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HYDRO23521
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HYDRO23521
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Entry Properties
Last modified
8/24/2016 8:44:00 PM
Creation date
11/20/2007 3:53:06 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981044
IBM Index Class Name
Hydrology
Doc Date
7/28/1999
Doc Name
2nd Qtr 1999 DMRs
Permit Index Doc Type
DMR’s
Media Type
D
Archive
No
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PERMITTEE NAME/ADDRESS pncmde Pnd)iry NamdLocnnon yDlg:mrq <br />NAME <br />ADDRESSE P.%t,F i°It~'' .. ~`F•I Fv <br />P. O. "rlY 5' <br />PACIUrY <br />LOCATION <br />NATIONAL POLLUTANT DIBCNARGE ELIMINATION SYSTEM (NPDES) FOrm ApprOVed. <br />DISCHARGE MONITORING REPORT (DMR OMB No. 2040-0004 <br />R~'6) m-{e) v • " ^ ~. Approval expires 0531-98 <br />PERMIT NUMBER DISCHARGE NUMBER _ c + ~ ` r <br />..~ ~ t <br />MONITORING PERIOD ~ ' ° - ''' '% ^n ~ ' ?~' r ^ " ^ c~ ~' r <br />YEAR MO DAY YEAR MO DAY <br />FROM 99 Q '1 TO ^~ nc ~n l: r.: :: ..~ ..._ _~..fr_^ i ,.,, ,. <br />Ro-zt) Rz-z3) Razs/ Ruzr) Rs-zs) l3oap NOTE: Read Instructions befo leting this form. <br /> (3 Cert/Ony) QUANTITY OR LO I~G (4 Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-6/) .;k~. (38-45) 46-53) (54-61) IX OF TYPE I <br />(32-37) AVERAGE MAXIMUM NITS MINIMUM AVERAGE MAXIMUM UNITS <br />f6zsi) 'wur515 <br />(64-68) <br />6570 <br />('8 SAMPLE ': r: r-!vyr, ah~~;~:. ,. ,. ,... ( ~) <br /> MEASUREMENT <br />fiU4U(I I C 7 PERMR rx S*eRr4 7trctttR# i¢41k IR4b ~P f§"f/ RAC <br />F F' L IJ E: I+ T! R 7 i^ i' 4 ;, rl c REQUIREMENT =.<~r C G 5; ~ 1 - <br />• N H <br />°OLIUS~ rrn•v °' :r SAMPLE : ... r:`.::r,. ..,y:f..r. r <br />'rrl <br /> MEASUREMENT <br />G .);4? i ') PERMIT 4kxYpt(c ktR#;a'#R r^: ': QM, .:. .m.. .m:'i}"h'(`. s5 .. Nr_'°/ ~Rk f~ <br />F.FFLU'r'° GF',^'; `' 'fRi'I t. REQUIREMENT er; '.`` ~r ..r /t ~e ~m <br />L - SAMPLE h•r Y:nnR r.. r..tr•.. a< J i ~ <br /> MEASUREMENT <br />'.^~:^ 1 D N PERMIT 4##tY#t! 4Ur}RG+Y r* r~•: r. [t tLYX31I!( .. ~' #6C:.•~~ ' °, .: F14I?'xl{ ~k6 <br />F F L 11 E F T G P D'i S v? L'! F REQUIREMENT ~ ~F~ 4 ,~ t V r/ r . <br />FI.'':• Ia ~D.~gI1IT C,u SAMPLE -.. ( C3i r: >:.n,. .. ,. #'YC7#a A~ki~r;-e <br />T r .: II T P C a. ^ v c r! ^ I~ ~ MEASUREMENT <br />`aU('S:1 I :) I) PERMIT REPORT P,FPOfiT ##!trtglyT R#IpRal!+ D3~F ~ 4~" K!'?f " N!STkM <br />''FFLi:=ti" ;?1ci '!1 [."- REQUIREMENT j(}{)A AYa D ~ sr !( - }-.- 4vs u"'< <br /> SAMPLE <br /> MEASUREMENT <br /> . PERMR -. ...;-_-- - . y <br />w, - <br /> REQUIREMENT - <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - - <br />! ~ - <br /> REOUIREMENT - - ,~?- Tt± <br /> SAMPLE <br /> MEASUREMENT <br /> PERMI'[ ,. .. <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERRFVUNDER PENALTY OF LAW THAT I HAVE PERSO NALLY E%AMINED AND <br />AND <br />N MV TELEPHONE DATE <br /> <br />Richard wltl{s AM FAMILIAR WRH THE INFORM <br />INQUIRY OF THOSE INDIVIDUAL <br />THE INFORMATION <br />1 BELIEV ATION SUBMITTED HERE <br />S IMMEDIATELY RESPON <br />E THE BUBMnTED IN BASED O <br />IN; <br />SIBLE FOR OBTAINING <br />FORMATION IS IAUE, / <br />r'~ <br />n / <br />', <br /> , <br />A <br />O ~ I / <br />Environmental A7ana <br />er P E ~ ~ <br />"' 970-870-?712 7 28 99 <br />g ENALTIES <br />FOR <br />SUBMITTIN G FALSE <br />INFORMATION <br />NCLUDING <br />THE <br /> POBSIBIL.ITV OF FINE AND IMPR IBONMENr. BEE 16 U.S.C. § 1001 AND 33 U.B.C. $IGNATURE OF PRINCIPAL EXECUTIVE <br /> <br />TYPED OR PRINTED g 13te. (Perialtlac under Mace sdMes mey inclutle lures up ro ff0,000 entl w <br />minimum lmpnsanmem or beMreen6monMS end5yevs.) OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reverence ell et[acnments RereJ <br />$£TT L~R`1 L.; `:}L'~_ LT°T^ .:4TV?D ("1v )IOyc.~',7No n7 r('Tr eLr r•rm_^t. -. ~. 7. f, .. TVr r~r .'r•;.I N^' fT <br />+uc+rc r 1. <br />:.4FhSF. ,hAP fll"^t.r Rr~Ai.Y'IS !~$?!fIGCrT Ic PIgIq{c cti; rx; ^.,t~,r rOly=n. '1pTD'v "A N;. I.~eP 'u~TngCT7f~VS-?~°.1, <br />EPA Form 3320.1 (08-95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) R n n tl 0 / 9 ^ ~ U ~ z_ 1 5 ~ 3 PAGE) OF <br />
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