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PERMITTEE NAME/ADORE551)~dr FaeWry Ns NLocanon rr/OrQG.wr <br />NAME II ~; ~,. ( !; ~,. LI '.Tp.~ <br />ADDRESS `;O.n C .. 'I ~i 1 ~ a ~~ _ . !", L V c. S <br />~ r . J. ~ ~'•: 1 ~1'~ <br />aA~1, itl :4? . <br />FACILITY :!i n •t ~~ i '~ L'., _ . ' [ `...- <br />LocAnoN <br />.t P. i I .,~ n' S -1 <br />NATIONµ POLLUTANT DISCMMGE EUMINATON SYSTEM !/VPIYCJ/ <br />DISCHARGE MONfTORINO REPORT lOMRI <br />l7-18) 17-I9 <br />::C0~3 03`_ ~0/ <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO AY <br />FROM ~•~a TO 1` !- ' <br />!70.2/1 112-731 !11.751 l7G771 l18-791 !36311 <br />.. ~. A~~sroved. <br />'?Ih'e. Ai~F, .4 T7 `;°EDMQ No. ~o40~t)ROM1 <br />(_~ n ~. ;7 1 r) Approval eapirl~ ~5 31-98 <br />r - FTI aL <br />~ j \:'. ,I <br />_. N: <br />NOTE: Mad Ir»trueNana bNon eomplaNna th4 form. I <br />PARAMETER !3 0.rd Onlr1 QUANTITY OR LOADING 14 Ord Onh/ QUANTITY OR CONCENTRATION ND FREOVENCY SAMPLE <br /> 46531 l545I 38-151 48.63 6L511 EX GF TYPE <br />l37-371 ANµYA3 <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ns1-asi l51-881 159-701 <br />..: 1.. :'," .~ A P 1 .; .. SAMPLE xa ~ t . ( q:~) ~ .. ~ ~ .. ~ , ~: <br />~~ i ~~~ 4I MEASUREMENT <br />,4 .;, t. L C PERMIT ::a7L ~s rp:. q?PiIrT~ ~_~ '.'r.•',-~.. +b ~~'. fi'~Y.~C:~ .. :i:i: $' «:t: ~K: ~$~: ~l~d <br />~~F': i,Gc.V: ~;y(t~.:; 7aLC EQUIREMENT ~ ~TN;iT~~HAR N"=;: ~ ~ ~ ~ . <br /> SAMPLE <br />MEASUREMENT <br />nl~) ~~ I <br />- C h h17// ~ <br /> -~ ~.PERMI7~ . ~ .. - .. ~ .. ...: ~.,~.... .~ <br /> REQUIREMENT. ~ ~~~ - <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~~ <br /> REQUIREMENT ~ ~ . ~ ~ - <br /> SAMPLE <br /> MEASUREMENT ' <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> RERMIT <br /> REQUIREMENT <br /> SAMPLE <br />• MEASUREMENT <br /> PERMIT ~ ~ - ~ - <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~ ~ ~ - <br /> REQUIREMENT <br />NAMEA7TLE PRINCIPAL EXECUTNE OFFICER I CERTI <br />AM FA FY UNDER PENALTY OF <br />MILIAR WITH THE INFO uW THAT 1 NAVE PERSONµLY E%AMINFD ANO <br />RMATION SVBMITTED NEflEIN; AMD BASED ON -~7 ~ / ~ TELEPHONE DATE <br />I <br />1 r ? i ~ ~ ,l t ? ~ ~ ~ MY INQUIRY DF THOSE INDINOUµS IMMEDIATELY RESPONSIBLE FOR <br />OBTNMING THE INFORMATION <br />I BELIEVE THE SUBMITTED INFORMATION IS ~ / <br />r ~ ~ <br />/ <br /> <br /> <br />I <br />, <br />TRUE. ACCUMTE AND COMPLETE. I AM AWARE THAT THERE AflE <br />SIGNIFlCANT PENALTIES FOfl SUBMITTING FALSE INFORMATON <br />INCLUpINO <br />(~~j <br />j ~~,~_ <br />/c' / <br />v <br />' <br />~ <br />' Y~ l , <br />1 I <br />S ~/3 f <br />~ r +~ ~ I <br />` <br />, , , <br />t! THE PoSSINUTY OF RNE AND IMPRISONMENT. SEE 18 U.S.C. 1 <br />001 AND SS SIpNA7URE OF PRINCMAL EXECUTIVE l <br />C - <br />?- ; _~ / <br /> u.s.c. s t Gt o. IA.,.rnb. uWr Mar mnmA Irlrr Eca.rA Akw. w ro i ro,00D AREA <br />TYPED OR PRINTED .ns ormuila.n lmPHaanwrtNMnrwrsmmN. rl4a Yaaa/ OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Referents e8 etlachmanfs hare/ _ <br />. ,:Lc L!(... „)i-. _ !,l ~ ! :i i'. i.:..- ~ .'/ j' ~.] _~~. ,I(+v ~ .. ,. ~ ~..?T 1~'I. '1.'r' '.: '7'7. , .., <br />I~r I <br />EPA Form 3320.7 108-96I Previous editions may be uaed. ~ /REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) ~ _ PAGE OF <br />