|
PERMITTEE NAME/ADDRESS pnclude Faciliry NamdLocntbn IJDif/erenq
<br />NAME 1' i n ' .. ,.
<br />. . 'J . ^ ~ 1 ~ ~ D (
<br />,I, r,.
<br />FACWTY ~ .... • .. .
<br />LOCATION
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) FOrm ApprOVed.
<br />DISCHARGE MONITORING REPORT (DMR) OMB No. 2040-0004
<br />..I,•.)•
<br />•-.nom , r n
<br />(S~i o= ej
<br />PERMR NUMBER DISCHARGE NUMBER
<br />• - n i.
<br />MONITORING PERIOD ~ - " ~• `~ ' ~- L - ~~~
<br />YEAR MO DAV YEAR MO DAY
<br />FROM ')I '1. ;'l TO Ji ]:- 3~ :a :: :;} _}°__A R:. - ... .
<br />unrc• oo~R lnefn irfinns hofnl inldinn this form
<br />. J t" n ~I - .. '
<br />OUANTITY OR LOADING QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER EX oP TYPE
<br />AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALrsls
<br />' SAMPLE ..... ~ :::: ~~ .:.,: .. . _ ( 1 . )
<br /> MEASUREMENT
<br />
<br />.:
<br />'~'T'f ~~ s : ~#j ~ ~.~5 t~'~fJ
<br /> r u . ~
<br />"s
<br />~ z~ ~
<br />~: ~
<br />a -
<br />,. , , ,Yy3
<br />..
<br />t. .,~. SAMPLE ~. ~. +l7wR :: rti: ~: ~': ... :.
<br />
<br />.,
<br />., _ MEASUREMENT
<br /> Y .. .
<br />~~..
<br />'' f 1. P 1 - Y i 1 .I .. a~ ~. `
<br />r,: r,, _: ~' -. r ",~ y~;,..7tr
<br />.,:~ , _., .."L 14nS SAMPLE aa;r r• r:: r::r n. j:' ~ :: r::fa+` ( 25)
<br /> MEASUREMENT
<br /> ^ .. :-,
<br />..~ .. f' - l't'
<br />.' T1GG1V
<br />.... xd'~ t ~~,:, / '-"L t' / -'• Mk .~' ~ y,j ~~ M, ...
<br />.. ) 1, ~.. ;, i. SAMPLE .. .. ::-, (: ,', ':
<br />V
<br />/'. a~ ~'t ~.=0 ~ ( 1'i)
<br />(;. ~ •) MEASUREMENT
<br />
<br />
<br />,) ; !. d rJ :) G i( }. A ~ r. SAMPLE - ! , ###l;r ~<.. .. ( _ )
<br /> MEASUREMENT
<br /> n-.
<br />..
<br />_, ~~,d,
<br />I si CJtJUIl 0!t SAMPLE ( n3) :4>z### {rR;: Ktt~: h#'###Cr
<br />4 ; " d N T 7 L A A 1'
<br />'+ •. U ~ " t; MEASUREMENT ~
<br />.
<br />
<br />.,.+. ~a cc:
<br />* . ,,
<br />x ~.
<br />'
<br />,~,.
<br />~
<br />"f LJ~IT ;~, 1' VRiIJr
<br />` ~.r '^ ;n 1': 3 t z t•- 'r _:: ~'
<br />T.%1'1L
<br />;'~LID~ SAMPLE ~ a'.t' t~'~n;y#:e .. ,r;::, , ( 1G)
<br />,
<br />r f ~'i J L J :?'' MEASUREMENT
<br />l~, ~ y ~ ~ ,_
<br />' '
<br />~~ ~L~ RAC' .
<br />'
<br />' ' 4 MA_4
<br />~
<br />*' ~. ~.. ' .. ..
<br />.~ r
<br />n
<br />x
<br />v~JJ~
<br />J ALIT ..
<br />}''LJ*..1 ..... 'ri "
<br />4 i
<br />• 4
<br />NAME/fRLE PRINCIPAL EXECUTIVE OFFICER ICeniry untler penelry of lsw that mis tlocument end ell enachmenls were TELEPHONE DATE
<br />prepared untlm my tlirectlon rn superrision In acoordence wim a system designed
<br />.., toessurethetquelif~edpersonnNproperlygatherendeveluetetheinbnretion
<br />'ordon Patera
<br />(
<br />~,{d 970•-824-4401
<br />~.C--• ~ ~ -~'~
<br />O1
<br />
<br />~
<br />l
<br />7
<br />25
<br />,
<br />submmetl. Basetl an my Inquiry of me pereon or pmsona who merege the system, ,
<br />President/General Manager ar moss pxeona directly responsible br gemedng malnbrtrWbn, melreonnetlon
<br />submilled b, rome bwsl of my knowledge and ballet, true, eaurate. end complete. SIGNATURE OF PRINCIPAL EXECUTVE
<br />Ism aware mat mere ere signieram Penalties br submiNng false inlormebon,
<br />TYPED OR PRINTED inclutling me posaibiliN Ol ens and lmpdsonmerrt br knowing WOletlons. _ _ OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY
<br />nnMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
<br />::i ~ .')':AL I'.a'. LISI;., ...L .. •.!J";;, ,.:i :TfL~?L.: ..~Ii_ ;.l'.I'. A. 'l. .. G=I 1'i~r.. ~ •'.~CI .. -
<br />... ,.'(~:y JF 2ft0~}' ~ .;UI^t:.'c:' ..;•'.ih5'F: I. A. 3. '~`.- ~':I1'JhI1G - L. ~.3. ~,TL ~ ...~.. - ~ ., I. ... (: ).
<br />EPA Form 33 D-1 ( §/99) Tsui us i ions may a used:' -' " "" ~ "' '~ - " ` ~ ~ ~ ~ THIS IS A 4PART FORM PAGE OF
<br />
|