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PERMITTEE NAME/ADDRESS (Include Faciliry NamrJLocarion ~/Digerenq <br />NAME FiCI(fT1tIRE FFCCLSSINC:, LLC <br />ADDRESSN F. 4i E L R MIN E <br />1311 URENTACCL LeIYE <br />FACIUTVEVAtISVILIE IN 47711 <br />LOCATION~c,~TCN CC B1U9I <br />RTYI~: AL FENRY, MANAGfI; <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDESJ <br />DISCHARJGE MONITORING REPORT (OlMR~9J <br />PERMIT NUMBER OISCNAF(GE NUMBER <br />MONITO ING PERIOD <br />MO YEAR MO DAY <br />FROM ~~, ~ TO C G d <br />(2 "~23J (2425) (262]) (2829) (00-31J <br />Form Approved. , <br />`. L N C F OMB No. 2040-0004 <br />Approval expires 05-31-98 ~ <br />F - F1AII LACAS <br />FEFG`[ FFFA FCi+C 1C FLfGE1C]FE <br />{ox nC C1:ChFFGE ~ ~'= <br />NOTE: Read Instructions belore completing this (orm. <br /> (3 Card Onry) QUANTITY OR LOA (a Card Only) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53J (54-61J (8-45) (46-53) (54-61) EX OF TYPE <br />(32-37J AVERAGE MAXIMUM ~ h:M~NIMUM <br />_ AVERAGE MAXIMUM UNITS <br />16z 631 ANALYSIS <br />(64-68) <br />(69-70 <br />PN SAMPLE fiLAGY# ~~40>t ~' O+ECS~9 I i.) <br /> MEASUREMENT <br />-UUUU I o G •'` aeRMlr ao~looa.. a >Qe~..:a »y~ .~ - <br />^~ ~ .; „ EENtY IrsITN <br />i F F L U E N T G R C 5: Y A L L E ~RFJ)REPY1Et;ht ~: ;. >< tt 11f I ~ '~-2~! 6- ` L <br />`'Ii LIDS, TGYAI SAMPLE °'yC`}r;: ;}r,t:a'•L i~yi440 ( It) <br />+ U i' e N G F G MEASUREMENT <br />UU~3C'~ 1 U C v.' AERM17 gIR01N.C Yil OaOaA r.; O11• a,. <br />~~ C MCE/ F;1E <br />r.FF'LUENT GF.GSS YALL'E FIEQUIRE¢i}ENT ~ :t;~X .. ''MQ`" ,y <br />~ <br />-i'Y !!X NC/L !.C'Y7F <br />~CLIUSr _:ETTLEA2IE SAMPLE 'j''~~`X"f "'"' 4'0~9t~A 04C 'F~' I :`) <br /> MEASUREMENT <br />uU~4S 1 U C PERMIT A .A o4 gtSOAOA .>0 *L4~ 0>Q#CQ -r ~,. ~-:"~{ <br />~ •B? C YCK/ FIDE <br />tF"FLT7dNT GRO55 YALLE ~FS?UIFIGMENT ' +•~^* <br />i _ <br />'_w` . <br />Y h1/1 pC.7tTF <br />IFGN, TGTAL SAMPLE ,•.:'t'4`'"~ ::'~'"~ ,, t. '~+' ( 1~) <br />(A 5 F N) MEASUREMENT ( G - <br />1J1/5 1 U U ~'.~PER~1( I m>0## 04A F x:k' +R - ,;, w C CF/ F!ll <br />uFt'LUE(+T i;R055 YALLF ~L9UTA~,Nf ~ s"%.% -'!.~, ~ Ci, _~'~"~~~ ]!% PC/1 t!C47E <br />_iL AKC GREA$E SAMPLE .k+?~X%ti:: K'4^r=?•^. K'+. {:rv ~p -, IP09+'. ( IS) <br /> MEASUREMENT <br />UJ5i2 1 U C F!EHyIkT o>9!OAI # 394>d '~:c Cm ii+6%: CMTIM fAF <br />t' F F L U E !: I G h 0 5 5 Y A L G E EQGIFIEFIEN7' +• +~ +:• ~~ `~ ,,'t 1 li " M G/ L t A 7 <br />iLGi+, Ih CJNDUIT CF SAMPLE I 3) '~''""''`~" ~ t A "++tt <br />?'hU 1'niATtlEWT PLA FT MEASUREMENT <br />`.+GG~t? 1 U G "`'"p~FtM1T: pIlA ~ . 8 FC d ;4 - ',~-. <br />+ -. O <br />~ ~ IG{C ~ " IiIY M9T~6 <br />cFFL;:kY'[ GitC55 YALGE 'RECtE)I1~EM~FfT 3'~D! ~Yfj{' 11AILt M~ !C[. s <br />~ <br />~ o+;x'. <br />_IL AND C.hiASL SAMPLE +"~;~''~` I `ITt) na:.:,; 40 Ob:: >a <br />t:SY <br />L' j j U n L MEASUREMENT <br />c~:Joc, I :1 U :. PERMIT .. EE=1 - ~#~~# ;;~x ". ~, Stt f <br />~ FkRF1 ]fUAI <br />~~: ?~.-{!#~- FC=O ~ *' r,'"'t~`: <br />rr'LJENT GkOSS VALUE a'C©CVIEiEMENT' <br />NAMEjTITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED AND TELEPHONE DATE <br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN: AND B45ED ON MV <br />A INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br />u THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE. , <br />L <br />~ <br />, <br />- <br />, <br />~~ <br />~ <br />1 ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT <br />INCLUDING THE <br />E <br />OR <br />ING F <br />INFORMAT <br />N <br />P <br />NALTIES F <br />SUBMITT <br />IO <br />. <br />ALSE <br />Z 111 1 %] <br />(Q <br />a <br />(A A (ti POSSIBILITY OF FINE AND IMPRISONMENT. SEE 18 U.S.C. 4 1001 AND 33 U.S.C. IGNATURE O PRINCIPAL EXECUTI , " <br />TYPE OR PRINTED merimurriPmnn'sonmefM Ol bet tea n6mmonNU ~SUde tines up ro St0,000 entl or <br />P Yeam.J OFFICER OR AUTHORIZED AGENT <br />DE <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference al/ ahacnments here) <br />3C UF.Y AYiRAGt IS h1CEEST MCgTd1Y AVG. CUFI~G PEFICL E~FCF.TEL. Cll L GFEASE - `_cE I.E.I.C, F. S. 1`~ Z <br />::]_?.L TFGN LIRITS 41L1 EE i.AIYEL, ANC SETTLEABLE °_CIILS IIY11S AFFIIEL FCn <=1CYF,i4t:F FFECIF EVEF7-SETT. <br />u m cc rvcr Ter T; ~invo ~r Me r ~sr•LF i'V T SEE Ai4 'r~~"~/er~~sn iN re rE~.-F Ff~l-i°e`-i-.--'~-~rF' <br />EPA Form 3320.1 (OS-95) Previous editions may not be use ~~PIACES EPA FORM T~0 WHICH MAV NOT BE USED.) C C C 2 3 J C G C I ] 1- ] E : ( PAGE 1 OF <br />