PERMITTEE NAME/A ODR E98 UnrLrdr NATIONAL POLLUTANT DIeONARGE HLIM (NATION SYSTEM (NPU56) fWrR AO'pTOYW.
<br />FRnhry A1rmr /Lurarinn r/ drprrrnr) DISGNARGE MONITORING REPORT IUAfR) OMB No. 2010-000
<br />I'LAI!UCY I.I AL 1', ;:'.. I- ~
<br />NAME ___
<br />~
<br />1
<br />l)1 !} L II
<br />-
<br />ll
<br />''
<br />'
<br />1'
<br />(I-Ib)
<br />-- t
<br />:'i
<br />)~l:
<br />I i- - r Ifl.'.:
<br />(f7-19)
<br />f71':
<br />LIi:;
<br />(I 1
<br />` o /erpiror B-3046
<br />
<br />.Rj r 1"JTI
<br />._ y
<br />...
<br />H!.Y
<br />1
<br />.
<br />r!i I -
<br />=DDPEB l
<br />.U L
<br />I
<br />J v .
<br />.. ..
<br />.
<br />rf )h Nti,; ;•L ., J ,. ,: y PERMIT NUMBER Dlsc Nw RCE NVMBER 111
<br /> Q ~Y
<br />~
<br />---------------------- -- MONITORING PERIOD ' Upr -~`O F~`~ ~
<br />e
<br />~~
<br />` `
<br />~CILITY YEAR MO DAY YEAR MO DAY [[
<br />11o
<br />------
<br />-------------
<br />-- FROM TO
<br />
<br />,
<br />tPI~ •VOv
<br />LOCATION
<br />---------~------------
<br />'
<br />-- - - p`'4c~_ .
<br />
<br />1 I1
<br />;t I_EL'fVrr„) :.)1' /[i'1. h.
<br />rm.vl'
<br />IZZan
<br />rzr-zsl
<br />Izb z7>
<br />Ize-z91
<br />Ido~ifl ~
<br />II[F DB
<br />NOTE: Reed lnatrucllo !eF~h4^IP6 thlH lorm.
<br />RVP4..._
<br />
<br />PARAMETER (d Card Only) QUANTITY OR LOADING
<br />(Ib-SJ) (Jtfil) (4 Card Only) QUALITY OR CONCENTRATION '!i •Jf(f. {
<br />(38~J) (Jb-JJ) (SILT)
<br />1E~~ {r[I'yjU1r~~~~
<br />i~
<br />P
<br />~ QI q•1
<br />T^R y~
<br />N
<br /> •n
<br />Y1J
<br />Y E7 ~~~f~v
<br />c
<br />(37-37) AVERAGE MA%IM UM UNR6 MINIMUM AVERAGE MA%IMUM UNITS 61LA (M1JfiRI IM19-0n)
<br />
<br /> SAMPLE ,
<br /> MEASUREMENT '
<br />)a1rE l~(' 1 !'' x, ~' OVa.-V.ts :;r;' h'x.K4u01P ..tt ~ w ~ .ii
<br />' yr '.. ,: :a X:k ,1. "r : t ti.Yl,: art ':
<br /> PERMIT a
<br />
<br />_1'hLllf.IJ~ `r1U:>7 ~.1~1[
<br />REOVIR8M8NT
<br />. .. ...
<br />
<br />~
<br />Orta
<br />};.y?;I+~It!fa {
<br />trFzl`sylPl
<br />1 rIL
<br />( t. U•: 1 )1 vrr~ l .`V ..r
<br />4Y V'} a \'1 ' I,
<br />~ li
<br />. SAMPLE ._
<br />'
<br />rLIJ FI-L)F,L I, MEASUREMENT
<br />.11 JOT) 1 (l ..
<br />~
<br />~~ Mtl:,:.R4 .. gatYV AYtiLY~. P .>y ., ,r+Fti ^'II%~' };3 !; n ; tKL1:
<br /> • -iRM 1T
<br />;
<br />'
<br />_1-rLU~.n11 hnUS$ Yi~LL,t REQUIREMENT .. I;AVi ,jI,A /AV ~?._d iay iO~L
<br />11L MIL
<br />( l>hIAJC w.: ~c V.I .{C4'.aR V4.• f
<br />l'
<br />.
<br />. SAMPLE ..
<br />-NL ~:N ~.X TR -(. ii1V f':[ th MEASUREMENT
<br />1 U:A 11b 1 Q ~ .. .k#x•,~a# 'rF A+4kd•R # rvp ,e ..>MtoN ~,: rX wP..N 1
<br />L:
<br />N -~+
<br />:
<br />1
<br />Y
<br />t
<br />IoI, J:L
<br /> . PERMIT- . .. ,
<br />.
<br />_
<br />_Ff~LUc:iT GRGSS YL.LIi RHOVIpEMHNT d•. 4. 4.Pyi-Y iu_T AIh 1.;/~
<br />:JIV\i~i l ~
<br />h
<br />UN
<br />Lh L
<br />I .. ~
<br />1 I / I~I q v. A . .. :. .r "/ +. r If I' L
<br />.
<br />:
<br />r
<br />V HAMPLE . /
<br />IIi2l1 wE~114LiiT N~I~.)' ~ MEASUREMENT" '
<br />,1)()~)(
<br />' 1 ti .. .. .,f p;~wa#u. 4. ik'Y.'3-3a nx :,a c'.'.~u. :-i ,y v: >~'.~ •. T:x ,: r,~ :a a'.. .: ,, ~~,KLYI J:r i.: ,,
<br />. ' ' PERMIT ~
<br />' '
<br />-~FLUeNI I~+R~'SJ YALI,'[ pBOVIREMEN7 ' j'Rlvl`I ,'}.)( I ~jl •) 0 '.»
<br />11 A
<br />11
<br />i ): ~• LUU I:
<br />I .( r 1 . /A•; 4'.O~rl' . /... : -, •y. ~.a 1
<br />' :.
<br />.
<br />.
<br />-
<br />/ SAMPLE ,/
<br />// `
<br />. LL I E:~ Alj LI~. L !~r•'~ L I MEA9U REM ENT
<br />/UZ`%~ 1 !1 .. R, IrorA'
<br /># :
<br />xLN1F1'~Y 'c4" .. ~ .-:'a x^4T.r. .. ..N.-vH . I,
<br />,Y 't r1 ..
<br /> PERMIT' .
<br />.. : -
<br />.
<br />
<br />:fl' ULNT 1 kl%55~ YALI;F
<br />pE0U1RHMHNT
<br />.,
<br />;y T A
<br />L; iIJ •: Y.V
<br />Ii L
<br />/ ..ti' r
<br />
<br />/!1:',:a~." ~ r ~
<br />( SAMPLE
<br />MEASUREMENT
<br />N•.'~.,
<br />~~
<br />~ II .,_/.~_ -_
<br />_
<br />
<br />i " '? RE4UIREMHNT .. - ~. - -. '
<br />o ~ ~ ~ ~ ~ SAMPLE / . r:. IJ ~ r / ) /• -~
<br /> MEASUREMENT ~ '
<br /> ~
<br /> REOVIREMENT .. '~/
<br />~
<br />~ '
<br />NAME/TITLE PRINCIPAL E%EO UTIVE OFFICER LAw THAT I NAVE PERSOHA1LV EAAMMED
<br />l CERTIIY UNOCR PCNwliv OF
<br />I
<br />TM[ INFORM/aTIOH $UBMITT[D HEREIN wND Bw$ED
<br />F
<br />IR w'IT __,~~~' TELEPHONE D A T E
<br /> LI
<br />H
<br />wNO M1M
<br />AM
<br />ON MY INQUIRY OF TNOSE INpVIWFyS IMMEDIrITELY R($PON$IBLE FOR ) ,Y/
<br />:`
<br />
<br />Mednick
<br />Ja OBT/11NING THE INFCRMwTIOH I BELIEVE THE SUBMITTED INIORMw110N
<br />[TE I AM wW1RE THAT iNERE •PC' $IG
<br />RAT
<br />n
<br />OMP _
<br />r 1-"
<br />~ '1 /~
<br />~np ~~/' f 711j /
<br />lI
<br />~/~ /~
<br />',
<br />y I$ TRUE ACCU
<br />E
<br />ND C
<br />L
<br />HIF'UNT RENALTICS FOR SUBMITTING FALSE INFORMATION wCLUOING ,
<br />• j `
<br />II tjPO eol o~tist
<br />y g THE VOSSIRartv OF rrNC wN0 IMRRISONMENi SCC r8 USC 1 IOOI ANO
<br />1.• Jlrr rvm
<br />r r
<br />]]u5C 11)19 IP
<br />r rhrv ramrv. no. nrldr lm.'. u
<br />ln
<br />l 91GHATU RE OF PRINOIPAL E%EC UTIVE
<br /> p
<br />•
<br />rnn
<br />r. urv
<br />r
<br />d :
<br />M1
<br />A
<br />A A
<br />TYPED OR PRINTED ..ar.r
<br />.~IUwn
<br />m~.nr
<br />. en
<br />orW.~•nraarl.IUI.Ir^rm~.,~•Ir•I.IIr.,I OFFICER OR AUTNORIZED AGENT D NUMBER YEAR MO DAV
<br />1Y
<br />COMMENT AND E%PLANATION OF ANY VIOLATIONS (Rrlrrrnrr ull nundlmrnl.r hoe)
<br />1F NU UI:iL.I':Rr~F CiL.y,((M.;, kk1'L!11 ".v i. DiS._r,dkh.':R ;IJ YU:r: il'!M.
<br />$F. F. F'FKM1T Ply Il f ( !:r'F41.~~L MUI~1111':R1'i.i UI- P,UG '
<br />..L T .. ., cl.D r_r. :v AI ~..Ir ,.."I rrll 1 u .AJ 11[1 •T v 1'•-Nf10"AI
<br />EPA Form 332O-I (RlV. IO-JOI PREVIOUS EDITION TO BE USED YfREPLACEB !PA FORM T-LO WMICN MAY NOT SE U9ED.> PAGE OF
<br />UNTIL SUPPLY 18 E%HAU9T ED - r /( 1 ~ '<. _ I ~" r~
<br />
|