|
PERMITTEE NAME/ADDRESS (IbrlrisWryNan/fxanm f/D(Binp
<br />NAME T}.A?P;.~~ ';;' I r o, .'.'C.
<br />ADDRESS Tit nPF'.','~ '! ~~'.
<br />P.J. S:Ir , ,7
<br />CNnIG J 51':6
<br />FACILITY
<br />LOCATION
<br />..Li'f: .. t, G,t li:19 ~ .,.; E:;, .-... -•/I; E'N `.un
<br />NATIONAL POLLUTANT dSOHMOE EUMINATId/ SYSTEM INPDESI
<br />DISCHARGE MONITORING REPORT IDMR/
<br />I-161 I7-19)
<br />cooo32715 coa A
<br />PERMIT NUMBER DISCNAROE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAV
<br />FROM ~ ~: ~ TO •' _
<br />11011/ III-131 174151 !7617/ (18-191 !3631/
<br />Form Approved.
<br />F C ~I L A_ T O N O V A Ff]MB((~(o.L2B~i0-0004
<br />f ,~ II T ~ ~ .~) Approvellmfplr~B OS-31-98
<br />_ rIrA1
<br />nr~l f.F
<br />NOTE: Reed Inetructioro 6e}ore completinp`thie lorm.
<br />PARAMETER (3 Grd Onlyl QUANTITY OR LOADING I4 GFd Onh) QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE
<br /> 146531 /54-671 138-151 ~ 1663 !5~-e/ E OF
<br />l37-371 X
<br />ANALrss TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !a]-a91 (84681 (6?701
<br />r. SAMPLE Ct-'v;:0{+ :F{::~:::;: :. r, ~ db..., ( 12) /
<br /> MEASUREMENT ', ~ 8.f V /' JI/.1•
<br />~U4!iU I G U PERMIT O'r#~Xr4 OOc~JlYyri'# ~~ tY=: 6.5 ~ ~?C>:`~i>?#
<br />q.o
<br />r1;t~LY
<br />INSlr1
<br />:: F'F'LUES"C CAOSS YALU REQUIREMENT :~~ :..~ .. 00>r-i= M.T B.I t•UM : ~~ :.w, .. ~ :~Ff .X ~.!!D~!1 SU
<br />";JL,IUSr '1'fJTAL SAMPLE ;~':0#~-.? 'r~.`•%k;LCJF 40rp004 19
<br />( )
<br />~
<br />.; U i P t'. V j1 =; ~ MEASUREMENT y,'ys ~~ O ,j/I GJ/N/j
<br />I?Og3V 1 0 0 PERMIT r}r0#>tt4 : .. •. •,•~F.c44 :Oi: C+.449~0?G T
<br />::E"E'LUf':tiT C:RO55 YA'..U REQUIREMENT ~ ~ tO;:;t .. 3~~1`i1 ~,~.A Y6 ' ~Cw I~I~Y ~C!.7F pG L ~-. ~ ~N'~~.~:H ~.
<br />~ .•F .• .. SAMPLE 4~T C:3'T :: ^: :4#44 400404 ( 25) ~
<br /> MEASUREMENT _
<br />13 (, f'~, p O
<br />JU~45 1 U U ~ PERMIT ~+ ~+# '" ., rsOs3p0>3 CF?ICRAL 9);.i0?t?. NC /: AE!'
<br />iFE'LUt:NT G$pSS YAL!1 'AEQUIREMEN7:
<br />.. :':i.'
<br />~..
<br />~ '-°, S:•'.: 3C[p AVC DAIIY "fX eL/L
<br />.. flJNTH
<br />y ~f ~ SAMPLE ,/' .4;1 nom; ',":•:' ..-.'.~4fi ( 1T) ~V
<br />(A F i?) MEASUREMENT
<br />• ~-O. G /Z/ U ~~U' l.«
<br />v1JU5 i U >: ~F
<br />MR
<br />~ -# :x~.,:: :.~::. '~~::rs-:: ;,rc: 04+4;0 .C fi.4 tiCF.! 'sR,Af3
<br />cY}'LUEN'I ~~ YALU AEf~NIREAnENT (
<br />,. x!~:
<br />... :,~.,;: 3UCA AYG CAIIY.!~X :9.,/L 9J?iT:i
<br />'.~ ., ~t.-'.~ : SAMPLE ar7 •:: ;Y K::}.'.: :;: t'!'4fi4K ^; yC4'.: 19)
<br />(
<br /> MEASUREMENT N ~ ~y~q ~y~s
<br />L j`.,SL 1 li :t .. PERN117: ~ ~•• ~~,•
<br />~ G>X..nYt fa# 60;: >r k0~'40 A-4`901EI.t%::; :. ~.fl:'..: dv:'I it it?AP
<br />:.~eLJE:NT (;ROSS YALU ~REQU)FtEMEN7 ~ ~ ~~ :~ 90fip .~:~~)ipq. ',TAX "f/L ;iNT
<br />..ref :. SAMPLE /O. S(a U3) 040'x''; 0200'-31` r, ;:;: ;, ;: .- ~ ~
<br />..i.:L 'INEATMl:NT PL:1 '~ MEASUREMENT ~~~~ Q ~ i..•tlr+-
<br />i..~0 1 0 0 PERMIT nE!':1RT `: I[EPi)R7' ;Fond^4 ax4>r"1G';~-
<br />~ .,.4;~+ri>:: :-':<:-'.: ^^:"'LY
<br />~` CgS°A.
<br />Y:'LO ENT L; Fi ~JSS YA 1. Il REQUIREMENT 30JA AY:i: ~. ~i~7.AI LY~ l4X~ NGL' ~ ,
<br />- G - • SAMPLE ~.r .<~f •:,: ,. ~ .. 400b5 C (
<br />19)
<br />., i~ ~ U L Y E D MEASUREMENT ~ ~ ~~1G U /~ ,r,,,,~,
<br />/u[':1S 1 U 0 PERMIT •`' ''f
<br />~ ,-fi.;:;'.
<br />! v'so tv00.n:•` GF ..CkA, n'ECFT 1FkL1 •RAP.
<br />•, F r L. U E N T ~: d O S ~ Y A i. U :REQUIREMENT ~ ~ ~ •'~ '"'"~
<br />~'"-'- ~ ~ ~ 1
<br />;F76 A..lg. ~ ~
<br />CAICY D1X ~
<br />to/L
<br />..
<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENUTV of uw TNAT I NAVE PERSONALLr E%AMINED AND TELEPHONE DATE
<br /> AM FAMIUM WITH THE INFORMATION SUBMITTED HEREIN; AND BASED ON
<br /> MY INQUIRY OF THOSE INDINOUALS IMMEDIATELY RESPONSIBLE FOR
<br />OBTNNING THE 1NFOIWATION, I BELIEVE THE SUBMITTED INFORMATON IB I~~ ~~
<br />f~
<br />W. Gordon Peters TRUE, ACCta1ATE AND COMPLETE. I AM AWARE TNAT THERE ARE
<br />SIGNIFCANT PENALTIES TOR SUBMITTNO FALSE INFORMATION
<br />INCLUDING 'l 70-824-4401 98 4 28
<br />
<br />President /General Manager ,
<br />.
<br />THE POSSIBILITY OF RNE AND IMPRISONMENT. SEE 10 U.S.C. f 1001 AND ]]
<br />BWNATURE OF t>1IINCIPAL EXECUTNE
<br /> u.s.c. E t]u. q+NrN4. MWr rn.~ wcvw. nrY NclueA 6n., to ro sfO,000
<br />TYPED OR PRINTED rNanlvHwninp/smwlr orblwwnamenNs rWay,ra/ OFFICER OR AUTHORRED AOENf CODE NUMBER YEAR MO DAY
<br />COMMENTS AND tXPLANA ZION Oh ANY VIVLA I IVNJ lMererence e// ertscnmenrs Here/
<br />,n, b '1'u'CAL I~iG`1 LIrIT_ BILL ;iE e11iYL0, a;li:~ JFTTL£I,iSLF SZLIC° LI!1IT BIFi.I°.'. ECF <=10-YI'., 2u NF P~+$CI'r rV%'hT-
<br />}._ $UF.06N Uf' PEOOF E•`.:JlfitflF,N7S 'u':/JEti 1.A.3. PqF."ITT£F. MC'~7 TAKE ACI FFASCNAFIF `EAS'1F°i TO 3'000": PH
<br />.nr.~.-.n. urn ..mv c.. ,. ..r vm n: •.~n r-. ~.- .. . . ~... .-.,. ._...~__ _ _
<br />EPA
<br />maY
<br />CCC1?/977211-16u5
<br />
<br />
|