Laserfiche WebLink
PERMITTEE NAME/ADDRESS (/nelur/e <br />Faeilin~ Name,2urariou i! diflrrrnN <br />NAME ~_ <br />--_ MTNnP I-Rf'-r------------- <br />ADDRESSMnRT~y~~~DS~rI fpR.--~•~ "-rl-~c-S_----_ <br />---tF~ rTy,~~~~pCRI~-R46'r+1FD-r~Q~$-~~--- <br />--- ~r°B~nJ-Mr- --SD--iR2~._- <br />FACILITY <br />- _ i~ <br />LOCATION___ ____________^~_ <br />,LTTN: JTn STOYF'k <br />NPTIONgL POLLUTANT DISCHggGF ELIMINATION SYSTEM I NPDtS ) <br />' DISCHARGE MONITORING REPORT (DM1IRI <br />f'-161 (17-I ~1 <br /> <br /> ,qi 9 <br /> ERMIT NUMBER wscw Agcc rvuweLq <br /> MONF7 LRING PERIOD <br /> YEAR MO DA~_ <br />~ AR <br />YE MO DAY <br />FROM 8 ;,1 D <br />• b n <br />98 D? 1 <br /> <br />on1 ~ oD~ cor~,~`,:,D n°~~rR~ <br />($ li R R YC) Form Approved. 1 i ~ fl <br />P~ P I N A I OMB No. 2040-0004 <br />~T 7a Approval expires l0-31-94 4 <br />J NOTE: Read instructions belore completing this form. <br /> (?!'a rJ Onl/y O ANTITY OR LOADING (a rd Onl '1 ~CUALITY OR CONCENTRATION <br />PARAMETER fab-Si/ (il frl S7 <br />~ lJa-61) <br />/db <br />Id <br />a5 Ep. FREOOUFNCV S <br />YS <br />E <br /> ) / <br />) <br />J <br />- <br />- T <br />PE <br />f))-T]) ANALYSS <br />' AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MA%IMUM UNITS ldl.nJ) I6Jfi31 (69-IO) <br />OC:. AND vRFASP. SAMPLE .. ^ q) 'a ;. -..:.. .-r,r~QO: O#iEl:rrti / r <br /> <br />Y I S D A L <br />MEASUREMENT <br />V J~ V <br /> <br />84D66 L [7 D <br />PEP.MIT <br />%~~ ~i4 <br />li <br />~~ <br />O/R+OrK## <br />~QX<CI~ <br />A# <br />O-'.Y :: <br />~ T L <br />aIGS~ •• <br />2J~AM <br /> RECUIREMENT <br /> <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />RECUIREMENT <br />'.~ 1 <br />~ <br />: <br /> . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - - ~ ;` <br />~-~ <br /> REQUIREMENT ~ ~ ~ <br /> SAMPLE <br /> MEASUREMENT <br /> <br />~ <br />- T:~ an <br />" <br />"' <br /> PERMIT <br />REQUIREMENT X'~ ~ .:'i< f <br />" x• <br />. <br />r' <br /> Y7j . <br />' <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT _ ~ ,' 1 'Y <br /> <br />RECUIREMENT <br /> <br />) , <br /> SAMPLE <br /> MEASUREMENT <br /> <br />PERMIT .. t~ <br />.'r x.H. <br />.'i~~~ <br />:w <br /> RECUIREMENT ;y'?py <br /> SAMPLE <br /> MEASUREMENT <br />~ PERM <br />T ~ <br />. <br />_~ - S+_~plN ~rt,~ , - <br />~ <br /> I <br />RECUIREMENT ' .: 1 <br />~ ~0 ~ I ~ ' <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OR Law THAT I HAVE RERBONauY Ex AMwEp TELEPHONE D A T E <br /> PND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN qND BASED <br />n <br />J <br />E <br />~ YC-t~ ON My MOUIRV OF THOSE INU1VIpUALS IMMEDIATELY RESPONSBLE FOR <br />OBTAINING THE INFORM4TION <br />1 BEZIEVE THE SUBMITTED INFORMATION IS <br />• <br />- <br />.. . <br />TRUE ACCURATE AND COMPLETE I AM 4WFFE THAT THERE ARE <br />SIGNIFICANT PENALTIE <br />F <br />M <br />T1 <br /> <br />paES/pFU g <br />S FOR SIJBMITTVJG <br />ALBE INFOR <br />0N INCLUDING <br />TH <br />P <br />I <br />n <br />4 ` <br />O' <br /> BILITT <br />E <br />OES <br />F FINE AND 1MRR6DNMENT SEE IB u5C <br />1001 4ND <br />33 <br />S <br />G 4 <br />9 <br />P <br />l <br />i <br />h <br />' <br />d <br />d <br />% IGNATUREOFPRINCIPALEXECUTIVE J- <br /> 131 <br />U <br />. <br />( <br />cno <br />l <br />n untlfr , <br />csr vumrrs mm <br />m <br />u <br />c <br />mas up ro <br />< <br />~ <br />TYPED OR PRINTED Slt?000 ~nJ nr mdlinmm 1mFroonrnenl ul he,u'ren n mnndu <br />anJ <br />,e~n J OFFICER OR AUTHORIZED AGENT D NUMEIER YEAR MO DAY <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS j ReRrcnie all mlaohmams here) <br />PF.RMITTFF '1U5'C NOT?FY Y{;CD 3n DAYS IQ In P, TO .,^t+rFiIaI!~G DI`C44?I:F'3-2saT I.A.4, PG IY. !lOuT9LY _°A'^PLiNG F'~? <br />PH, FLOP S 08G ALLOWED DURING PERIODS ^F LTA ACC°.SS; ATTAC'1 STAY°'+9'I'P ^.'O Dga, D°TP.CTION LINTS-SLB T. F. 2. <br />EPA FOr 320- (Re . 9= eJ Piem Le'ditidn a e' used ~ ~ ~ V IREP~ACES EPA ORM - 0`W C M•Sq'Y NOT HE SED:S'r j ' L -+ V G t! 1 ' pgGE i ~ DF <br />00022/950829-0929 2 <br />