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PERMITTEE NAME/ADDRESS pnclode FaciGO•Name/Lncarion ifDi//erenq <br />NAME S::At'CA CCAL CCrF6NY <br />ADDRESSU 1i A M E k D <br />t1AYDEN <br />CG 81639 <br />FACILITY <br />LOCATIOf~ATDEN CG 41630 <br />A'fTN: G. bU0 5NOitw, GtNE:tAL MANAGER <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION <br />DISCHARGE MONITORING REPORT <br />(Y46) <br />occL <br />PERMIT NUMBER p~ <br />FROM <br />MONITORING PERIOD <br />f~9~26) r26-2]J <br />(NPDES) Form Approved. <br />M I N C R OMB No. 2040-000, <br />Aoproval expires OS- <br />~suse ~~~ <br />DUMBER F - FIIII FGUTT <br />GI:CHAFGE TC GEI_'S1 C6EF! <br />DAY -- _ <br />~U fitrYS NO CIECFAFGE ~~~~ 0 t <br />r3o-or) NOTE: Read Instructions before completing this form. <br /> (3 Card Only) QUANTITY OR LOADIN (S Cerd Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-61) (38-45) (46 63) (59-61) EX OF TYPE <br />(32-371 <br />AVERAGE <br />MAXIMUM <br />UN <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS <br /> <br />r6zm) ANALYSIS <br /> <br />rw se) <br /> <br />(6sao <br />I A N E <br />i(I S U A L SAMPLE <br />MEASUREMENT ~ a ~ r v I: q ~ ,~ 4 a D ~/~ V( 5 <br /> <br /> <br />4 b6 1 0 1 <br />~:p};RralGr'-~ <br />:''~ <br />;~ ;. <br />15=1 fifi <br /> <br />F:FFLOEAT UHUSS YALU <br />~l~k~l~~M$N~ <br />- <br />` <br />~ <br />`~~:`, <br />0 <br />,~~ <br />- ~ fiat ~ Is6il~ ~~"_ <br /> , <br />r ~ _-- <br /> SAMPLE '"`S'am =4" <br /> <br />MEASUR <br />E <br />M <br />ENT r <br /> ," <br />,, <br />S5,, ' <br />~ <br /> EiCOmREyIEN <br />T ~ ~ <br />, <br />u .:~ ~ <br />- <br /> , , <br />. <br /> SAMPLE <br /> MEASUREMENT - <br /> <br /> +~G{UIFi6MENT ~ - , <br /> SAMPLE <br /> MEASUREMENT <br /> t.-;~E .M~ . - - <br /> <br />• SAMPLE <br /> MEASUREMENT <br /> ~ <br /> 'AEQU <br />E ANT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> <br />. . <br /> e <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTI <br />AM FAM FY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AMINED AND <br />ILIAR WITH THE INFORMATION SUBMITTED HEREIN <br />AND BASED ON MY TELEPHONE <br />~ DATE <br /> ; <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE, <br /> ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICAM <br />PENALTIES FOR SUBMITPNG FALSE INFORMATION <br />NG THE <br />INCLUD <br /> . <br />I <br />IB <br />OS <br />LITY <br />F <br />ME <br />T <br /> P <br />I <br />FINE AND IMPRISON <br />N <br />S <br />O <br />. SEE 1B U.S.C. § 1001 AND 93 U.S.C. SIGNATURE OF Pll NCIPAL EXECUTIVE <br />TYPED OR PRINTED r§nexlmuml~mnASOnmen~ol beMeene6 maonlM1t entl Setle lines up ro fro,coo entl or <br />p years) OFFICER OR HORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br /> DE : <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference ell ettachmenf5 here) <br />TSG t; iNOir LIMITS iIILI E1; YAIYEG S 58TTLEABLF SCL7C5 LI!'IT AFFLIEG FCF <=lOTR,2GtF FisECIF FYEd7; T55, <br />IRON L ScTTLFABLF SCLIGS LIri1T5 iAIY~D FOR J10TA,iYNN PRECIS EYEIT SUBJECT TC BUICEA Cf iACCEIT I.A.T. <br />A !.. T <br />_„~PA~Form 33207 (OS-95) Previous etlihOnsmaygot4g,VSed.-. _ -, -, (REPLACES EPA' M T-40 WHICH,MAY.NO'~~~B&tlSEb.) ~,...+,. ,,, ~ ~ .. - ~ .. ~. ~ PAGE - OF <br />