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<br />PERMITTEE NAME/ADDRESS pndude Pacilirv NOmPILe(nllen i/D~eram) <br />' NAME <br />NATIONAL POLLIfrANT DISCHARGE ELIMINATIO TEM (NPDES) <br />DISCHARGE MONITORING REPO r A4R1 Form Approved. <br />QMB NO. 2040-0004 <br />{ SENECA CGaL CGlIE6NY !z-,e) - Tn.5P) !'I NGfi Approval expires 05-31-98 ~r <br />~ <br />ADDRESSDR6Y2R D ,~-C0000C721 5 (SUER hti) <br />NAIDEN CO 3is 3) .PERMIT NUMBER CHARGE NUMBER F - FL l,Il1 ACUS'!, <br /> ^ L L T E M E 1 1 E 511 ! 0 Y C I C 16 A I' <br />FACILITY MONITORING PERIO D <br />LOCATIO <br />~IAYDEK CO tll'.5~~ YFJi ; ~ MO DAY YEAR <br />FROM TO uL MO DAY <br />u.. ~U <br />~~~ NO <br />II°CNAACE ~ .soo <br />A TT R: G. n U U E i'~, O Y A. C t h Y R 6 L C A 9 A G F M lzos 2z-z31 rza-z51 !ze-zn lzazs) (soap NOTE: Read Instfuctions befofl completing this form. <br /> (3 Cerd On/y) QUANTITY OR LOADI (4Qgrd Only) QUANTITY OR CONCENTRATION 'NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-61) - (38.45) (a6-53) (54-67) <br />~ EX OF TYPE <br />(32-37) AVERAGE MAXIMUM "INIMUM AVERAGE MAXIMUM UNITS <br />lezra) ANALYSIS <br />(s4-BB) <br />69-70 <br />~. U .v SAMPLE -. .rt;t: aK,. t: C:` .~ Ca,G ~K^v Y ( a.t) <br />CEAIOf)APMYIA MEASUREMENT <br />A213H 1 0 C ~ KC: ~ A~ . Ei- i <br />hfFLUENT GA055 VALUF t~,, ~~~-" ~,~~~ " it0~ I};-~' ~ ~ <br />4^ iEbt ~ `~!-~~ <br /> SAMPLE ~ ~~ <br /> MEASUREMENT ~~? ~" <br /> ~'g!' <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> C~I~UIREMENT .~_, ~:,': <br />a to ' <br /> SAMPLE <br /> MEASUREMENT <br /> Rfu11T_ <br />- ppE <br />~ ~`L;e t' r' y ~1r -- <br />a _,: <br />' <br /> ~ <br />.RI:4]UIp~MCNT ,- ti +" ~# ,~ ,k~,., +.~ <br /> SAMPLE <br /> ENT <br />MEASUR <br />E <br />M <br /> 1 <br />y <br />~ <br />I <br />T <br />5' +r <br />I <br /> y <br />' <br />n <br />-I NT i:4 4 - C <br /> SAMPLE -' <br /> MEASUREMENT <br /> ''PAR tT., - <br />~ rrc. _ ,., ,.w <br />' <br /> 1 <br />~~ <br />' t ~ <br /> K <br />T <br />gEfilllRE '+es . <br /> SAMPLE <br /> MEASUREMENT <br />,~ <br /> <br />' sr: aT, <br />PERMIT <br />:~ <br />~ sir <br />. <br />~" <br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AMINEO AND TELEPHONE DATE <br />AM FAMILIAR WRH THE INFORMATION SUDMITTED HEREIN; AND BASED ON MV <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br />~ <br />THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE. <br />s.)t.~ <br />ACCURATE AND COMPLE-rE. I AM AWARE THAT THERE ARE SIGNIFICANT <br />INCLUDING THE <br />PENALTIES FOR SUBMITTING FALSE INFORMATION <br />!\ <br />, <br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE 1B U.S.C. 4 1001 AND 3311.S.C SIGNATURE OF PRIN PAL EXECUTIVE ~ U <br /> § t3te. IPenettras under Mesa statutes may include lures up ro St0,000 arM or <br />d OFFICER OR AUT ORIZED AGENT R UMBER <br />N YEAR MO D <br />TYPED OR PRINTED 5 years.) <br />maximum imphsanmanr of behseen B months en O ~ <br />. _ <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rere/ence all attacnments Here) - <br />SEB PART I. A.4 f0A CETAILS Ol TEST PROCEDURE. AEICP.T LCYEST GIIUY]Ct~ (; kFFL0EA7) MMICN I9 LEIbAI 1C SO;i <br />OF TL'ST ORGAAIS!15 (LC50) AND ATTACH ACUTE TCIICITI TEST REFOhT FGA!' TC GM A. <br />EPA Form 3320.1 (OB-95) Previous editions may not be used. : ~ (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) 0018 9/ 9 9 G E i 7 -16 5 3 PAGE 1 OF <br />