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PERMITTEE NAMEIADDRESS Ou"LV F~rNry NaWlauran I/Dl~irar) NAME h:.An ~,VAL l'G71E'nh~f ADDRESS dCAn 60. 3 Bll+t >:.c. eox 51ii SGiyi.~5t,' FACILITY LOCATION C~ Blu3u nI-t :.: GADLl:L cL•i•. :ti, !'YIh_. ::nNAC:ck -. ,•_ r„ - :.: n~ .i:.,.: Forrn Approved. .; s~~ ~oU 2040~Q~ ~~1'-98 Approv 1Xplf - J :.. II L. ..1 St. llA nGi ^t+°" NOTE: Rrred Mstruetlarr t»ta ompNthlp thk lam. PARAMETER l3 Grd Onty) OV OR LOADING f nlrl QUANTITY OR CONCENTRATION NO, FREQUENCY SAMPLE lI6531 5.451 ! -~5 !6653 51-571 of TYPE l32-371 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !ll esl MALrsls l5F681 15&701 F d SAMPLE -:.=9 '~'> ~.~ '~ as#a -) t. <:1.:::" ( L L MEASUREMENT •_v~.U ~ U U ,;.: ~P(RM4T~::~ ~ as§.##0 YJpoel `#::. o' . ~ ~ "E~«~: ~:':. Yr~i~i+I ~~~ti'~~.~ ~ :~~g~~r'~.:.~:~.:~: .~:..:: :~~; ~ll}~~C.;IEk~~~ :l~ti:a~..~~. c r: L U i h I ii H U 5 5 B A L L EQUIhEk1EN7.:~ ~ :: ~ >~ . . ......... ~ ~. . . :i !.ill:-i, iC'tAL SAMPLE c~+p ~i ~r:r oud, ;r; C4#%7+;~ ( :9 ~ L:i r ~ N il:. 1. MEASUREMENT ~.,L~~l 1 O U ;:::.>.~PERMIT~~; ~ ~ Llr~tras~ ~:~:~: a~i.~. ~;~~'".:#It~6cq~r ~ a~<;; ~~?`, .... ~~ ~~3~?., ::. '.'; ' ' ~~.. ~-p ..::~, ::':. ~ ~:~~G~V'. i3~~~IfE~ ~~ GFF LUt yI i;hU55 YALU RE4UI.REMENT ~~:: . . . . .. , ;+~'~:: ~..:::.:.;.":~~: :a : ;~::r •;. ..... : :.. , . .. . H~ I . ."' . . . . . , .. , : . JLyi: J, ~L'L iLte. . Li SAMPLE +x il,}rf ;y aao~raa V#~dl9ta ' +7~Oa4~. ( cS MEASUREMENT ~ ' . ~ L ~ ~ ~ 1. U U PERMIT :. .:...>ti~aar~~ gAitli:?Ilii,.::;:: va a?4if.#~%F±IEx<: .; ;::<3i?;+R~.4t, .: .:.,:`::'.:.. ,.. 1fi;~UAr£ .: {3~tCG,ta ;t* ~i}i ..rELJtNi :,HU55 Vl..U EGUIREMENT: .......,. ...~.~...'~ ~ ~. : ~ ~:'~ Qa .~.~.` a !11 ihl1V, ~PUinL SAMPLE 4#~`?L;: i•i:•L::::; I,u#Ar#~I ( .lg (1f ,, p4~ MEASUREMENT ' . ti,~ 1 • PERMk'l;':. . ~.~: ~..~;R4.,. #~ ~ ~...::. ~.. x+IG.~!'0'Xs ~«: .'.:: %A ~.1i''..`., .~.~. :: ,... .. .' .... ~~.i. .'~ . ~•~~~ .rrL'Jth1 c,kU55 Y.~LU . EOUIREMEN~ . +1t;<„ #vr,v ;'~~ A'L+Er Y f3~l.~~k rX r.:,/L ~:,~ . i( ..1L it :ID uA6A$5 SAMPLE ¢a#Mt01131 #y##rA: k+s ~...::. ~, 4u###G ( l.)) 1 MEASUREMENT ~9~.i i fl C fiRMiT':. `. ~ ;~z ; :~P ~: .. ~$4 ~:(N~ <~~ Iw~>pi.~:a : % r,, .: .: :3~#.G.S!~IW#.~: ':'<:' ?L~Xi!~:: '~:~' ::;':.:~ '~Gt:~ ~i ~i "pia ~S~; ~;~: :Gi::~>t ~i~ .,FF UL;vi C,A05~ YALU . . . . ; ~iiE.O.UIREMEMt .. ::, ::.: .:~::^<>~~;' ......: . .. ..,.... ~::._,. ...~~:.~ . ,. . ~ ~~ .. ' :: ;~ -~e.;':~::," .. . . :. Ayy y~y !1G/ . : :. . f1~:, iA COM~UI Gk SAMPLE ( }~ ,.. #:::;u,:: ,:-r r, .nnU nb il. Mf.R. rLAy MEASUREMENT ULv 7v i i} 0 ':"'.°PERtiAIT::...: ~:, '. i~H. ..: ~~ ~~~ <~9 ~„: :~ ~~': ~:A s:.:: #;~~u ~, ~.ah:~gG.?. ...: ~:?+#r~.gG:p:: :1~Oai !':%;~.£i ~ ,~' ~.~~~~.~'lf:. :: E r .. U t a I L; Ha 5 5 ti A L U f1E0Ul9.EM.~NT . . . . ;# (t}~~Y~: . . ~~ .~E~ "'$iX• A ., L ; ...::,..., .. ... v a s A :'::i ;, ,... . . .,LL VS, U SAMPLE ~ '~' ~ ~ ~ ~ , 1 ( •' ~) u._~uLYaU MEASUREMENT ~.~-J. '~ ~.,~ . :...:. ~:: 4 •j:'S:,.i:;.:::::.~a> .. : ... td ~ ~':' $:u i':S i: G ' );;:: ' 'i „~ . u. ... . x ri ~.!: '~': :. '. LL.:L ~"' N~': :<::'s:.:~. ...~'~. ~' 'y~''~'. •:~'~ : : .:~ :i :' _'~ ~ Vii.: ~ .~.. irr LJLdL I~HUSS YA1.U . . . .. . .. :.:.f1GfIi~,N:l.~:~ :.... .. R . . ... :::: ~ :....: .::::....,,.:.~.. .: . .. . ... . . . : : . <:.>....:.:.....:..:...:.., .:.. ~` ~.,...:.•.~,^.~.:.:.:.:.. #u,t4 ~;. ... .: ~ ~ ....:..: ... .:.:. .. .3kDtt ,: A:.V.b :.: .~:A~1:~:Y.:: hX lS ~~/L ~r,.~¢: . . ., s:i1~:?`:;': ~.':::: •:.'~:'.::::'.' NAME/TITLE PRINCLP,AL EXECUTNE OFFIC R 1 CEIITI A F FY UNDERYENALTY F M V T 1 THAI/ NAVE PERSO TIppNN 917eMITT 1 D NALLY E%AMI D eA EREIN NED MD 9ED ON TELEPHpNfi DATE ILIM M A A H. THE INf0 MV INQURY OF TH09E-I E H M 1 UAL9 IMMEDIATEL : M Y RE9PON91l LE FOR OSTANINO 7HF •INFOIIMA I E UEVE THE 9WMI TTED INFORMA TION IS ~' ~ TRVE. ACCUMTE AND 91QNIRCMT PENALTIES f011 1 lt. AWM MITTND fAL9E INf E THAT THE OM1ATION IN RE ME CLUDIND ~{ ~ " l , ~ ' ' %~r r F, ' ' ( THE P095191LITY OF RNE µD I MMI90NMENT. 9EE 19 U.9.C. 1 f00t µ0 79 PRINCNA E E E T '- . r . U.9.C. f 171f. /MrRW uMU ehrr mNroa rnrY IxAA, M.. w ro t rO,ODO iIONATUR OF L X CU IVE UTHORQED AOENT FF R R Q N(1 R C YEAR MO DAY TYPED OR PRINTED .nd>rnuh..n lrwdm.n.+r oranr.nsnwna..lss r.ral ICE O O A O COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRef~rence ell ratt~ehments here! ' . :.~ v 1v~AL I1cUh ;.191 I.: RLLL 5B 1fAi4~~, nNL Si.21LLw LLL .i •.LL :. Llili Ac r.,. _.~ rLh <=L~YNfZYM F. Fh~~, c' !'.S-~ +~'r 11tJ i+ AhU >c:T'lLtFESLt :;GL1D.~ LIFIii;i ~r.iV~~u fJk: ~=~Yn, 1b~r,,:. l:Li• r:r..,li-n. :Allf ;;VCU9FgiAS IOri-Sic ..... J. EPA Fam 3320-1 10 •951 Pnviow editions mey be used. IRE LACES EPA FOF1M T-40 WHICH MAY NOT E U8ED.1 J 4. U 6 7 / y b U oV 1' U :~ 4 j PAGE , pF