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PERMITTEE NAME/ADDRESS qkA+. ~+'mo N~.••• L~~rmo.. u n p..n... <br />rInMF TP.APP.°R ~4iN7`I~, IKC. <br />ADDRESS TRA PPF,R rla~ <br />P.O. BAY 197 <br />C..°.AIC <br />"0 91625 <br />FACILITY <br />LOCATION <br />IITTNi Y. FDRD~!1 PL'TFD`;. FRES/G??8 ISCB <br />NATIONAL POLLUTMT DISGNMGE ELIMINATION SYSTEM (NPDESI <br />DISCHARGE MONITORING RFDORT D~ <br />IT-161 I7-191 <br />PERMIT NUMBER DISGNMGE NUMBFA <br />MONTITORIN6 PERIOD <br />YEAR MO' DAV YEAR MO DAY <br />FROM gg B 1 To _ 4'~ _ 06_ 30 <br />(20.111 !21.231 /14151 116171 118-191 !36311 <br />Form Approved. <br />h T M a R OMB No. 2040-0004 <br />(S 11 D H N i'' APProvd expires OS-31.96 <br />F - ~T~qI. PDFP" <br />~ISCv,gFrr T7 G~011SF. GULCF <br />#a~ q~ DISCggRCP (,/( al~# <br />NOTE: Bud imtructiarr before phtinp this form. <br />PARAMETER l3;6rd On/yl QUANTITY OR LOADING !4 Grd Onlyl OUANTITY OR CONCENTRATION NO. FREDUENtr SAMPLE <br /> !4453/ 154-511 138-451 /46.531 151-511 <br />EX OF <br />E <br />l31-371 AVERAGE MAXIMUM UNITS ~ <br />MINIMUM AVERAGE MAXIMUM UNITS rs1-ssi MALY9a <br />(61681 TYP <br />!69.701 <br />GIL AND CBP4SR SAMPLE aas#aaa ( 91t) 4IIa¢•tT a44a4II tC#+!`-41: <br />Y I SU d L MEA!~UREMENT <br />84066 1 Q c7 PERMIT >ap#O#a RERDYS ES= ltlDptaAi .:. p, . .~T 7JeNe"~li^lli.;" yr+: f <br />Y <br />q <br />hU <br />EPPLUQNT CROS"+ REQUIREMENT <br />, .. ~ n <br />___ <br />_ <br />_ SAMPLE <br />_- ~, MEASUREMENT - •~ <br /> REKNIT ~ ~ <br />~~ - ~ <br />~ ~~~ <br />~~~"~~ <br />~ .' ~- <br />~ ~~ <br />- i REQIIREMENT ,. <br />~. " <br /> <br />- SAMPLE - <br />. MEASUREMENT . , "+-. ~" " <br /> PERMIT ,~,.~kL'I <br />~ a'...'~ ~. <br /> <br />REQUIREMENT 'l:fi:-«. <br /> <br />,.-~~• ~ .. :: <br />' SAMPLE r <br /> MEASUREMENT <br /> PERMIT ~ <br />. <br />~ <br />" ~.~ <br />" ~ REQUIREMENT I <br />- ~ . <br /> <br />~ I SAMPLE <br />MEA:>UREMENT <br />- ~ µ <br /> <br />:. <br />~" -~ ~ <br />.. ,. PERMIT <br /> <br />- <br /> <br />~ <br />- <br />- <br /> <br />" <br />~- ti --. ~ ~.. $EQUIREMENT :" , ". -. ".r. ~ _, ,_ , .. <br />~ x _. <k„- -:", " lk+l, ~, . <br />- ~ ~ ~ SAMPLES ~" ~ <br />;H <br />r I,. ~~ <br />3~ <br />s n F <br />- - .i MEP.SUREME~IT rl, <br />r . <br />. - <br />. - <br />. .. <br /> . _ _ . <br />F . <br /> - <br /> .71EIIUIREMENT ~ " " <br /> <br /> SAMPLE <br />' MEASUREMENT ~ . <br /> ' ' PERMIfi .- .... ~ .. <br />. _ AEIIdIREMENT " ~" . <br />NAME(TIttE PRINGPAI EXECUTIVE OFFICER I CERTIFY uuDER PLNAiTV of uw rHAT I erAVE PERSONAUr ExAMINFD AND ~ TELEPHONE DATE <br /> AM fAMILIM WITH THE INFO RMATON aUBMITTED HEREIN; MM0 EASED ON <br />- - Mr INQUIRY OF TNOSE INDIVIDUALS IMMEDIATELY REBPONSIBLE FOR A <br /> OBTAINING THE INFORMATION, 1 BELIEVE THE a11BMliTED INFORMATON la ~ <br />C <br /> ACCUMTE AND COMPLETE. I AM AWME THAT THERE ME <br />TRUE <br /> . <br />INCLWING <br />AGNIHCANT PFNIILTIES iOR SUBMITTING FALSE INFORMATION t <br />9JO <br />824 <br />44 <br />1 -l <br />G <br />W. (30LCIOD PeC~Z~ , - _ <br />0 99 O/ 1 <br /> THE POSSIBILITY OF flNE MO IMPRISONMENT. SEE IS U.S.C. S 1001 MD 99 SIGNATURE OF PIIINpPAL EXECUTIVE <br /> <br />` T u.s.c. t t G1 s. rnwb, Mlerr ul,. mnm, m,y icAld, rn„ w ro F ro.000 <br />wwmrArwnnwLanrltWbH+wlfmmrh, rd6 wral <br />OFFlCER OR AUfNORIZED AOENE <br />CODE <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRelrncs sll sthehmsnts here! <br />2Sti !: TOTgL I&!tH t.T^T?~ JILL HP YgiYED, AND SF.TTLCg9L°. S(1L'.DS LT"(iT 11S9LT°n r~P ~-Ir;Y=,?LINK DFgCTP ?*fY*- <br />SEF. RURD69i 9F Pti0'ir fl°:IRcMp11?S !1DID~R I•E.3. Y9S 'DNTTORI"IC - I. R.~. r?II r' r•,vaa~p _ qt•F i. P. 1.(D). <br />EPA Form 3320.1 10 •951 Previous edltiona may be used. f A F HI Y USED.1 ~ r)1 1 ? ~ ~ ~ (111 ? ~ -~ D ~ ° PAGE ~ OF <br />2._ <br />