Laserfiche WebLink
P[RMITT[E NAMEIAODREee (InClud[ <br />Faediry Nalne/Lxrf,becn if dlfJnrnr/ <br />ADOR[tt~' CC-'F-'!~=~4v E-~~"p~~{{r~*--C~-E-~Y !'~i-N-=~--- <br />~~ _TUT T~YT`.Y .. ~ .T. TT n~0 <br />-TS~i0i?4TE~t' -~T ~1TCT~ <br />-wu uTv <br />LOCATION <br /> <br />n wrlDHwL ro LLUrw NT D1scNwwGF FLIMInwTlon srsr[M INPDESI <br />DISCHARGE MONITORING REPORT /DMRI <br />1-/b (7-( fl <br />PERMIT HUMBER o1.<HwncE n1IM.eR <br />- MONITORING PERIOD <br />YFAR MO DAY YEAR MO OAY <br />FROM ~ G . TO 9B 03 31 <br />170J 1I /?1J 41 /llJb lJ6J ]I /JR.?OI /40.311 <br />N I ^. U ,. Form Approved. ~ <br />(S U b d Y C ~MBftlpY 2040-0004. ' <br />F - t'1 NALApproval expires 6-30-91. ~ <br />FOST-f"INING AUNOFF''77""~y~S77..EDI PO:+D , <br />NOTE: Rasd~instructlonR before EBTplet ng hie form. <br /> (3 Card Only) OU ANTITY OR LOADING (I Card Only) QUALITY OR CONCENTRATION FREOU FNCr <br />BAMPLE <br />PARAMETER (M-53) (J161) (38aJ) (16J3) (Jr6/) NO. <br />E% OF TYPE <br />(31-37) ~ wNwLrs15 <br /> AVERAGE MA%IM UM UNITB MINIMUM AVERAGE MA%IMUM UNITS 6163) (61681 (69-70) <br />FA ~~#~~~ #V#1600 #Y~#4## ( IZ) <br /> MEABUREM ENT <br /> <br />U J4l' G 1 Q D ~~~y1 <br />f ~f+iPy£R1'f IT„$i <br />~IIS,.• <br /> <br />r <br />te „s^':+" <br />Y <br />d <br />##Y: ... .... .. ,~ <br />c'' *a. <br />~ <br />i~, <br />' <br />•~~ *:tr•.,a^ <br />° <'y«° -. <br /> <br />°..'rea°`~ <br />~' qyL~ top a +4rp~ <br />x <br />Y , p° e <br />t® ~I~ <br />a b'~eexe®a <br />x 8e <br />~~~~ ' a°`na°s''•s .. <br />`~ A.° <br />~! <br />e <br /> NEQUIREM%$flTi °~'~e °~~ sy <br />~r <br />.,1 <br />; «.,. <br />~ ~ f <br />P t~ <br />,° <br />, ,« <br />~ y n <br />~.. ~! <br />, <br />~-"C <br />c v'n. c r ;,°s;.°~_~ a_« <br />:=a _ e~:n ~ <br />° cn •a <br />SOLIDS, SET?LSAE;LE BAMPLE 016#0?16 0900Od - - ---- -. ( ~~) -. - - <br /> MEABUREMENT <br />GJ54 <br />5 I G G -" ..,, <br />"e+pPERMIT:' <br />' ~ r{, ~. <br />~ ;aq~±~~[ <br />~w <br />Y4## .' yA~~~ <br />°~L* <br />. <br />Ar <br />" «.,.x;»°p< <br />>? - ~,~~« ~«. <br />e ~&d <br />"~R<g~~'e' <br />`~ <br />~ <br />° °e. <br /><°°~% rp~f~ =•k-' <br />) ~A <br />" <br />° y^~.° ~,°iA •, <br />4y ~~py~r~ <br /> < <br />^REOUIREM <br />HNT . <br />a s s .?~`~ } <br />ar <br />7 <br />{- _ <br />`4" <br />~- . <br />& <br />*. <br />t°yx°°s`, ~v °>d', Y <br />± <br />s AY <br />>< x±y«V`Taidr <br />e< <br />C T C CL' C I ;.c• aS' ^.k z~f :~. y., a . <br />GLL AND UAEASE BAMPLE 0#O##0 06160#a ~.~016#000 p4d04# ~ 14) .. . . <br /> MEASUREMENT <br /> <br />FAECN E1RTA-CRAV MET <br />UU556 1 G G <br />~>>,?,PERK«IT ~~. <br />'~`asi~x ax o <br />~~I,g~~ <br />~ <br />° <br />##fr <br />°<r~sy ~ <br />$°~e <br />'> <br />~p $~ <br />f s ° h <br />~ _. <br />s' °~o?n>4'>a rre <br />' <br />+ <br />- m <br />° <br />f <br />~~~ <br />1 m,-- <br />~ <br />~ ~~x ~ <br /> <br />gRfiDUI41EM E <br />NT•: <br /> <br />~ a <br />~ , <br />;E ?~,a <br />" t <br />! <br />s p ~ <br />% <br /> <br />> <br />- <br />;d °.'. <br />";,•~. <br />, <br />« ~ < <br />` <br />~{s `~ <br />e <br />® <br />` e <br />° <br />.. <br />d' <br />a <br />F i T 1 • <br />, >9" < ~~„~; <br />T <br />.~ <br />" B: riA8 « °U .°a,« <br />: d'aq. k°? Yr : ... <br />s ,-n..< <br />F'LOr <br />IN CONDUIT OR BAMPLE ~ ~ ~ a#aoa #>;•a~4tyR #>r#u## <br />, MEASUREMENT ~ <br />THRU T <br />EATMENT P <br />LAN <br />R <br />5 0 0 56 1 0 0 /~ <br /> <br />x" ~- <br />..°.HP€RM~7•„e,°° <br />T <br />.. .~. ...~. <br />• k~'[~l3 ~4 <br />° <br />, g ...'~ ., :: <br />a ksp~ <br />j~ <br />- <br />~ <br />e ... ,.. <br />I~Rr4%%il' It1~ <br />w <br />~ <br />P <br />0 ~ <br />:«~,.. s ~ <br />~~I~ <br />°~>~ <br />° <br />' <br /> <br />r ~ -r :: <br />'d+`y~'o <br />,- i«~ <br />e <br />: . Mt+.«so- <br /> <br />'°. <br />r I GO T FRE:OU(REM EN <br />. <br />:" _ , <br /><R <br />2`b .F-` r` < eT„°'..e `~ <br />-Z«-''. ^.i• i <br />Jv « <br />.~:L <br />n».. ,! <br />?a^a.e°m§ v.w`E <br />F:°..~.*e. <br />..z, <br />~ ~.wY %' ie Y°e?1«i <br />TOTAL <br />SOLIDS BAMPLE G,T##X+# OOVit#:r -J###0# ( i9) <br />, MEABUREM ENT <br />GISSOLYEU <br /> <br />70295 1 G U <br />•=.~~ERnli;~°°~ <br />:•#~+~~^r~+~~a m.x <br />~' <br />aK <br />:~;~~ <br />#o>x „. °.. ++ <br />~'~~3i~aa`a~±r~ • :_:;. ua <br />~~e v nA.'.uywP"ate <br />( k <br />« <br />"s y <br />s°~Y °p -x,~;b <br />i v^ R gI'a <br />; <br /> <br />I w. I I REBWREMeNT <br />~~ n - <br />" . ~ :e : d , <br />,.-- <br />:.-:. :lxx^%i :"fix .dxs° <br />-~"~°~" .+ <br />^ xw^ a <br />°ce'4° <br />°i° ` <br />e+ <br />;Y"a <br />' '".'S, w« C <br />:e.°si+.^ a~°.'. <br />.- Y . u <br />OIL AN'D GREASE SAMPLE ##004# ( yu) 00>xO## ##OOa# t+OL'%1## <br /> MEABUREM ENT <br />Y I SU A L ' <br />b 4 J 6 6 q ~< u ,® ', <br />4 <br />:REG <br />IP EM ENT 4sW ~~ <br />... <br />'~ ~^" <br />x:~~ ~°~~~' E S =1 ~~~~ ~~r1~ _'a <br />~a'n. pH <br />~ 's ~" <br />~..«`~ <br />~ °"x'; ~#" ; <br />~ <br />, $'~s,- <br />~~ <br /> <br />LPP 1 e' T f'D CC <br />n <br />« <br />'^~" - <br />rib:'. °'i ..-,Sn,~z.•F. <br />^y:w'~b <~ <br />-11 <br />«R ,:,~': 'xa <br />i '~4"-. aa`, <br />y~ <br />g <br />hi°.rn+.I~^=8: . <br />+m°.«^: <br /> SAMPLE ' <br /> MEASUREMENT <br /> .l ... ...~ t.w °~~. <br />`'PERM (Ts° a V: ~ .°t~ /. <br />p~sr...°r~ <br />:~>~ <br />~ 5~ :~ <br />WSJ '?~~ <br />0 <br />5` <br />{~ 8' °seylY T°fin <br />~ 8"~,''x, a <br />~J~1 <br />L '418" ae;wku <br />a d <br />`°"ae ~ "" g"y• <br />~~a# 74~ 8' <br />" <br />p,~<~d .~ <br />31t1~ <br />~ <br />e' <br />~ II <br /> <br />~ FA .en&px <br />4~,}~ <br />Tir <br />~~ <br />$" <br />~ 4'"mY~a°%`Y <br />~~x 8. <br />'° <br />12 <br />~ <br />' <br /> 11CgU1REM'ffNY,~ <br />• a' Y :t<m •° ;~' <br />.'~'•:a>:; :':&, <br />,~ :nxi_ a <br />~ .4~ <br />.xc <br />k ~ <br />°s.~.°~"...u $'*"u'.< ., <br />,~~ . <br />`z.. 8 p <br />~'7 N,.. ~~:`M'1.< y <br />h <br />m <br />,,, <br />aa <br />a*~'~y't•a:r <br />°:~ °5 .V°:' ¢ <br />~ <br />. <br />. <br />.,~a.x`d".. A, <br />"~ <br />.. <br />°«~', <br />% <br />NAME/TITLE PRINCIPAL EX[O UTIVE OFFICER uwocw PEnALTr OF uw TwwT I HAV[ rER50Nwur CAwMINED <br />' CERpFV <br />TT TELEPHONE DATE <br /> <br />',E <br />yCy/ /1ND AM FIMILIAR WITH iHC INFORMATION SUBMI <br />ED HCREIN AND BASED <br />ON MY INQUIRY OF TN05E INdVIDUALS IMMEDIATELY RESPONSIBLE FOP <br />OBTUNING THE INFORMATION I BELIEVE THE SUBMITTED INFORMATION <br />G„ IS TPUE ACCURATE AND CCMrRLETE I AM AWARC THAT TH[RE ARC SIG y <br /> NIf ICl1NT PEN1LT25 FOR $UBMITrING FwLSE INEORYATICN 1NCLUOING L ~ <br />/ <br /> <br />2 <br />S <br />THE ROS51B1uTr OF FMC AND IYrN150NMENT SEE IB USC f 1001 wnD q~` <br />~ R <br />~ ( <br />Jy <br />• D~ <br />Ipgµ <br />( <br />.E <br />f 1319 <br />ld <br />b d <br />M <br />A <br />t <br />L B NATURE OF PRINCIPAL E%EC UTIVE L J- ~ " <br /> <br />TYPED OR PRINTED rv a1om1+. mvr m <br />r <br />n.. uy e. <br />u <br />JJUSC <br />IP..wOV. u <br />r. I <br />l <br />mul ~u mumunl m~Prun•m~nu.q A.mvnAm.mlA. ands •b.•I <br />OFFICER OR AUTHORIZED AGENT <br />A EA <br />NUMBER <br />YEAR <br />MO <br />DAT <br />COMMENT ANO EAPLANATION OF ANY VIOLATIONS (ne/oPnCF ul1 ulwrnm(nre n[FE/ <br /> <br />SETTL£A6LE SOLIDS LIMIT MILL BE YAIVED FUR >1J-Yh, L4-Rfi 1~dECIP EVENT-SEE I.A.:., PG IV, FOE PF.IJIRSt.EFTS. <br />(iF(PhLY SAMPLING INSTRUCTIGNS-I.C.9, FG IX. ,3G DAY AYG IS MiVHEST MONTHLY AVG DURING PEF.IOL R?PUK':ED. <br />EPA Form 3320.1 (Rw. iF88) Prwhue editions maybe used. <br />(REPLAC ES lPA FORM T-t0 WNICN MAY NOT EE Uf[D.I <br />aoiaai94oulz-ie3e <br />PAC[ <br />OF <br />1 <br />