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PERMITTEE NAME/ADDRESS (Include Faciliry h'ame/Cucaricn ifOgerenQ <br />NAME CIP!{IJS I•'•PLRF. CORPORATION <br />ADORE$SgpGLE ~Iyc. ~^IfP1.EX .. <br />P.O. 9DC h1 <br />FACILITY CRA Ii; CD 91526 <br />LOCATION <br />A".";N7 A('.EOR;F. E. YA.7DA_ Y. P_ <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM MFOES) <br />DISCHARGE MONITORING REPORT (DMR~ <br />(z-rsl !Ir- 91 <br />^'YOn i T ~ n~ <br />-. PERMIT NUMBER DISCHARGE NUMBER <br />MONITORINO PERIOD <br />YEAR ~MO DAY.. YEAR MO DAY <br />FROM ~ TO ~' ' `~ ~ 7 ~ <br />(~ ~•(%2-201 l7aP51 (2621) (1B~28) (30311 <br />Form Approved. <br />OMB No. 2040-0004 <br />~ I ~ O R Approval expires 08-31-88 <br />('1^4R Nw) <br />~T~'~t. v?rA <br />^c19'l lt~r ~~T n+P~rTvr, AT 'f 211 <br />NOTE: Read Instructions before completing this Corm. <br /> (3 Card Ony) QUANTITY OR LOADINO~Y~ (4 Cero'Onty) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-B7 38-45 46-53J (54-61) EX OF TYPE <br />(32-37) AVERAGE ~ MAXIMUM U TS MINIMUM AVERAGE MAXIMUM UNffS <br />lszml Avat~IB <br />84-Bel <br />6370 <br />"; P.F'y~h:CT STATR% 7DAT SAMPLE sst01p8.x ta..~a _ 4f-;:t:;` ( ~lJ (~ ~ <br />/ <br />C H :i C E k L'J D A P 9 Y L A MEASUREMENT ~ <br />Q Q `~ OM 0 <br />T C I' 19 i U D ~1 <br />, <br />~ . £kE~iMll ~ 1r#~ ; O ~ : ~ ~ `-`~' >IKiFRP .T ## '1I' - P u- TtLx ~1 <br />SEF <br />C6r!MEMTS 9~'f <br />"1~ ~ <br />; <br />AEO[)1~EN)~NT, ~ u , <br />'"" k= :.' <br />3 .. <br />y rcr* <br />. <br />. .r . _ <br />- <br />+Y.FFECT STATTF 7nAf SAMPLE rT8i8"~ 0~~8+"• <br />~~ O O B yS";x <br />? -.. .. -. ( ''11 <br />O 1 <br />~9 /' <br />it H P I' E P H A L F S MEASUREMENT ~ C O <br />TCPhC S 7 n . '`PEF#MIY <br />- "¢8A!!pi~ P 8'91 ,#:,, '~ ~•` IRS` '- .': 1 A#~+~i1nR -. cR- T4lL'f~ ~ <br />3P.8 COtlf1F:hTS Rg(,7Y , <br />PEOUf~EMENT „~~ t =':r;:z -•.~j~ "'~" ~ r->:' .r <br /> SAMPLE <br /> MEASUREMENT <br /> ' ' - <br /> AEOUIREMENT ., _ <br />',,,, ~ , t ~ Y <br />r - <br /> SAMPLE <br /> MEASUREMENT ~' <br /> ,, s <br /> <br />REOUIfiEA1,~NT <br />- <br />"' <br />- . <br />,=~ <br /> SAMPLE <br /> MEASUREMENT <br /> =s ~a ! ~ <br /> REQUIJ~~<y~~NT ~a yt` „+,~~+~. a. ,~~*. <br /> SAMPLE <br /> MEASUREMENT <br /> ,PERMl7,' <br />F <br />~ <br /> <br />~ <br />~ <br />~ . _ = <br /> <br />+ <br />:~ <br />~ <br /> AEOLIi~iEM~N _^ ,. <br /> SAMPLE <br /> MEASUREMENT <br /> <br />~ ;. <br />` <br /> <br />REQUJREI <br />~ z <br />1~NT~, ~ ~ ~' ~<:. <br />~ ? ~ ~ l~ <br />~ <br />, <br />y ,,, ~: > <br />, - <br />. <br />, <br />NAME/fITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTYOF LAW THAT 1 HAVE PERSONALLY EXAMINED AND <br />TELEPHONE DATE <br />AM FAMILIAR WRH THE INFORM ATION SUBMITTED HEREIN; AND BASED ON MY <br />~` <br />INQUIRY OF THOSE INDIVIDUAL <br />Richard Mills THE INFORMATION, I BELIEV ~. <br />S IMMEDIATELY RESPONSIBLE FOR OBTNNING <br />E THE SUBMITTED INFORMATION IS TRUE, <br />2i2 <br />ACCURATE AND (:OMI'LEIE. <br />EnvironmelTtai A4anBger ~ <br />1 AM AWARE THAT THERE ARE SIGNIFICANT <br />Gf.Gc./ <br />~C <br />r )7D-87D-2712 <br />E <br />7 28 99 <br />pOSSIBILffYO~FINEANDIMPR v <br />ISONMENi.SEE1eUS.C.4100CAND33U. C <br />SIGNATURE OF PRINCIPAL E7(ECl1TIVE <br />' TYPED OR PRINTED 4 t3t9. lPeneltles under arose a <br />menmum lmpdsonmerrt ol6etRae Mtures mey Include Brias w ro 510,000 end a <br />nBmw4hs ondsyeen.) OFFICER OR AUfHORRED AGENT NUMBER YEAR MO DAY <br />s <br />lS <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference an ettacnments Here) <br />SEc I.H.) F7R 9~?PA fL`i. 4'4P?4T LPTHILITY ?rFIYATI7RS AS °'.E°pr^r'r~ 'R~yTo~avp~ry~;lt-T77M Ac "TnTTCir~". RPM <br />LO.INST t'PP[.7^NT AT L'9ICN STA• SIGYIP RIFF dF.TIF,F.W C?iT ° !'ONTRDL WAS ^Q'OOVoh rICTNI: rrST Cppg r1M~ ~.-~~ <br />EPA Form 392x1 (08.95) Previous editions m`ay `not be'used. `' (REP~i4CE 'EPA FORAAII'T~0 WHICH~MAY NOT'8~'LS D.)r `' ~ ~ `~ " '' 1. 1 ~ ~ ` I t ~ > T. IP OE OF <br />DDL 159/97 ^+al 2-1523 1 <br />~~ <br />