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<br />PERMITTEE NAME/ADDRESS R.d•'d•FrdryNaw/!a•nw UDlpi.wn)
<br />NAME C. T'" .. ..~.. ~
<br />ADDRESS '"I I \ ...; 7- • ~ '. 7 i 0 G'I.!: E _ `. ^ .. f •J r
<br />'~ ~NGL ..r I~.^i ~i ~~'L7]
<br />FACILITY
<br />LOCATION
<br />NATIONAL POLLUTMT DISCXMOE ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MOfITORING REPORT (OMRI
<br />l1-761 lI7-191
<br />~g0~27T5'J null e
<br />PERMIT NUMBER DISCHMOE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAV YEAR MO DAV
<br />FROM '1 Y !S ~; TO ~". ;~h 1'1
<br />IJO-J/I IJLJ31 /J4.J61 /J6J71 !J6-J91 /3Q3/1
<br />Form APProvad.
<br />~- o- , -. -. r-,OMB,No: 2040-0OOa-
<br />. ~ Approver expiro9 OS-31-98
<br />f';.r~~ .;•.~ '
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<br />NOTE: Raed inetructione befor co Istinp this form.
<br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING !4 Grd Onlyl QUANTITY OR CONCENTRATION NG FREQUENCY SAMPLE
<br /> II6531 15x671 I3B-451 !46531 154-E'Il DF
<br />132-371 EX
<br />MALYSs TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 16J~6J1 !64-681 (6'¢701
<br />~~'~7UCT.ViT'i SAMPLE ,'F1:: ..^;t;:.^: r. :tr:.:~N f tll
<br /> MEASUREMENT
<br />')C J'.1 !7 i (7 :1 PERMIT '.`-yF-.Frf ##L+#fi: .;4;: z~I:t.-...s Hj?D7F'I' C'0"-'LC."'~L 1 'M".7/ 1 ~~'?LY 1R4"
<br />. ;' L'J @ y T• (; Y'I ~; :; •f : r r c REQUIREMENT # y;.y r
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<br />P'i SAMPLE ,-. tFFC"-#;:
<br /> MEASUREMENT
<br />,l IJ 1;J'J 1 U l! PERMIT ~:~^Fr. ,: :x'.`44# t' #~ti y,5 #^y`O#Y.: ~ n vo
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<br />.. REQUIREMENT F#FF iC!t7yt"I ~eTI"i"K Si'
<br />30:.7'J :iF Tl1TAl. SAMPLE ;: ;t': ;: ': r--i;: rFFri yt:Y •; #.A ?: ~ i 3~
<br />j tJ g p g y n 1~ ~ MEASUREMENT
<br />.'~i3^ J 7 1 PERMIT ~;::;;~FF 44•::.F.i~' ,. 2:t'r#"."r nPnn.aT A?FJ,"" 1 'f`•'•/ '~4°
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<br />iO Li i)S, TrJ °'!. SAMPLE :^:h {c.-~:;; ": .^. ., ...c..;...,~.. ~ ~0~
<br />.:J ~ P F. N P c, ; MEASUREMENT
<br />'JSSO - 0 ~ PERMIT ~;:,-.`t.'=»;t #?a;F'~ -r ;#x ~'x3~>':r,: tc 'G f NCp/ :De'
<br />•FFLUEf:; JPCSS v1L'.1 REQUIREMENT C44P 3[1DA AYr; DAILY MX yf:/L ?1^PTi/
<br />i'ti,IDS, :>ET?LEE"•1.°. SAMPLE :"."tt.^F'.c r(:tF;~.`• :`.:k:~':•:i: ~ ~~~
<br /> MEASUREMENT
<br />JU~45 ~ U !' PERMIT 't#;L:t'Y •`- . ..FF-; .-}* t#Lt:!t#:!t ^-:OL1AT z:c . ..n/ i.~F..
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<br />JCL_ , 'S F: L 1 :L SAMPLE ^'s ~7rr: r: ,;: •SF:;::;: ¢$##[e ':
<br />~ ?5)
<br /> MEASUREMENT
<br />JCj'l5 1 D ') PERMIT :tr.`•'~SF:+ <#r"t^.a^.. # •".^•: TY't'GYJfi^ ocll,~va rt^. nnnT C "7^~/ Ta4
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<br />''.;'LIIENT GR~;~ ", I," REQUIREMENT r:#yt ?DpA RV^ fj6*jY MY ~,./L ~~rm,
<br />,, t~' SAMPLE '"?F~i=:` ^c¢.x .^:':
<br />,'.:.~Y F.XTft-;+: '.' .^" MEASUREMENT
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<br />~U55 c+ 1 U n PERMIT . . ... 'vG '>;~t~t # `'`:: `Y,!YS.',rCir . ~r:;•<•:t- T n )VT'T" '"',3 ~
<br />.•' L J ° N T G B ~: ~i :- ' i T.'J r REQUIREMENT ~ ~ n -'.t •: , n ~- in ~ .I
<br />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER I CERTI
<br />AM FA FY UNDER PENALTY OF LAW THAT I NAVE PERSONALLY EXAMINED MD
<br />MIUM WITH THE INFORMATION SUBMITTED HEREIN
<br />AND BASED ON TELEPHONE DATE
<br /> :
<br />MY INQUIRY OF THOSE INDIVIDUN.S IMMEDIATELY RESPONSIBLE FOR ~ - .:/
<br />
<br />Richard MIII i OBTNNINO THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATON IS /~
<br /> TRUE, ACCURATE MD COMPLETE. I AM AWME THAT THERE ME
<br />SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION
<br />INCLUDING
<br />Environmental !~iana Br
<br />9 .
<br />THE POSSIBILITY OF RNE AND
<br />PRI ~ 970 B70-27 ~ 2 7 Z 7
<br /> IM
<br />SONMENT. SEE 1e U.S.C. 1 1001 MD 9] BIONATURE OF PRINCIPAL EXECUTNE 9$
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<br />TYPED OR PRINTED U.9.C. ! t 3t e. !/11IIMMI uMr BI••N mtuh. /r.y Ycpd~ Fn.s w ro S 10,000
<br />rar muinun/mF•!••/unent o/brw•Nr6monaa.n06 yva/
<br />OFFICER OR AUTHORIZED AGENT
<br />CODE NUMBER
<br />YEAR
<br />MO
<br />DAY
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<br />EPA Form 3320-1 108-951 Pravloue ednlone may be u9ed. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.1 n ~ ~ ,
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