P[p MITT[L NAM[/ADDR[33 (/nt/udr
<br />Rcdiry Nrmr/Loe3fbR IJdiJferrnrJ
<br />iI!I. i. i. :l yl I ::oi l~:: -.'i 'F' ni"i. n .S1
<br />woow[n F_ I i i(~ v r, r,
<br />___I'At C'I~~FQ3 __-_-- CG c`Dllr17
<br />rwclLlTV --- -- -
<br />dlil,: ti:c5 HItCH^P
<br />Nwnoflu Po uurA nr oncpwROE cuYlNAnoN SYSrEY lNPDEJI
<br />DISCHARGE MONITORING REPORTlOMRI - )
<br />1-/6 17.1v ~1 i k () It Form Approved
<br />CL>DD3Cifi59 OD1 A (aU~4Fl IIN) OMB No. 7040.0004
<br />PlRMIT NUMBER ~ ol3cN wwcL NVMSSR F - Fi :1 A L E%plres 9.30.91
<br />MONITORING PERIOD TgT,1L ::T.'i l'!!,.''AC, t+O PFE~I[
<br />FpOM YEAR MO DAY TD YCAp MO DAY ~ {,4t;
<br />o F~1 DT_SCftAk6E )~) Tx `, 1,,
<br />/moll n7. rl /v.7a n6. nR.7ul / a n NOTE: Read initructiom hB}ore wmplatin6 this form.
<br /> (J Card Only) QUANTITY OR LOADING (1 Card Only) pUALITY Ofl CONCENTp ATION Fp EOU ENCY BAM PLE
<br />PARAM R[R (16-JJ) (JI31) (JBIJ) (16JJ) (J131) NO
<br />E% OF
<br />_
<br />TYPE
<br />(37-.17) AVERAGE MA%IM UM UNITE ~ MINIMUM AV ERAOE MA%IMUM 'UNITE 673)) wNALYiIi
<br />(6138) (69.70)
<br />1 .1 BAMPLL ~i~.'x1 l`-:: ::: 4`+r l.: pT :!: ( .) 'v`{<t::}I;/'.: ( 12)
<br /> MEABUREM ENT L
<br />I,.)~Il 1 1 U t) :.'«<pcRw i~C .° B ,~a Gam"
<br />'
<br />~x ~~ ;isr~~«
<br />,.R 4fG ~ e ~~
<br />5 ~- ~ '>'-~
<br />9 K '+~~,'~~.~`»~ • ~ ~ ~fl~D=~~A
<br />
<br />
<br />1 [ f:
<br />i:Ch) GkO~`i Vl LCF
<br />
<br />R[ta~IRdN [NT=
<br />¢~
<br />.,P.
<br />~.: Sp.
<br />~
<br />w-6~i:
<br />~
<br />V~ P .,~., m
<br />~ e ffi e °
<br />e
<br />
<br />
<br />t: t: 4
<br />t%..
<br />
<br />+
<br />~~ y k S
<br />m
<br />~~'-e
<br />~~'.o-tt ~"`
<br />° P' ~~-
<br />~'', .
<br />
<br />
<br />1
<br />
<br />xam
<br />ti
<br />
<br />~.~.F*~~„
<br />f' .
<br />
<br />,~w. .
<br />aM1 °
<br />. v @
<br />°~ , y..n a.
<br />.: . ,~ x
<br />~ s.o,~ w S
<br />1 ~., w•
<br />.
<br />.I'.fL7i'+S, 'rn-Af. SAMPLE Ik4v=Ar,:l 4.34:: :s 1:; ( ) :LLC434 ( lq)
<br />:. J ., 1 •: :. li E. (~ MEABU REM ENT ~~ ~
<br />L .I:_,/ 1 i~ to @,. «
<br />`PRRMIfn°r~. 4 4b#x
<br />.. - a. «w~ a ~ dR dA'
<br />~~ ¢tr~~~ «fi 4i,:y ._ ->S'
<br />N^~ r~~ ~ ~
<br />¢s~,' ~~ F~s~~%~
<br />` ~m <
<br />~~
<br />,~x;&~ ~,
<br />~ ~
<br />i*..
<br />« '~~
<br />~
<br />.,
<br />
<br />D S 5 V F 1 U :
<br />F I U ° t
<br />i G P
<br />aR~avIRE}1aNTs
<br />.' .~ x s ; ®~ ~ e~
<br />~~- ~~~~~ ;~<
<br />Ix4# d~
<br />~
<br />~~~
<br />e~
<br />~~
<br />.~;
<br />~
<br />' ~
<br />~
<br />`~~ a
<br />~~. .
<br />.
<br />.~
<br />r
<br />.
<br />. ~
<br />R ~
<br />g
<br />,
<br />~
<br />~ ~
<br />w ,
<br />fl(). ANII IF ft F.A:yC SAMPLE yj /: 15 :,`. (: YF Fr I;t 4:k4':: ( ) (t'[.G44 .. ( 14)
<br />~~.
<br />I -(::l is F~'1'k-(:4AV ff~T MEA6UREMENT .. •
<br />'
<br />u,/-.'I /1 1 G D ~
<br />,°~.rvCN/h iT''Yp,
<br />g°.. #.~!~~s~: _..~
<br />~
<br />,<f.~°»yiicY8~4.'i~
<br />~~
<br />RIYn ~-
<br />`~s.a~ ~.:
<br />~
<br />'
<br />~~a
<br />.~~s°, q~ »4
<br />;~« ~-~rg ~•~
<br />~`"$s.: °.P,,. ~~
<br />A ~
<br />'
<br />f
<br />~
<br />~
<br />r a
<br />~
<br />~
<br />~
<br />
<br />~
<br />
<br />7~;$d~
<br />~
<br />'F'1 UEa1' Gk0~5 YA1
<br />11 F «NEQd11}F
<br />N[N~ '
<br />~cw
<br />~ ~(x~
<br />l o~~w»
<br />~'~_
<br />°' : I i 13
<br />:d, .
<br />~~
<br />x
<br />~
<br />~
<br />'~~ ~
<br />"
<br />' '~~ ,
<br />.r
<br />'~
<br />" M ~
<br />.
<br />~ ~
<br />~'
<br />~~
<br />" ;
<br />L r
<br />. /
<br />s.
<br />•. a
<br />°
<br />W a, f .
<br />, . M
<br />a
<br />s a °s„ ;~
<br />s
<br />.a
<br />, ~
<br />, L
<br />, G L >; s
<br />i •ir;t , 1'u CA i. i e/LMPLe O.:kt~G4 ~l;[LI=f4t= ( ) •' {+P~tG1x4 ( 19) i
<br />(A ] FE) MEASUREMENT
<br />~
<br />L 11111'/ 1 l) () i''~•[RM''x'~ A A
<br />'
<br />~~
<br />+
<br />.
<br /><.~ Rt.~f ~
<br />.
<br />®g ~g~t
<br />s
<br />~:
<br />~ °'.r }?'~t«,-~.`~'a'A' '
<br />aa~
<br />~ :)'
<br />F [f44 ~ .,^,(~,`
<br />~
<br />r ~,~°~ ;qy,, Rf '~,r.
<br />~« ~.f
<br />~ ~py~. •'
<br />A'NS~Jo-~fv
<br />P' ~ w
<br /><'~:~,~
<br />~° p r
<br />xr
<br />ri~~••y
<br />,
<br />'irl
<br />;t
<br />' GRDSS fALllp
<br />F
<br />' GUIFI[K
<br />RN
<br />[NT
<br />^ ,
<br />°
<br />m
<br />.
<br />,
<br />~~k
<br />~ g
<br />$~~
<br />@
<br />~
<br />3:
<br />` t:pr•
<br />rY ~r ~
<br />~ _
<br />~ S
<br />' Y ~ °
<br />.
<br />r
<br />I
<br />)
<br />( e, :s , g x
<br />,
<br />~~:;:~< . a,
<br />~, x° 3 hG ~r
<br />) L':'IU, 1.. COt:DI17T ~R SAMPLE ( U3) 4Tx+;t+a4 444444 4r....,;,;,h ( 1 .
<br />, :1 .: I. I: ^. A i tI F'1
<br />l C' 1. R N ; MEABUREM ENT ~ +
<br />'
<br />~.
<br />111: ~ 11 j lI V ®`:SPE.AM17.~' a' FE /~
<br />~ 1' ffi .
<br />~ ~ 6.H ~}4 y
<br />a /nr{
<br />~~~` ~11 g1~o~
<br />d".A
<br />~e 4~'~~' A'Y!q.~~ ~`F
<br />I ' 4
<br />a..~y "'
<br />S YcTP MY9"¢
<br />'°~
<br />~
<br />R .° y
<br />Yf ~dn 4¢IC+
<br />TF ~,~L: ..~@'~ ~'.yy
<br />"F'~ ~p•
<br />~ {'O~
<br />m~
<br />
<br />T
<br />
<br />IIF
<br />'~ 1 U
<br />:r
<br />GkOSS VA F
<br />IEdOU1RE ENTs
<br />
<br />~~ ~
<br />S ~R .., x ~"%;°
<br />
<br />a
<br />;
<br />® .~
<br />
<br />x '
<br />: .6Y
<br />z
<br />~
<br />I
<br />~~"
<br />~~
<br />
<br />C
<br />M# ~a~B R~~ xy:6
<br />
<br />;
<br />R
<br />p $ S6~ yn:
<br />`~ y
<br />8;g F;~R
<br />H ~R14'~: Yx
<br />'
<br />s~
<br />
<br />
<br />~`~ #
<br />° .
<br />2 ~
<br />'3a
<br />~
<br /><
<br />- .
<br />a
<br />i
<br />m
<br />~xs'
<br />~°~
<br />L r
<br />+
<br />.
<br />r °
<br />~ .~ma
<br />,
<br />•
<br />' N.
<br />;E
<br />~k
<br />" rt :
<br />H ~
<br />_ ~» « ~~:: ~~~ e
<br />@ ~ r,.~x
<br />® .« n,.
<br />:. 61:44 ~ ,
<br />>
<br />.
<br />~ ,
<br />;
<br />.
<br />x,
<br />~.Il;
<br />ins
<br />'rDTAL 3GIx
<br />44.3 [p::[4131Yi ( ) rlx1e41}4 ( 14)
<br />,
<br />. BAMPLE '
<br />I•) `rl/LycU MEA6UREMENT
<br />~
<br />%..„~)'., ~1 ~ :I °k~°P[R7R47e ,A: s ~1G ~6 4~ dye
<br />:e
<br />x
<br />'
<br />~s 'p@a ~. #'~ ~
<br />~ 1: 113 , °'~
<br />a~ R `
<br />`
<br />~` °+xy ~} ~¢ }~ tr~
<br />a .,, '~y r,~m
<br />~
<br />a ~ P
<br />
<br />° :~y
<br />~~{.r ~1• q.>:
<br />R~A;~ , '«
<br />c
<br />VT
<br />~111
<br />'b'F
<br />ikDS
<br />LI)F hE4U R8 E Tc
<br />f ~
<br />= &..
<br />~-
<br />w
<br />.@1
<br />a
<br />-=s
<br />ti ~ , . ~.~ w«
<br />;g
<br />%r~«
<br />~ -
<br />~ tf444~ !s'; a
<br />a
<br />,a
<br />.
<br />xy~z~
<br />~r
<br />R ;
<br />a
<br />a:. . a. x
<br />~@., =R « .~<;E.
<br />'b .,~. •x.
<br />r
<br />•1
<br />E.:1
<br />l
<br />. ,
<br />~ « .
<br />ro
<br />~ ;,
<br />»
<br />, .
<br />~ ° .
<br /> SAMPLE
<br /> MEABUflEMENT -
<br /> ,b'°-VgPMIT .°°
<br />
<br />'
<br />x~
<br />~R`~:~~,~°-$%. •¢~
<br />.' °s ?:~» ~a~~ ~r/~~'xn~e^e`'~d;a
<br />~' #81•
<br />m ~AZg«an ~~: ~s~„~
<br />a
<br />`~ °i@
<br />'" x, «,gp b
<br />s A-e LaaaY ~,~e.
<br />?.m. ,_~ «« ..
<br />~ ~~ ,.~ x
<br />yp'
<br />n"
<br /> 1
<br />'8~4Wl1[M[NT e,
<br />.ya ~.. s~ A~'« ~ ~ ~.g%',
<br />1 °~~
<br />y
<br />~.,-a .~,~e
<br />~
<br />~ ¢
<br />3°
<br />ro Az u,~
<br />~ a
<br />ID s@ arc
<br />' ~ a.i. ° ..
<br />-a'., ~.
<br /> -~Y x s.a .I.h
<br />'~Aa'e °r
<br />tl
<br />rc <
<br />~:.R ..ire ~ # e+-
<br />v~~At' .._b
<br />w 2.~rn. @«.
<br />r
<br />g
<br />LAw TXAT I
<br />RAVE P[p60NALLr fEAMIN[0
<br />NAME/TITLE PpINCIPAL [%[CUTIV[ OFFICER 1 CERTIFT UNO[P KIULTY OF
<br />ANO AY FAMILIIR WITH THE INFORMATION SUBMITT[O NIREIM
<br />1ND LASED. ~ 1,. ~
<br />.'
<br />. TELEPNON[ ~
<br />~ D A T
<br />E
<br />'
<br />.
<br />ON Yr MOUIRr OF TNO~E MgV10UAL6 IYYEOIATCLY RE6PON61BLE FOpI ,
<br />'./'~ 7 -
<br />
<br />OBTAINInG TXE IMFORMATq:. 1 BELICVE TX[ SUBMITTEp INFORMATION'
<br />IS TRUE ACCURATE AND COMPLETE 1 AM AWAR[ TXAT THLRL
<br />ARE SIG ~ ~
<br />1' r
<br />~ "~~
<br />- -~~
<br />/
<br />~- _
<br />,
<br />/
<br />NIFICAMT PENALTIES FOR fiUS.11TTING MLSE IMFg1MATgN INCLUONG
<br />r I (
<br />1
<br />1
<br />J II'
<br />' .
<br />(
<br />.
<br />/C'I
<br />L
<br />L~ `
<br />- -
<br />.~
<br />~ - y :,
<br />.
<br />~ (
<br />,
<br />/
<br />1
<br />THE POSSI&LITY OF FINE ANp IMPR50HMFNT SC[ IB USC 1 1001 ANO ~1' ) ~
<br />~
<br />- C' (i ~1 ~ i 1
<br />]]USC 11]19. ,Prwlur. ..Mrr lhrr Yuml.. mrr mrlWr /mo.IiP u. Lu!uw BIONATUflE OF PRINCIPAL ESECUTIVE .
<br />~ 1 ~.. (~
<br />TYPED OR PRINTED n.d~.•ma,Inlum lmonn.nnl.nr „/M~lu..nBm~.nlh. and .5 .rr..I OFFICER OR AUTHORIZED AGENT A '[ NUMBER TlAR MO DAY
<br />COMMENT AHD E%PLANATION OF ANY VIOLATION6 IWr/rrrnre ull ulluFnmrn/T Rerr)
<br />:= :.1/ I~1:,C'E!AflGI-: nf.i:IIN~ hSPQHT I'Ni) DCSCFlARG5" ON YDUFi Dt'R. I
<br />:i Ci'. E'uUT;(D'CE J F%,.3 OF l1 Ft)R !1EA SUFI[NG OF SETTA6LF: SOLI DS.}'LDN IS ti F.ASURF.D AS MGD (J i);i T' A RiY.7 VDPRj
<br />EPA Form :1320.1 (Rw. 48B) PfBVIOBa Bdirlana maybe used. IR[-LAC[a L.w roRM T-.3 WNICN MAY MOT BL Da[D.) Pwc[ of
<br />gp01)]/9)0372-11.1G 1
<br />
|