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''z ; <br />~I: <br />PERMfTTEE NAME/ADDRESS pneS~dFsWryNr/fxaun JD~....o <br />NAME 9:)eI"t. !{'•S1'!V~33, :.I'!I^.:1 <br />ADDRESS D J'A 1 c. P! 7 , L ') I ~~ :. <br />V, il. d~C ~i1i <br />FACILITY !iJ.i:J R~'37Uk_:'.ir L1'+iChil <br />LOCATION <br />a P T u. T l l r. a I ~~ n r 1 n c o A T a[ <br />NATIONAL POLLUTMT DISCNMOE EUMINATON SYSTEM /NPDE$I <br />DISCHARGE MONITORING REPORT lOMRI <br />11-IR 117-191 <br />~'I -• 1 ~ fl .'1 7 <br />PERMIT NUMBER DISCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAV YEAR MO DAY <br />FROM 9 H ~1 J L TD s •t J' <br />IZQZ11 l11-131 !1416/ /16171 /18-191 !30.31/ <br />Form Approved. <br />P : e ~ I ~ -I : r r; ; ~ r J ~C}NJ,BLJ~Ioy~Q40-oo04 , 1 <br />Ap^prdvel expiree'd15-`31-98 <br />C-;L'sP :^) 12345 <br />e - rIyAL <br />"Lt c,.~ <br />NOTE y Reed Inetructlom belori eomptetinp thb form. <br />PARAMETER J !3 Grd Onlyl QUANTITY OR LOADING /I 6rd Onlyl QUANTITY OR CONCENTRATION NQ FREQUENCY SAMPLE <br /> !/6531 154-67) 138-15 !4653 !5461 <br />EX OF <br />TYPE <br />l31-371 µALVSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS e1-e.T~ /54.581 159-701 <br />UIL A:~J .. SFAS% SAMPLE ,.~... ( 47) ,.:?~-: .. ..... i <br />Y I i J r <br />L MEASUREMENT ( O V,- I q l <br />1 <br />naJ:•IJ 1 G U PERMIT ~G;kt4 itEP33P ES=1 +•.-~;<+::t .,,:<,t -' •::;~r~::: .. HBRLY ' ISl'P! <br />I: .' i' i. ~ :: ~ t ~.: i; ~ i 'i V P IJ - AEQUTAEMEN7 s, _ r __ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> .REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF LAW THAI I HAVE PERSONALLY EXAMINED AND <br />AM FAMILIM WITH THE INFORMATION SUBMITTED HEREIN; AND BASED ON - / , TELEPHONE DATE <br /> MY INQUIRY OF THOSE IMDINDUALS IMMEDIATELY RESPON98LE FOR / <br />~ ~ <br />/ <br />(' 1 ~ <br />" FIT llt b~ ~ OBTAINING THE INFORMATION, 1 eEUEVE THE SUBMITTED INFORMATION LB <br />TH <br />T THERE ME <br />E <br />A <br />M / <br />.~, <br /> TRUE. ACCUMTE AND COMPL <br />TE. I AM <br />W <br />E <br />A <br />INCLUWNG <br />SIGNIFCMT PENALTES FOR SUBMITTING FKSE INFORMATION ~ / <br /> <br />7Qt, ~ i J~~T-{- , <br />THE POSSIBIUTV OF NNE MD IMP11150NMFNT. SEE 16 U.S.C. f 1001 MO 77 <br /> <br />BIONATURE OF PRINCIPAL EXECUTIVE <br />~ /~ ~j~ q <br />~L /'~ T U <br />:i <br />Q) <br />/ ~ <br /> u.S.C. E 1J1e. lANWr,. ud~r 01r~ mtuni n+.r 1+dM. !.»s Ne ro r 10,000 AREA <br />TYPED OR PRINTED Wamu4m,nMP'bu'nnrNWbrMwnemanerrAMSyrra.l OFFICER OR AUTHORRED AGENT CODE NUMBER YEAR MO DAV <br />~ COMMENTS AND EXPLANATION OF ANY VIOLATIONB IRs/arsnce ell ettschmanrs here/ <br />SETlLHA:`L~ S~LIUS LICiIL APFLIi33 s;LY LP := 1J-rllr 2¢-1~ Diia.:ie' l,i.,ei IS "LAT~:~n, rc ,... ~ T; -I~'PNJV~D <br />BY UQCDr T°,3 ~ CR7^I LI!Li5 MILL NJC 3E AP2LlED r7 hFPJR.f°7 5tn~.lric.L~NT,S -$E~: L, i.LAr °'• ~. i,I`..II:r P:1 <br />I , :IL .i „ 2?Y-'r I -951 P a 'o _ iti l ey d, (EP[ACES EPA FORM T-40 WHICH MAY NOT BE USED.1 PAGE OF <br />