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PERMITTEE NAME/ADDRESS p.3,6 Fard~ryNar'Lx.nm UDld..ap <br />NAME (,YYKU~ tHN1Kc L•~KPuiCAT1L'N <br />ADDRE55P 11 dUA~ 6C{ <br />-RAlti (;U d162b <br />FApuiv CYPkUS EMP[rtE CL1kNUKATIQN <br />LocAnDNL~Afv GU 01625 <br />aTihl M1i.HAtL N. LUOLl1H. iitNERAL HGe2 <br />~G;~_ 31 Ot.-ylr, <br />SUbk Nr~ <br />F - FINAL <br />k <br />Fonn Approved. <br />OtXIB No. 244R~004 . <br />I t_~ Appiove a ~i ee OS-3Y-98 <br />~~~ <br />MI.~L <br />NOTE: Raed inetrurgons before mpletlnq thu Corm. <br />PARAMETER !3 Grd OnIYI QUANTITY OR LOADi Q , . ~ id On/p QUANTITY OR CONCENTRATION p, RIEOUENCY SAMPLE <br />l3I-377 106-531 15L5I1 :138-151. M6531 l51-d11 EX DF 7YPE <br /> <br />AVERAGE MAXIMUM <br />~ <br />MINIMUM AVERAGE MAXIMUM UNITS <br />161.69! ANN,YBIS <br />(5q-58) <br />169-701 <br />Fi .SAMPLE V##+II <br />p9 ###### ####M11 12 <br /> MEASUREMENT , .I <br /> }, <br />C.4JU 1 U U <br />i- <br />~ ~# <br />.:.:.. <br />.5 it44~+1<f#:. 4.A ~~ILEY :; A£ <br />FFLuENT Gk ~S3 VALUE .R~QUIREMENP 'c ;;;':'-a. <br />""' # :31ty hj U . <br />s iq . <br />SLLILSF ~tTTLE:.ALE SAMPLE ,py.}.:{<:~ ######' #44##4 ~5 <br /> MEASUREMENT <br />~J047 1 (; J :..>;<.:PE~ <br />I~IIIT ~: ~~~ 1I##91 `F ~7 ###$IR# LI a. ~, >it#.*~^ <br />: ' <br />~:~ ~ <br />. <br />: : ~~ <br />~pl~K~: Qeh ~ <br />: ~ H}L~G/ kAii <br /> <br />FtLUt~`I I ~KUSS YALUL . <br />REQU <br />~ :•::!REME ~ <br />~ ~ ~ <br />: ~ ~ <br />. n,~.# ~ <br />...: <br />. • ....,:..:. <br />' ;: <br />: <br />.. <br />.:.:,.... . : : <br />~ ~ <br />~ / <br />. <br />!L. ANU bkE <br />A <br />SE SAMPLE ti<ti#9iy4 :•t`ti#?It vda~`k#f #`k#### 1`7 <br />r <br />~ <br />RtuN tXTK-VKAV Mtll'I MEASUREMENT <br />G»o 1 O 0 '`eERMl7 ?. . W#'#>}~# ##$##Y # i•i dFil#4#*: ,~####t.~... 14:' - Li:NTIN .;iAri <br />FFLUtAT l+AU55 VA1,Ul REQUIREMENT: •#.;.{. #1$.T...NAX iiL/L 4itNF <br />Li1nF 1N CGNGUIT {}k SAMPLE ~~ .t {.:,. ;,. y<p Yj#@### ###0#4 <br />Ir+KL TI<tAi MENT PLANT MEASUREMENT <br />l;~~i1 1 0 0 `FERMI? FftPU/ZT wLPtJkF ##i~@4v ###### #+•#iF## #`ri- ,"i~f;/ iJ5TAid <br />-FF-t.Ut~YI liR(T55 YA ~LIE .:gEOUIREN1E.bl?.; '~uUA AVii . <br />1:A.1L.Y MX 9uu C<0;•# p!L"}~iTH <br /> SAMPLE <br />,.. MEASUREMENT <br /> ... <br />. .. <br />~ 9EQllIftEMEFI'P. : ~ ~ ~ .~ ~ . <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> REQUIREMENT' ~ ~ ~ ~~ <br /> SAMPIE <br />' MEASUREMENT <br /> <br /> '.~. UIfT ~ ..,. .:. . <br />NAME/TITLE PRINCI6AL EXECUTNE OFFICER I cERi1Fr UNDER PENNn of uw T«AT I HAVE PERSONULr ExAMIN <br />AM FAMIUM WITH THE INFORMATION SUBMITTED HEREIN; AND BA EO AND <br />SW ON TELEPHONE DATE <br /> MY 'INQUIRY OF-THOSE INDIVIOUAlS IMMEDIATELY RESPONSIBLE FOR <br />< <br /> <br />'{IC (13 rd Nt1II5 ~ OBTNNING THE INFORMATION, 1 BELIEVE THEQ SUBMITTED INFORMATION IS <br />igUE. ACCURATE AND COMPLETE. I A14t AWME THAT THERE ARE <br />BIDNIFICANT PENALTIES I'OR SUBMITTING FKSE INFORMATION <br />INCLUDING • <br />t <br />F.nvirunrnental F1;311R Cr , <br />THE POSSIBILITY OF RNE/Jip IMPR190NMENT. SEE 16 U.5.C.E 1001 AND ]3 gIONA7URE OF MIINCIPAL EXECUTIVE 970 570-~71? 7 `7 9~ <br /> U.S.C. f iGtY. lPwWe.. vNr drw rblvna nuY A,cAN~ /irwa Ip m E ID,000 AREA <br />' TYPED OR PRINTED Andrnn..imnr inMa'vrlAnt P/atwwnemonNa rld6YAral OFFlCER OR AUTHORIZED ADENi CODE NUMBER YEAR MO DAV <br />COMMENTS AND EXPLANATION Uh ANY VIOLA I TUNS !HS/e/once en efteCBmenls AB/Bl ' <br />,~I ILtAJLt St,LI~S L1M11 nAlIIEU FL;K 1~YKF[4hln P~ttLlr' tVtN7-j~c,. i.A.~F r'~ iY, FUrt ~~tdUlKt~rri.T~. L.1L <br />~KtA5t GrtAb 7.i;11'Lt ANALYSIS icE4lulRtU 1F yISIJLE SHLr_N IS i,tlSLr;lLU. Jhi4LY _;NNPLItvI• lr~STKUCIIL.++S-i.t.:;F <br />r <br />EP Form 3320-1 108-55) Previous editions mey be used. (REPLACES EPA FORM TdC `"`4iCH MAY NOT 8E USED.) PAGE OF <br />J~~u~/t1E,iUJ1-1311 L <br />