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L <br />PERMITT lE/ADDRESSpnclude Facility Name/Locanon ifDgermf) <br />NAME L• •.°^SHP r'(`c7 ^•,frrO.• <br />ADDRESScP "T.''': 'n°S'L°X <br />~,r I.n <br />~ ~ ... . <br />FACILITY C A A I' ~ ~ D ? 1 5 2 5 <br />LOCATION <br />If ?T•r A! ~': F'nf '~F C- L.q Trr p_p <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDESI <br />DISCNARGE MONITORING REPORT (LINK; <br />(4-f6) in- 9) <br />^ n •I 7 ~ n 1 n ~ o <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY_ YEAR MO DAY <br />FROM o~ nq ~TO ~n n~ ~n <br />fzo-2fl (zz~z31 (4415) /zuz71 (z&zB) (30J1/ <br />Fonn Approved. <br />OMB No. 2040-0004 <br />Approval expires 05-31-98 <br />-r,cTr p; ., .. . <br />7?^c 7n [ Tt^:T1p T(~ T1y n~ ^r:'r'.. <br />MOTE: Reae~ Instructions beko plating this form. <br /> (3 Clvd Onh) pUANTITY OR LO" NG (<Card Onhl QUANTITY OR CO CENTRATION <br />~ NO: <br />EX FREOUEN <br />OF JAMYLt <br />TYPE <br />PARAMETER 4653) 51.87 (54-Bf <br />(38-45) 4653 <br />(3aa71 AVERAGE MAXIMU '~ UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />lezm) ANALYSIS <br />64-68 <br />6&70 <br />S"; SAMPLE .:-n a a r,.4 t 2 n .~ ,. ~!: r.. ,.' ( "~ <br /> MEASUREMENT <br /> r <br />l)(?~Il ll i kl ~ PERMIT a##aaa ###IErAf dr. rt ~:~ <br />: <br />: ` #n+tr r,. r: o~!f <br />~:: <br />~ -::: (.'£{ ~ R~~`-. . <br />^ ° ::p,~.._ ft •~' <br />.Yrh9. h'. REQUIREMENT 'c'.vaC . <br />~:. <br />... ~ ,~,.. r( .. <br />':01.7J~~ ~^r: .'I• SAMPLE •: r. •:arc ~:......:.. #{#.: rr.. ( ~rl <br /> MEASUREMENT <br /> <br />l~Ot.riS 1 D r PERMIT •F;"nr,.aC R4e$arXCs 'r>':^• f![+ .oppncT Amt ''~',a`•' <br />. MCE/ '~~.$: <br />~'P-FLUi.'/~: ;F'1'': ',n• REQUIREMENT ..z 4fl tV' Tt rrro MT T ~':.- <br />U T. S. E ': t:';, 5'r. SAMPLE .... :'. ':. ;. r. ,.. .., -: ( 1'IV <br /> MEASUREMENT <br /> <br />C :1'>i!. 1 0 ^. PERMIT #oaaaa aPaaaa ~ a~ #blt ld3h 1 "' OMTIR flA!$~ <br />~F:.U°'~° ~ADFS YpS. `"P ~REOUIREMENT <br />~~ T - <br />FL'J=~ IY C7Nnflf^ '`P SAMPLE ( r]) '- 'rr''`Y <br />n <br />d " 7 <br />^ U ' <br />F ~ <br />k <br />'f " %+~ MEASUREMENT <br />I, <br />; <br />q <br />T <br />? <br />i <br />`,U,+`, (1 1 <br />P ~ PERMIT P P9~" RF^)P" r,.#trir~b °.^ <br />#$tdkL~t ~! hR#Yx## <br />? NC*# '1r5'1">~ <br />. <br />r • r . r; <br />F.F. LI,F..T L.F')F, Y4L'.F REQUIREMENT r <br />3 0 . t • <br />D Y :1. a <br />''' = '' ~ '''" <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT '"~°*-. - - <br /> REQUIREMENT _ - <br /> SAMPLE <br /> MFJ~SUREMENT <br /> - .:...'.z::. . <br /> .. ` <br /> . PERMIT 'x' ~ <br />- <br /> REQUIREMENT - - - - <br /> SAMPLE <br /> MEASUREMENT <br /> ~ <br />~ f:;. <br />PERMIT- :. ~ 'Ya <br />~ ®,G <br />7,.w ..h <br />,~.. <br />REQUIREMENT ' <br />" "'~~'~` - '~"~' <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT 1 HAVE PERS <br />AM FAMILIAR WIrH THE INFORMATION SUBMITTED HER ONALLY EXAMINED AND ~• TELEPHONE <br />EIN; AND BASED ON MY ~~ r <br />., DATE <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPON <br />I BELIEVE THE SUBMITTED IN <br />THE INFORMATION , <br />SIBLE FOR OBTAINING /' <br />FORMATION IS TRUE, ~ '' /~ q <br />. <br />, <br />Richard Mills <br />TE AND COMPLETE 1 AM AWARE THAT TH <br />A /~ <br />ERE ARE SIGNIFICANT ~ { l'/ / p <br />/ ' / Gf <br />CCURA <br />Environmental h"ana er PENALTIES FOR SUBMITTING FALSE INFORMATI <br />POSSIBILRV OF FINE AND IMPRISONMEM. SEE 18 U.S. ,. <br />ON. INCLUDING THE 970-070-2712 <br />C. § 1001 AND 33 U.S.C. SIGNATURE OF PRINCIPAL EXECUTIVE 7 28 99 <br /> oOO entl a <br />nemas under mesa sbtures may Incfutle ones up ro EtB <br />(P <br />4 7318 D AGENT <br />ORIZ M DAY <br /> . <br />. <br />e E <br />OFFICER OR AUTH NUMBER YEAR O <br />TYPED OR PRINTED menmum impnsonmenl of pefween a rffanln5 entl5 years.) <br />COMMENTS AND EXPLANA I ION OF ANY VIVLA I lulus (reference an artacnnrenu ner <br />~ ? i1 L "TT f7D l III {Frrn rYr•.(m_,..= r fly). rqi ^ - r'`.•?R~'~'NTS• I~1I. c. <br />.:ET Lf;A:~LF LT''- T ''+A IY~;p ICY°,. l1't p'. <br />r ~ c- r,ru r n:9 i[' ~ cl~c qurey re (Tn~:. .ran ~o.~nr.. e.r-.I T..r T~'.T Pn('TTC+VC-~~~ °r <br />GkeASE G,A ..d", - 1"ALY`;Ig i%;)~J[ Vi, I .. - <br />EPA Foim 3320-1 (OB-95) Previous editions ma not be used. (REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.) PAGE OF <br />