Laserfiche WebLink
pCnMll ICC IYq MC/gYUryLSS/IIM1ib F.[WIy NiLILO[.(!«(rD(j~Tl!/ <br />NAME LOi;EACITL- ";~;aL CC.'7PAhY, LLC <br />ADORE55 LORchCjTJ Cali-tOK NIhE <br />1311 BENTNOiJf G5IVE <br />EYAN:;YILLE IN 47711 <br />FACILITY <br />LocpnoNyESTUN CO 81091 <br />aTTN: A.L. PERF:Y, f1AMA;l:ia <br />NATIONAL POLLUTMT DISCNMQE ELIMINATOM SYSrEM I/YrYw! <br />DISCHARGE MONITORING REPOIIT lOMRI <br />11-161 I7-191 <br />PERMIT NUMBER DISCNMOE NUMBFA <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM j j TO ] j ~ ? j <br />I?0111 II2-231 !II-251 12G77/ 139-19/ (34311 <br />=inn Aa xoved. _ <br />DISCHAFGE TO Coy k-P1~I1e~~P"°-DOar-sa <br />(sveR sE) j~°~a~ <br />F - FIAAL <br />'IVCN <br />A° NC DISCiiAitGE ~ ~ #:°~ ; <br />~NOTE: Reed Inetrucllom before , pletinp this form. -, <br />PARAMETER l3 Grd Ontyl QUANTITY OR LOADING !~ Grd OnlYl QUANTITY OR CONCENTRATION NO FREQUENCY SAMPLE <br />7 /1653 !5467 l3B-151 l16-531 !5461 QF <br />l31-3 <br />1 EX <br />ALras TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !6l-s]1 M <br />lµ691 169-701 <br />PH SAMPLE #4Calpq 4##### CICC### ( 12) <br /> MEASUREMENT <br />OO4U0 1 G 0 PERMIT ;xpi;t>Qi@¢ 4a4#~s# ~#r: 6.5 4o>eg~l# 9.0 EEKLT LN5IT <br />EFFLUENT GROSS YALU :REQUIREMENT. ##,.-d ~{ <br />SULILS, TOTAL SAMPLE ##t4## 4~#4## #IC#EF4# ( 19) <br />~UJ'PENDED MEASUREMENT <br />UOS:iU I Q Q PERMIT : LI###fAG #~~i, llt>~Ip OE}# #a0~~ <br />35 <br />7>0. <br />8GE! <br />;4A8 <br />cFf'LUENT 6ROS3 YALU REQUIREMENT x#00 Y <br />SOLIDS, SETTLEABLE SAMPLE ;=aa::~. .;:+eoa# #a##oo ( ZS) <br /> MEASUREMENT <br />UU545 1 0' 0 PERMIT i:fi>riK# II###04 #C# G#•##10 $El;CRT 1~8~ORT NCF.j ,RA9 <br />EFFLUENT GROSS VALU REQUIREMENT #~# <br />IRON, TOTAL SAMPLE ~=AV t::eF ?Y#rr# # L ( 19) <br />(AS FE) MEASUREMENT <br />01045 1 ' 0 0 PERMIT ###R;:4~ #?a>:#%t# ### P# x 3,Q <br />~ (~10 XCE/ :RAE <br />EFFLUENT ~G$0S5 YALU- REQUIREMENT ~ . <br />3- A A ~Y <br />JIL AND GREASE SAMPLE Sr#;<~.a ##o:k# t0#C;t !;#0#4 ( 19) <br /> MEASUREMENT <br />u3581 1 0 D PERMIT #o-saro>x ##iFp#~ #;.# #?Dat}## #:qA#.# jQ .ONTIN :EAB <br />EFFLUENT 6H055 VALU REQUIREMENT ~~#,~ 11 <br />FLOY, jX COIIDUIT UN SAMPLE ( Q3) #0+A#L 9YI### 4X#',!## <br />THItU THE-TFIEiT PLAN MEASUREMENT <br />iU05U 1 0 0 PERMIT REPOR REPURT 4#>Q0:# 'Otttd#6 #t!16#yA# #~# EEKLY XSTAN <br />dFFLUENT GROSS YALU REQUIREMENT 30DA AYG DAILI !!Y l1 GD 4##Jr <br />uIL AND GREASE SAMPLE ##a~a# ( ga) #~eTao~; >:><##r•-~ ooY##r <br />Y I S U A L MEASUREMENT <br />:,4Ubb 1 0 0 PERMIT ##00~## REpORi ES=1 #'4'B### ##fi~#L 4#;##3 ### £EfiLC ISUA <br />L:PFLllEN2 GR035 YALU REQUIREMENT' IRST l1AA NC=O #### <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CFATI <br />AM fA FY UNDEII PENALTY OF lAW THAT I HAVE PEgSONALLY E%AMINFD MD <br />MILIM NCTN THE INFORMATION SUBMITTED HEREIN; MD BASED ON <br />/ / TELEPHONE DATE <br />/ <br />y~{'~L( (~ ~ f H~ 07~C/ <br />BTNN NO E MFORMATION,IIRBEVEVE TNEESUBMITTED INFORMATION IS <br />TRUE <br />ACCURATE Mp COMRETE <br />1 AM AWME THAT THE <br />E M ~~ <br />/ <br />/~ <br />J <br /> <br />. <br />. <br />R <br />E <br />SIGNIFICMT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING f <br />I <br />` <br />^ <br />~ . <br />THE POSSIBILITY OF RNE MD IMPRISONMENT. SEE 1B U.S.C. 1 1001 MD J3 <br />c <br />Etale <br />M <br />f <br />B <br />d <br />- BIONATURE OF PRINCIPAL EXECUTIVE - <br /> . <br />. <br />Yrr <br />u. <br />. <br />r.uwl. <br />a <br />r .bnmr. m.Y NrAW l,... Irorosrodoo AREA <br />TYPED 011 PRINTED .nsrcnl.rbwnin,d..r,rlrnt orNM«n snloneM rg6Yw.1 OFFICER OR AUTHOg1ZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLA EIONS lR~IeT~nce sN ~KSMmsnts hale/ <br />i'S~ & IRON LIFlITS WILL dE yAIYED 6 SETTLEABLE SULKS LIMjT AFFLIEC FCF <l0YA,2UFA PRECIP EVENT; TSS, <br />LRON E SETTLEABLE SOLIDS LICITS WAIVED FOR >l0YR,24HR Fk°C IF FhENT SUEJF.CT TC BpNDEN OF PROOr IN L.A.Z. <br />D T I c r` o P e C Y S_C P_ L a ] r <br />f~ <br />EPA Form 3320.7 108.951 Previous editions may bs used. (REPLACES EPA FORM T30 WHICH MAY NOT BE USED.) D D 13 9 / 9 7 ] 111-17 ; H PAGE i F <br />