PERMITTEE NAM Erwoowess (Include
<br />PECiliry NEInEILocarbn if dillnenr(
<br />ADOR[t[~~~~T ni.
<br />___~.-3---MT-~ ~3-"+-F-F. LE-OT.s~~.~Ta^-r--r^~oi 'i----
<br />-wcfun _____
<br />-------------
<br />LOCATION
<br />i 9TA. 7TM S^(JV Fk --- -----
<br />N ATIOM1fL POLLUTANT OISCMARGE ELIMINATION SYSTEM //VPUE.SI
<br />DISCHARGE MONITORING REPORT /DMRI
<br />1 /6 /~
<br />,r,. ~ r-r nn v
<br />rPERM1T NUM[[R RncHw RCF nuMlEw
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM 98 Ol O1 T° y9 v3 31
<br />1I0~211 /1113/ 11115/; 116-17/ (1819/ (30~ lJ
<br />MIN 0 H Form Approved.
<br />FSUURIN6LAppBorva~ezp~'Ir s6-30-91.
<br />i
<br />CHRONIC GET TESTING FOR ~Q7A
<br />Tax NC RI SCVARGF~ ~)()CI #-`~`
<br />NOTE: Read Inst7uLKlons ba or GOmpletinp this form.
<br /> (d Card Only) qU ANTITY OR LOADING (AhCard Only) QUALITY OR CONCENTRATION
<br />5!'
<br />rvcr
<br />FREO
<br />U
<br />gAM PLE
<br />PARAMETER (I6-JJ) (Jldl) (383) (Ibf]) (J16)) NO,
<br />E% D
<br />F TYPE
<br />(JI-37) ANwLrsls
<br /> AVERAGE MA%IMUM UNITE MINIMUM AVERAGE MA%IMUM UNIT9 616J) (61fi81 (69-1U)
<br />AEFlECT STATRE 7DAY SAMPLE #aaa>aa ##a##a ##aaa# ###~4a ( _'3)
<br />
<br />CdR CERIOGAPHNIA MEASUREMENT
<br />
<br />O
<br />T
<br />~~
<br />W6
<br />T
<br />~
<br />~~~
<br />~'
<br />'
<br />~
<br />«~
<br />$
<br />~~„ y~~~@a,
<br />`~
<br />a k. mom.,
<br />S+rP
<br />~
<br />~?'
<br />P
<br />~
<br />P ETT-
<br />n
<br />a $,q "y3
<br />~7S L°
<br />' .{j~l T}
<br />'
<br />'
<br />"
<br />ya
<br />®>
<br /> QUIREMEN
<br />t ~
<br />. '
<br />z
<br />S-ax
<br />{
<br />i`, '~ ?„f
<br />'e
<br />< ,w
<br />~
<br />Z
<br />TTT
<br />+ z
<br />q F°a
<br />. 4
<br />.
<br />.
<br />ts a
<br />Y4
<br />MMR T J LI
<br />tsd ,
<br />nr
<br />PPP^^^
<br />%:BFFECT STATBE 7DAY SAMPLE as###%rl $#?#a:J aooa## #olam,# ( X31
<br />
<br />CHR PItlEPHALES MEASUREMENT
<br />
<br />T CP6C v D D
<br /><~'.'PEEIM'IT ° ~s
<br />ENT~
<br />RB'OV IREM .g,~
<br />~o- 9#>k~>~~~># Y.,,+
<br />~ ° ed~u~ ~+Pi ~
<br />.
<br />r"x Q
<br />#OIL'
<br />+°.^9 1 .5~a ,~ °'~°
<br />e
<br />^
<br />~ ~uS.
<br />o°
<br />•~~~
<br />~ ~ ~g
<br />~
<br />PER -
<br />~a'..c
<br />'
<br />~xt a„qa.~
<br />' ~~n-
<br />((~g~.
<br />°Y'~ .v
<br />~.
<br />'
<br />' , ry.
<br />< e
<br />.
<br />„
<br />ty ns ~, ~?ai.E<
<br />, <a.~ s~^~ .
<br />x +
<br />g
<br />e .
<br />C . M P T R e i
<br /> SAMPLE -
<br /> MEABUREMENT
<br /> <PERMIT:°:t . ~° s'n,
<br />~&_ x?~', 'a.; el, ° p3ra . a
<br />z t°„x '~
<br />'
<br />"•
<br />` a
<br />a~ dx $s a-! 'pat
<br />aQy s 4 gr~«
<br />a ¢ wx' '.q re a°9
<br />a'T'2 f a~ a
<br />a~:a <m ec
<br /> ;REQUIRlM Ej
<br />1t }
<br />xs s q y
<br />s «~° `~m'
<br />~ i +, a a.a .
<br /> °
<br />w y
<br />C «y g ,
<br />
<br /> SAMPLE ( -
<br /> MEABUREMENT v
<br />
<br /> ~. :. & ."
<br />' PERMIT yy ~°. ° F u
<br />
<br />a e °
<br />e
<br />' c y4°
<br />° :.
<br />°
<br />~ ptb° '#°
<br />,
<br />~j
<br />8°
<br />,
<br />a R B Y'^W rti ifi Lee
<br />~'a~
<br />a,~ ,
<br />}`&
<br />S <°~x'i
<br />x
<br />„
<br />~a eq a%..p^a~z
<br />a .
<br /> 'R[OUIRCM[NT. °ya
<br />, ' ax n° ¢
<br />,
<br />$
<br />~
<br />~ j
<br />°
<br />Y a4y
<br />s°.
<br />~I a
<br />a
<br />5 %w
<br /> a <
<br />° t ':fi°
<br />~4.v« °! qk-.
<br /> SAMPLE
<br /> MEASUREMENT r
<br /> 2.. SPERMIj • a
<br />'
<br />• Sa",
<br />a a~
<br />^
<br />• `k•"., '^„ „,
<br />,' ":; .~,, •
<br />°
<br />^_.„ °-°°.'"
<br />V
<br />°
<br />
<br />~
<br />j
<br />•.~ ~':a~•
<br />j
<br />y
<br />~. q
<br />« ~
<br />~ ice ~/",^ ~
<br />-"~'•' o °'•-'°
<br />~
<br />
<br />~
<br />w
<br />a
<br />" r~e~ :.s„x°°, «^'.$ s .sta
<br />°
<br />~
<br />p
<br /> 'R80UiREY
<br />Er~,T
<br />$ ~
<br />$,
<br />-
<br />k a
<br />5`.,Sr
<br />°ffi
<br />°
<br />a ~
<br />°.
<br />°~S
<br />>"ss~
<br />yf.".A°
<br />. *w
<br />j
<br />T
<br />j
<br />~
<br />'
<br />m~
<br />x
<br />-
<br />~ 8.'3$1 p}p pAd°as w°
<br />~~~+ag
<br />' y
<br />~
<br />lr'
<br />F YY Kea A;
<br />~
<br />« b~~'
<br />F°3°
<br />4.
<br />y
<br />~
<br /> as.a .
<br />n
<br />~e 6
<br />.
<br />p
<br />s %
<br />f
<br />) s „£ s a
<br />g1!
<br />~ FU -
<br />+II w-. « 3`^.e
<br />t 'n
<br />s _x
<br />,
<br />,6.
<br /> SAMPLE
<br /> MEASUREMENT
<br />
<br />.p.~ Vu ~;.K.
<br />ERfAlT
<br />'°a P
<br />r1Y ~~°°°g yy,,
<br />.3.°'x~n"r i:,
<br />°xIk
<br />a
<br /><e Y
<br />°+'°
<br />T
<br />° 3~x y~y
<br />r.s~nTV'
<br />Te`#
<br />° Fa
<br />m4dy°e~pLYS
<br />e
<br />x-~a ,~q
<br />i c+l
<br />a~
<br />~k'rS°Hm°eba ~8
<br />•
<br />..n a'®F °x',
<br />a ~.
<br />y
<br />B
<br />_
<br />
<br />.
<br />~REOOIREM'ENT•s.
<br />~
<br />« I
<br />,~ s .,I mi>,x, °,~/
<br />„ F
<br />"
<br />"
<br />^°, <.
<br />~
<br />~ °
<br />^
<br />~
<br />''~°ffi'q) ~
<br />,r
<br />Y'`«', ~;~ y
<br />~a<~
<br />m ~
<br />y« ~
<br />~A
<br />«
<br />« e
<br />v
<br />,
<br />.
<br />a
<br />b"
<br />~
<br />
<br />~a .w ~aa'•
<br />~x °
<br />Ar °
<br />x'°'i h.P~«'!.WT,.et
<br />.F'°
<br />n
<br />°n°~x.: °
<br />rS,Tav~
<br />i.ga~
<br />~*°.,~
<br />° ~3 fi..nS
<br />",fM°:•
<br />;x°s X,it +„°~s
<br />;P,
<br />x x
<br />• e+
<br />-z'
<br />".z
<br /> 9AMPLE
<br /> MEASUREMENT
<br /> "~''
<br />ERNlT ~
<br />O ,":.~i';.~'„-•, eA
<br />& ^
<br />$
<br />' m ~°~ ' Y,~x '„•a'.. r'
<br />
<br />a /"< ...•,.
<br /><^,.'a sin
<br /># ¢ ,,•, _.,~x° of
<br />„~°t ~
<br />'~°~'a
<br />a
<br />;x»g
<br />i5
<br />as ACt~
<br />'7 l4 yp .,'""y~°v.'"'
<br />a a
<br />d g~Pag me
<br />e ra~.°.. en°„ee"
<br />~
<br />a :y „aa°fyay^~.
<br />•y. ~"r°n^,y,
<br />~a
<br /> aR IC
<br />UIREM'ENT.;
<br />' s
<br />~
<br />v "n
<br />~
<br />^'^
<br />~
<br />~ °'~b`O
<br />x
<br />'J
<br />!
<br />(
<br />"~ x
<br />}~
<br />^
<br />,,.
<br />Z
<br />*i44°*
<br />``
<br />~i
<br />a
<br />'
<br />° w
<br />'^
<br />"n
<br />~'
<br />° ~ c
<br />~~
<br />~ ze
<br /> xa
<br />. ~„ ~° -¢. °
<br />.
<br />&, , x ° ~
<br />r. .'
<br />°
<br />1 +K
<br />,
<br />x
<br />I
<br />;+. ~
<br />s°
<br />o+k
<br />d~
<br />1M
<br />•
<br />d«As e
<br />a 'K°ax s a
<br />t
<br />,~T,
<br />s
<br />a ha;3a .,d
<br />NAME/TITLE PRINCIPAL E%[C UTIVE OFFICER I ccwnrv urvOER PENALrV of uw THAT I HAYE PERSONAIlr ESAMmCO
<br />•NO AM FAMILMR WITX THE INFORMATION SUBMITTED MEREIH I1ND BASEO TELEPHONE D A T E
<br />C
<br />~ ~ ,^
<br />E ON MV INQUIRY Oi THOSE IHDVIOUIILS IMMCd1TELV RESPONSIBLE IOR
<br />OBTAINING TXE INFORMATION. ~ BELIEVE THE $UBMITED INFORMATION
<br />.
<br />1 IS TRUE ACCURATE AND COI.IRLETE ~ AM AWARE THAT THERE wRE SIG
<br />MiIC ANT RENALTIES iOR SUBMITTING FALSE INiprMATON INCLVpNG
<br />`_` ^C_~
<br />I W LV +/L•
<br />~~ THE eO551BIUir OF FINE ANU IMRRISONM[NT 5[C IB USC f 1001 AND O ~
<br />~ ~U ~ O~ O~
<br />. 33USC S IJ19 IPrmhuv uMrr Ihne uamb. na. nrlude /.n.. •
<br />e, Ln ub IGNATU RE OF PRINCIPAL E%EC UTIVE L
<br />J
<br />TYPED OR PRINTED Y
<br />u.d"r maunLnl mlp.unnn,.m „/h.uwnfim.mrMand.; ~mr" OFFICER OR AUTHORIZED AGENT A A HUMBER YEAR MO DAY
<br />COMMENT AND E%PLANATION OF ANY VIOLATIOHB IReJerrnar ull ulmrhmemz hnr)
<br />SE£ I.P.S FOR TEST PROCEDUHi. RPT i1E5ULi5 JF Lz"THALITY DiRIVATI0N5 AS "':EFFECT", CROYTH E REPROGL'C°Ivh
<br />iliiRIVATIOhS AS "TOXICITY". RPT LOYSST EFFL AT YHICH STETISTICALLY SIGNIF DIkF nLT17E£N TEST % COV730L
<br />EPAaFotleg32all(N 1~i+8bj~ ~ s ifloDS riily b6=usBd. RP I.~JACESILs iIdRM Aa rNICH S7A•Y oR Busco!V =L~r.. ACH H N T P ca L~or fin.
<br />0019G/947u12-1838 1
<br />
|