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PERMITTEE NAMElADDRESS pM:J.facmryN«Wlncanon UD~.r«p
<br />NAME LYNKI,S tr.NIki: CUkr',:it4TIUN
<br />AD~SS-I' .~ oUX Otl
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<br />FACILITY ~yp~~S E^tP1kL: CUKI'UkATIUN
<br />LOCATION LIjA L., ~V d1G45
<br />ATTnI M1l,HA1;L. N. LUULUF~] GENERl1l M a
<br />PARAMETER ~ !3 Cerd OnlYl
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<br />131-371
<br />NATIONAL POLLVFANT DIBCHMOE ELIMINATION SYBTEM /NPDESI Form Approved.
<br />DISCHARGE MONITORING REPORT (OMRI
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<br />6 ~ PERMIT NUMBER DIBCNAAOE NUMBER F -,FINAL 11
<br />MONITORING PERIOD M 1 NQft
<br />YEAR MO DAY ~ YEAR MO DAY
<br />AVERAGE
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<br />FROM -. b Q~ TO ~ $ 2 31 ### .hL UISCHAKGf_ n ###
<br />/207 N 111.131 l2 ~75R. ~x 116271 !1649/ 136371 NOTE: Rad InrtrVedoru before comP~tMp thb loan.
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I_CERTIFY UNDER PENALTY OF _~Y.y,_THAT I NAVE PERBONrILLY E%AMINED AND _ \ TELEPHONE DATE
<br />F:icharci n~1~~$ OBTAINING iNE INFORMATIONS 1 BELIEVE THE SUBMITTED INFORMATIDNIB / -
<br />iRUE, ACCURATE µD G`pM~ftETE. I AM AWARE THAT iNFA[ AAE / /
<br />LnvlrunAlen~al Adana er SYGNIRDANT PENK[IES FOR SUBMIITIHG FAIeE INFOI{11{ATION, INCCUdNG
<br />THE POBeIBILITY DF 14NE µD IMPIIIBONMEMT. 9EE 1B U.B.C. 1 1001 µD 9] - 7 ~ q
<br />u.s.C. E Late. n+«vP:, yJSFt et.« mnm, m,r ~~• r,w, w ro slo,aoo BIONATURE OF PRINCIPAL EXECUTNE
<br />TYPED OR PRINTED .nsd~N.,a~Myr.,~,~„roran.«na~n,.nsE r«n<1 OFFICER OR AErtHOR¢ED AOENi CODE ''NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference s// enschmenm hers/
<br />StTitcAtl~t SLiLlt,S Lit11i eAIYEU FLiK l0YRF24MK PREGI? EYENT-$tE l.A.~F PV lYe FOrt Krv;UIktMENTS, UIL ~
<br />un~ASt i,nAb SAMI'Lt ANALYSIS KEgUi kEU If YISI~ILE SHEEN 15 Uli StkVLU. .ikTkLY SAMPL 1f.L INSinUCTIUNS-I.C. dF
<br />P Form 3320-1 (08.951 Pravioue editions msy be used. (REPLACES EPA FORM T~LO WHICH MAY NOT BE USED.) 0 U 1 U9/ 901 JU 1- 131 1 PAGE IOF
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