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PERMITTEE NAME/ADDRESS (IMrd. frYlry NaW(ucaum,JD,~inul <br />NAME (,v, DVq v.. -+I ~T .r ,.9pT ^.t. .. <br />ADDRESS ;~.INES !r;i i~-~ / '; `~FsAy ~/ <br />9100 t:,e;. - . T 'T~nL~ <br />FACILITY <br />LOCATION <br />ST'10 f',7:'fTi ?' S;yr ~:4 aAL B.1'VY <br />NATIONAL POLLUTMT DISCHMGE ELIMINATION SYSTEM IAlP~E$l <br />DISCHARGE MONITORING REPORT IDMRI <br />11-161 lI7-191 <br />00927 ~C ^~5 '7 <br />PERMIT NUMBER DISCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM ~ T 1 TO 'I.i n <br />I76I1I l12-731 /1415/ !76771 17B-791 !36311 <br />Form Approved. <br />-'Inn •• T r •y :• T T C- T TDMB Np.12O40-0004 <br />/ _ „ ~ „ ,..; ` Approvd expires 05-31-98 <br />L <br />C T 1' T <br />,.. ,nn <br />NOTE: Reed inetrucdone belore complatlnp this lorm. <br />PARAMETER !3 Grd Only QUANTITY OR LOADING !1 Grd Only QUANTITY OR CONCENTRATION NQ fREOUENCV SAMPLE <br /> !46531 151-611 l38-<51 !46531 !54611 OF <br />l37-371 EX <br />M'LV515 TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS le]-B.T! (5q-5B1 (69-701 <br />iFf'~CT >rarL:, Tr.3Y SAMPLE rS<C;:'ti: {: r.-^xe;:~• -a y <br />.. ~ ~;t <br /> <br />'9" CER TOUA?'i '+IA <br />MEASUREMENT <br />1~O G <br />IZ <br />„QQIII <br />iCp3B 5 '~ U PERMIT :t r4?RC ~'gIultp{c ~i:~ 19J >',t i!; :;:rt7~ r::>y+a-kw i pa_ TRI <br />T •Y RP"1 <br />;c~ COgI~t1!rq et•L-Ty .REQUIREMENT ~#~? My ~ALFI ~' CrNT . <br />";:FF~CT Sf4TR' 1`J AT SAMPLE `axax: aeGG~la <br />L0~ ;:>::r;;Yr: A~,r:r,>;;~: <br />( Z~) pp <br />, <br />~u~l <br />'~' PI"IEPdRL?` MEASUREMENT -IZ <br />°C,I;~ 5 0 ') PERMIT. ZkIfO?SS <br />~ 401g36+G G#Y L~9 #srr..tY'T# #tXL'.X## <br />RR- <br />~TRLT' <br />'1C`; 1R L'1 <br />~_,' COMN. ;;NTi °ELOIi REQUIREMENT . #3RR 1N V11Lt7r. C°NT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~ ' <br /> SAMPLE <br />' MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMElTITLE PRINCIPAL EXECUTNE OFFICER I CEATI <br />AM FA FY UNDER PENN-TY OF L <br />MILIM WITH THE INFO AW THAT I HAVE PERSONALLY E%MIINED MD <br />RMATION SUBMITTED HEREIN <br />MD BASED ON TELEPHONE DATE <br />Richard AAills ; <br />T <br />E INF <br />IEV <br />TTED E <br />O <br />O <br />II /BE <br />~ <br />S <br /> <br />Environmental t~lanagcr ORMATION, <br />BTNNI <br />NG <br />H <br />L <br />E TNE <br />EMI <br />NFORMATION <br />S <br />SIONEFICMT PMENN <br />TlIES FOR SUBMITTING FN <br />SE MFORMATIION <br />TNCLUDIMNO <br />'• n / <br />L~7~~87~-z7~2 <br />~~ <br />IS <br />9P <br /> . <br />. <br />, <br />THE POSSIBILITY OF FINE MD IMPWSONMENT. SEE IS U.S.C. E 1001 MD 53 g10NATURE OF PRINgPAL E%Eg1TME <br /> U.S.C. f t S1 a. !A•mld.. uM~r U.r mom. rrr.v hclua /M.. ,Prot /0,000 AREA <br />TYPED OR PRINTED Wrmuinrniw/e,nrrNnr erbewwnemonW rdet'.r.! OFFICER OR AUTHORRED AGENT CODE NUMBER YEAR MO DAY <br /> <br />GOMMtN IS ANV CAYLANA IIVN V~ ANY VIVLAIIDNS INB/B/BIICI a//etISCOTBnt3 AB/Bl <br />;~~: I.S.a e~'., .-sT ?tr,~n~:4L• „• <br />r II ., I ..v <br />.•;)Lr~ 1^ L'.T4SLF .r ,.: <br />.'=TV. T.~ ge •1~ ~,r <br />",r , <br />.,: ',-,,r,.-r,v <br />9S.~IYA'rr'.:N° ~> "T7YT'~iTYn. HFi I <br />.7 ~ •`:~ ^cr a <br />I. 4' ~ r74 r- <br />Sra?.. "4LLy <br />;T` -c c- <br />f,T :~'~• T , <br />~•r-T ~ ..~.~T~OL <br />j rTF G~~ Fn :T9 TNr T:S1' n1n C',1~1r •n"• T^7c cT51^ TOE n ,I M• rp+-~ nv nv-.nu <br />T T n ~c+. <br />EPA Form 33207 108.95) Previous editions mey be used. (REPLACES EPA FORM T40 WNICN MAY NOT BE USED.1 ~ ~ <br />- ~ - ~DAGE O <br /> <br />