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PERMITTEE NAMElADDRESS (lndude Facility A'ame/Locariun i7D~ecenq <br />~r" NAME SEpECA CCAL CCTFANY <br />F ADDRESSD A A A h A D <br />I HAYUEN CO !11639 <br />FACILITY <br />LOCATIONHATDadN CU 61t3D <br />FROM <br />ATTN: c;. 1tOD fiNOYp, GtNEHAL lfAYAGEC~ <br />]NAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Furm Approved. <br />DISCHARGE MONITORING REPORT (DMR;91 r• L A G H OMB ND. 2040.0004 <br />Approval expires 05.31-98 s <br />~sasA rr) <br />g~. MIT NUMBER DISCA'AA a~ENUMBER F- F I} l 1 N G _1 <br />MONITO GPERIOD 1CUTE;.,~=T T6577I+G FLF CGSA <br />YEAR. MO DAY YEAR MO DAY -- <br />p hb Ut .1 L75CtAFGf ~_-J C## <br />tzo~ztJ rzz-z31 rzm- rzfi-zr/ (zs~z91 r3o-3r/ :Read Instructions before completing this form. <br /> (3 Card Ony/ QUANTITY OR LOADING CeM OnyJ QUANTITY OR~ NTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-61) (9845) (d6-53) (34-871 EX OF TYPE <br />(32-37J AVERAGE MAXIMUM UNI MINIMUM AVERAGE MAXIMUM UNITS <br />(fi863) ANALYSIS <br />(64-68J <br />6970 <br />LCSD STAT 4&Hb hCU C SAMPLE <:~•":'`` .##O~~ <br />~ :sioa~ 0 %#q J i. <br />-, <br />U <br />J <br />I <br />hAGYA MEASUREMENT / <br />1 oU ~ p <br />-4 <br />TnAlC 1 U U <br />' a; -'F Mt"t A+q p4fi iq ;IP <br />' CLtltOal <br />' EII- '~. NA <br />~ <br />~~ <br />EFF <br />LU£NT G8099 VALUE `f3~~EM~NT ' ,, o ~' ~ ~~~ Cf~1 `~'~ <br /> SAMPLE ~~~ <br /> MEASUREMENT ~" <br /> <br /> <br /> <br /> SAMPLE <br /> MEASUREMENT _ <br /> -PERMIT -:,--3 ~ .-. :, '3'~ r.:_; <br /> ~EOUIREMENT ~ <br />,,^q "~ - ~'.~ ~ <br />`~ ~ '. ., '~">-` <br /> , : „ <br /> SAMPLE <br /> MEASUREMENT ' <br /> ~:' :PERMIT: ~:. <br /> <br />~~ ( :. <br /> <br />~ <br />- ~ . <br /> <br />- <br />- <br /> <br />~ - <br /> <br />` a - <br />t:`• <br /> ~lEOUIREMENT- ' ", - +, <br />. <br /> SAMPLE <br /> MEASUREMENT <br /> -'-~. -PERM.I'E. - # <br /> 'zf]~OUIREMEN7 <br /> SAMPLE <br /> MEASUREMENT ' <br /> vEAMI~ '''~ <br /> ~?~c~t1IHbN1~NT. '+ ' <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OE'I <br />AM FAMILIAR WITH THE INFO M AW THAT 1 HAVE PERSO <br />ATpN SUBMITTED HERE NALLY ENAMINED AND <br />AND BASED ON MY <br />IN TELEPHONE DATE <br /> INQUIRY OF THOSE INDIVIDUALS ~IMMEDIATELV RESPON ; <br />SIBLE FOR OBTAINING <br /> THE INFORMATION. I BELIEVE THE SUBMITTED INF ORMATION IS TRUE, ~ <br /> ACCURATE AND COMPLETE. I AM AWARE THAT TH <br />PENALTIES FOR SUBMITTING FALBE INFORMATIO ERE ARE SIGNIFICAM <br />N <br />INCLUDING THE <br /> , <br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE 1B U S C 4 1001 AND 33 U.S.C. <br />SIGNATURE OF PyI CIPAL EXECUTIVE 0o O, <br />f <br />TYPED OR PRINTED me+lmum~rn~sonmertlrt u/4Meen~6 mmonM ends tla lirlac up to St0,000 arW or <br />~rs <br />l OFFICER OR OTHORIZED AGENT <br />A AR <br />NUMBER <br />YEAR <br />MO <br />DAY <br /> P w <br />~ coDE <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE YAAT I.A.4 FON CEIAZLS GF TEST PAOC£.DUflE. FEECAT LCYEST CILU'f1GN (~ eFFL0Er7) iINICb IS LE7AAI 1C <br />SUS OF TEST OAGANISAS (LCSD) Ado ITTACH ACU7£ TOI]CITY TEST flEFGNT FGkC TC DlSfi. CCFIES Cf ALI <br />Trt.-nnr1 TZL'n r~lao ,~~ tEuT ^'C ESA! <br />EPA Form 3320.7 (OS-95) Previpus editions may not be used. (REPLACES EPA FORM T30 WMCH MAY NOT BE USED.) 00456199 0 Z 7 7 - T 6 5 3 PAGE 9 .OF <br />.. _ ~:.~ S,. , .~ .. ....._. <br />