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L ;/ <br />i <br />14HMITTEE NAME/ADDRESS IL,.rr~..~Ln M.r..~L,..-m,,..,gv.p•:..e, ' <br />NAME TRAPPER '1ZNTE' :, TvC. <br />ADDRESS TRAPPER `ITtif. <br />P.o. Rix i=~ <br />CiA'ii, .0.81625 <br />PACnrn <br />LOCATION <br />dT?M: 9, GORD7p PFTP. R.S_ PRY4/GRN 1!IGN <br />RATIONAL POLLOTAHT DISCXARG ELIMINATION SYSTEM INPDESI <br />DISCHARGE MONITORING REPORT IDMR/ <br />rZ-161 17-19I <br />PERMIT NUMBER DISCHARGE Nl1MBER <br />MONITORING PERIOD - <br />YEAR MO DAY YEAR MO DAY <br />FROM QIt TO q D5 1't <br />Izazn rzzav rzszsl Iz~zn vaavl r.Ta311 <br />Form Approved. <br />~ T .I.I p OMB No. 2040-0004 <br />{$(14t4 "11) Approval efcpirss 05-31-98 <br />P'1kp 11 .T^ UTF GULCH <br />aai N7 D75CRARGF( i at~a <br />NOTE: Read inatructlorr ba W B11np t¢ia lorm. <br />PARAMETER l3 C.Yd only! QUANTITY OR LOADING Is A.d Onlrl QUANTITY QR CONCENTRATION NO, FREGUENbr SAMPLE <br /> !46531 15i-611 138-151 /653/ I5L571 - Of <br />1J1-371 Ex ANUrss TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS rcT-s]1 /µ5B1 Is4701 <br />OIL Abp ,;}iEA$P SAMPLE >l+seraaa' (" q.4) 4ljOha# .. ~~kttt>< <br />Y I -iU A L MEASUREMENT <br />B4D66 1 O p PERMIT 004etCt¢ REPORT ES t: aer}erExl+ ra~aLro:. `aaE"Afa~~;::: ears 'c ;~'$lG~~ ~#~f:k <br />EPFLU'cd? GROSS_4ALIJ REQUIREMENT ~ <br />fi <br /> SAMPLE <br />MEA5UREMEAIT ~ ~ L <br />/ <br /> .. + <br /> PEAM!T O <br /> <br />-__.___ REQUIREMENT <br />l-;U- <br />. <br />" SAMPLE. ~~ _ <br /> MEA:iUREME-~T <br />." PERMIT f.,., tf,. <br />" REQlIIRF:MENT ?~< <br /> <br /> SAMPLE <br />MEASUREMENT <br />`' <br />~ ~ <br />~~ <br /> ~ <br />f ~.._ <br />~ ~ <br /> PERMIT .r ~... <br />» <br />.:. ~.:•. ~ <br />~. <br />.~ <br />i` <br />" <br />-; ~. <br />.r., <br /> REOIJIREMENT q~, . <br />, <br />, <br />. <br /> <br /> SAMPLE <br /> MEASUREMENT ~ <br />-"~ <br />~ - " <br /> - PERMIT ~ .. .: <br />. ~ ~~: ~. :~ <br />- ~{{EQUIREEIIENT _~~ .. <br />~ <br />~ - <br /> ~' <br />~ <br /> - SAMPLE . - ~ <br /> MEASUREME~YT ~ ~ " <br /> <br /> - ~ ~ y ~ <br />6 <br />I ~ pEnUIREMENT ~ _ - ~ <br />- <br />~ <br /> SAMPLE- ~ - " a. - <br />_ MEASUREMENT ~ ~ ~~ <br /> PERMIT _ ... . ,. .: .... _ <br /> REQUIREMENT ~~ - .. <br />NAMERRLE PRINCIPAL E%ECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I NAVE PEflSONALLY E%AMINED AND TELEPHONE DATE <br /> AM FAMILIAfl WITH THE INFpflMATON SUBMI7TED HEREIN; ARID BASED ON <br /> MV INQUIRY OF THOSE ergV10UK5 IMMEDIATELY RESPONSIBLE fOR /~ <br /> <br />W Gordon Patars <br />• <br />OBTNNING THE 1NFOflMATION, I BFUEVE THE SUBMITTED INFORMATION IS <br />' ~~ <br />~~ <br />G <br /> TRUE. ACCLIMTE <br />AND COMPLETE. 1 AM AWARE THAT THERE ME 9T0-824-4401 9 07 4 <br /> <br />P <br />l M <br />/ AGNIHCANT PENALTIES FAA SUBMITTMG fAISE INfORMATION, INOCIAING <br />rasidant <br />Ganara <br />anagar THE POSSIBILRY OF qNE AND IMPw50NMENT. SEE iH U.S.C. f 1001 AND ]] <br />BIONATUfiE <br />P <br /> <br />TYPED OR PRINTED U.B.C. f t]1B. lPww14, uldAr w,r w,runa nwr hrAAn ArN, W ro ! fO,ppO <br />nrn <br />: <br />s <br />d <br />dl <br />m <br />: <br />06 OF <br />IIIMCWAL E7(ECUTNE <br /> mr <br />A <br />nl.n <br />onnnr <br />Mr...n <br />mar <br />u.ft <br />fu <br />Ywr:1 OFFICER Oq AUTHORIZED AOENT CODE NUMBER YEAR MO DAY <br />....~.~,.,~..,.. ,..... ~-.. -........_.. _. ,.... ...,~...._.._ ...~.-.......- o.. -..-. ............ ..~... <br />T53 E TDTAL IRO!! LInITS f1I LL Rt: AAIP F. D, AIID $ETTLP.A9LP. S4LIP3 T,rA7Tw ~nnLTsD^>> c-'l ~T P, ?LLT!R PR F,CIP F'rF'NT- <br />SEE BURDEN OP PRDOP RE?UIRP.4P.N(S UNDER i.A,3. Tf,S !IOMIT'!RIRS - L. P,~, `7Tf - ^a><•AcF - aEF T.*~,i.(p), <br />711 T1A7 ^f/PC^(~`~ };Q d,l r~wace. wnYlwt• •ren•r-n nowt ur naw~.. r. ±pn_ <br />On TH ~~9 i^C~(-7177^ <br />i <br />