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PERMITTEE NAME/ADDRESS Rrrb FrWryNwdlasnwr lJD,~i.wlp <br />NAME ;iEHtCA CGAL COr.pA:{Y <br />ADDRESS URA 4 r. 8 D <br />FIATDEN <br />FACalrv <br />LocnnoN hl A Y u c N CO H 16 3 0 <br />A'T'ZIr: G. y0D HROMN, U~'NERAL lfANAGER <br />NATIONAL POLLUTMT pISCNMOE ELIMINATON SYSTEM (NPOESI Form Approved. . <br />DISCHARGE MONITORING REPORT (OMRI ~ r -~ y. BfN 20406(1.04 <br />ar5r n-/s/ DI..CHAF ~' :. If~~_9si ... ., .r. <br />0000 [c'1 C04 A (SUeP. nSr~) APprovella~p~r4e~05-31-98` <br />PERMIT NUMBER DISCHMGE NUMBER F - FINAL '~ <br />CO 81E39 <br />MONITORING. PER100 <br />Y6AR MO DAY YEAR MO DAV <br />FROM ~ w vi TO ~ <br />17 TT-T3I 111-15/ 1/6171 IIB-19/ 136311 <br />Nt'rR <br />•°`• N~ DISCHARGE ~__~ .-- <br />NOTE: Reed inetructloru before completing this form. <br />PARAMETER /3 Grd Only) QUANTITY OR LO' lI Grd Onlyl QUANTITY OR CONCENTRATION .r; ~NO. FnEOUENCr SAMPLE <br /> 11653/ 15661/ !38451 !46531 15a-611 of <br />131-371 EX MALY91s TYPE <br /> AVERAGE MAXIMUM ~ SYS MINIMUM AVERAGE MAXIMUM UNITS ~ IQI.69! (6458/ /6A70/ <br />t Ja, N OND IT OF <br />'1'HF.U THEATMGNT ULAN SAMPLE <br />MEASUREMENT `j <br />DA Il J 1 /1 ~('] <br />t-"•~t+w~ ( Oj~ lItAO#~ „•^,##C #Ct_'I,I.- <br />D <br />f/ <br />~k5 <br />SUUSG 1 U U PERMIT REPORT OPTIONAL brMalsro.l? o#C~Cb: ^a.",fi#t+ #~::: EEKLY CHSTA <br />EFFLUEtiT GROS5 VALU REQUIREMENT 30DA AY(; 3A1LP !!X CIGU #;'~## - <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I cI:RTIFY uuDER PENALTr of uw THAT I NAVE PERSO <br />AM FAMILIM WITH THE INFORMATION SUBMITTED H NALLY EAAMINED MD <br />EREIN <br />MD BASED ON ~ TELEPHONE DATE <br /> ; <br />MY INQUIRY OF TN09E INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br /> OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS <br /> TRUE. ACCURATE MD COM0.ETE. I AM AWME THAT THERE ME <br /> SIONIFCNVT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING <br /> , <br />THE POSSIBILITY OF NNE MD IMPWSONMENT. SEE 18 U.S.C. ! 1001 MD S9 BIONATURE OF P111N <br />L EXECUTNE <br /> u.9.c. f t91 e. lPrWd.. MKr NAr AYNhF ,nrr YCA.lA FANAwroSf0,000 A AREA <br />TYPED OR PRINTED .nermuYlenl i,rFriAOrv,IFrrr o/ArrwAAnfmNlNa rN6r..'Al OFFICER OR ALIT RIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANV VIOLATIONS (Rr/erencs sll sttschments heFe/ l <br />:55 Li:7I'i ilJ:LL r'. MAIYtD AND SETTLEABLE SOLIDS LICIT AdPI.IF.L FCF C=1C1P.,~4HA PAFCIP f.YEN?~ T55 6 <br />:,ETTLEAdLL SOLIUS LItl1T LAIVEll FUA >IOYR,24.yR PHECIP EV~vP °UFJEC7 iC EURL'E4 CF PPCOF' IN I.A.2. GLL i, <br />L; F.'rAiF-Sae: r. q.t.n. rna Nf;MTTAPTN C~CFV ThLT-v- <br />EPA Form 3320-1 (0E-951 Previous aditiona mey be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.1 0 0 0 3 6 / 9 7 l ~ 31-1513 PAGE 1 OF <br />