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PERMITTEE NAME/ADDRESS(/wrY/rfecelryNaiW/u[ellee ODlp..mq <br />NAME '- i '~'SU r .. .. , - •: ..: ' , <br />ADDR6EiS °INES T_,!'? t~J'.1"", ° "~;i ., '~ F <br />~~ <br />.. 91.00 ~a •P <br />T•t^•Ift. <br />~? ~^r' <br /> <br />FACILITY <br />LOCATION <br /> <br />NATIONAL POLLUTANT DISCNMOE EDMINATION SYSTEM l//PDE$/ <br />DISCHARGE MONITORING REPORT lOMR) <br />l 161 lI7-191 <br />--}Ol?7.Sa I ^.~^ r I <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM " TO ~ ' <br />!10111 l12-131 !24751 116-171 129-191 !34311 <br />Form Approved. <br />.- , ~ -. ~- - ~ -, ~ , •• - _ -OMB No- 2040-0006 <br />l: ,.nom F~ APProvef a~Pi~e105-31-98 <br />'• T ! <br />~ ., <br />' NOTE: Raed inetructiaru bef a compl~tinp this torm:~a~ <br />PARAMETER !3 Grd Onlrl QUANTITY OR LOADING !1 Grd Onryl QUANTITY OR CONCENTRATION ND FREpUENCY SAMPLE <br /> 146-591 154611 I3B-451 /4653/ !54611 EX TYPE <br />l31-371 µµv515 <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS rs1-gal !yF-681 !6&701 <br />Di::CIT'!, SAMPLE , .... 4~:. , :...+a' `r}' ~ ~ ~,:~ <br />C <br />.?~A Lc;g -.i ~: •, ~. <br />t I: MEASUREMENT <br />T <br />i <br />. <br />~l~l?d ~ C ~ PERMIT ##R4## -".+r.'*t=>r . 0'.,:~ p D u±` !;#~#^v . 4? I TP.,Y ,OMP~i <br />... CU "'7 H1 :. '-! J'a REQUIREMENT ~ ~::'k ep Y~LII°. "''1Y ('T ' <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 /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMERITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMILIAR WITH THE INFO LAW THAT I HAVE PERSONALLY EXAMINED AND <br />RMATION SUBMITTED NEREIN; AND BASED ON ~ TELEPHONE DATE <br /> <br />Fichard ~,7iil` MY INQUIRY OF TNOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS <br />_ <br />!an <br />e <br />l <br />1 <br />i <br />' TRUE. ACCURATE AND COMRETE. I AM AWARE TNAT THERE ARE <br />SIGNIFlCANT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING <br />97n~ ~TO-~ <br />]~7 <br />~f] <br />~ <br />rl <br />~5 <br />ag <br />r <br />C T1V <br />rOll TD2tT <br />f,U <br />1 <br />~ <br />.. , <br />THE POSSIBILITY OF HNE AND IMPRISONMENT. SEE 18 U.S.C. 1 1001 AND 3] BIONATURE OF PIIINCIPAL EXECUTNE • . <br /> u.S.t. E 13 u. lMr.re:e urger rA.~ mam. erer r'rrlde 6e.e w ro S ID,Dpv AREA <br />TYPED OR PRINTED ens ormuimnr MpbA'errene a/Mneerremanere enJe reeral OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS !Re/ergots e/1 etteehmenfs hers! <br />jR~ Ie 9e~l c. .. ~. T4 TL°. i''. P''... 1' ~"47Li: 7% L°.^/'1SITv ra°T':r A'- nq, _: rvr mu <br />'-a^._*•-1 .~--n';,, .. crg3 7 <br /> , <br />UT;)%LCI~Y". ~'~om .may vccr'l ~. V' <br />~... 3n ;~I.v }T.4 r~~"T.^_4LT.Y ^Tr 1T?' ~T^r c, ,. .~. ,.. ~.~ r r~~!'T^- "_~ <br />f I M1'- ) J <br /> <br />",~ . <br />- T'r.:' Ncu on'* - -.7c - <br /> <br />~ l n - _ ,.nr+ r -I n^ er., <br /> <br />^ <br />V <br />EPA Form 3320-1 IOD-951 Pravloue edmone may be used. (REPLACES EPA FORM T<0 WHICH MAY NOT BE USED./ ~ <br />PAGE <br />. <br />OF <br /> , <br />~ ~ n ~ ~ ~ ~ C U ~- ~ _ T ~ t „ <br />