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f'FAMITTEE.NAME/ADDRESS pnrYb rad^yNewlor.nw r/O~L.egl NwrloNK vouurANT DISCNAROE EIJMINAnON srSTFM lNPDESI <br />NAMEr,.yENgCA CDAL COMPINT DISCHARGEMONRORINGREPORTIDM9/ ~;1"~+ 7OND UjCHG <br />ADDRESS I7-16 ~. <br />DQAN6R D (50[iA 11 W) <br />NIYDEN Cry !3169 ERMITNUMBER DISCHAncEeuMem ~ _, IINAL <br />Fpo~rAm~A yp'p r o v~egd . <br />Tk'Pp7ba61''d~d~r~-0o~, ~~ <br />12 Y5 <br />0 <br />FACarrr MON ITORING t1INi0 R <br />LOCATION ~ YEAfi~ MO DA <br />tlAYDEN Y YEAR MO DAV i.' _~ <br />CO dio~J FROM ., 7 p <br />A I. To gg Dy ;~ sal,:-. Q' MIIRGE ~ 1. aaa <br />i <br />hb f <br />'LMll <br />b <br />i <br />~ <br />T Y N s G .tS U D R R :? Si R, 6 EA L R A L M A N A G E R 176 - -731 /7L r <br />a f <br />orm. <br />etlprr Mfon <br />rp <br />t <br />75/,:, 176771 /76-791 /3631/ ~ !iu <br />~ <br />PARAMETER /3 Grd Only/ QUANTITY OR IOAD ON ~, {.(O, FREQUENCY SAMPLE <br />C~'r' :Only! QUANTITY OR CON <br />(I <br />137-371 116531 15461/ i <br />3B.15J 116-53 " 151-611 L OF <br />;~X <br />YSIS TYPE ' <br />A <br />AVERAGE MAXIMUM UNIF5' AN <br />L <br />" IMUM AVERAGE MAXIMUM UNITS.. ls7•abl 161-661 !69.701 <br />Ptl SAMPLE <br />MEASUREMEN as~wraa atraatra <br />' r <br />41r1~a-} <br />5 <br />3 <br />! <br />~2) <br />~fl~ <br />~ ~C <br /> T ~~ "; <br />Z- ; , ^.l <br />U040U 1 0 D :..:PERMIT.:':: s~ia .. ...... .:..:::• <br />~ , . <br />~$ :U <br />6PF UEtIT ~RD ~A REQUIREMENT ~" ;: a0atr M ~:: ~ <br />~ ~ ` ~~ <br />SOLI US, fUTAL SAMPLE aaas~~ aaaaaa aaaABOIMI .' ( 19) !: ' <br />~ " <br />SUSPENDED MEASUREMENT ~ S C . <br /> <br />: ~ <br />r <br />oos.3o i o ,~ <br />i~;;::;PgRMIr:'.".": <br />aaz~a~s~"' .. ::.... <br />::::±~~~aaFao;' :D.. .. <br /><,::~a~~saa" . .. <br />.. , . <br />;.,..:::>: • .:".:.... ~ ,..~~, :. <br /> <br />E FF U N <br />EQUIREM.E.N7.; <br />- .... .. <br />o <br />.. <br />- <br />•: •: :•:..: <br />; :,:.p;:'c;•cg <br />jy;::; <br />a:::%4 . <br />...:.:. <br /> <br />_. <br />SOLIDS, 3EYTLEAi+Lr'. SAMPLE aaariaa aaaaaa aaaaaa ~ ! L i 2.5j ' <br /> MEASSUREMENT •~(~ U~ ~?~~ ^- k v <br /> _ ~ ~ <br />U054S 1 0 U -: :P MIT`~r" yt , <br />' ' ,awsta« fiID1 ~a.#+xiICE REpLtR; " R&~'EtRT; '` M <br />Ej .7lhH " <br />t:FFLUENT GR09$ iALU REf1uIflEMENT• f as#a _ ~y~ . <br />~: D „ <br />. <br />18UN, TO[dL SAMPLE <br />MEASUREMENT at«Irea aaaaas - aas~ + ( ~ I9) <br />(AS PE) ' ~ U ~ <br /> <br />01045 1 U D <br />?;:PERMIT;.:.:: <br />. ,Atp~'.,~~Iyy:'.~±.,,.+~~~:'(a';y <br />" <br />" <br />;i.•:'.R.IOI~f$O~R :. <br />' <br />fiat _ <br />.~.. <br />;" <br />~ <br />.. Q <br />~~ <br />6:..(}. ," ," <br />`~z'' <br />~ `:: <br />AAA :S°j. <br />iPFLUL+NT S <br /> <br />L,RO 5 TALU :REQUIREMENT <br /> <br />....:..::.: ....:...... ::; <br />. ,:'4 <br />"'-•::~<'.`': <br />.... ..::".::,F;~:;:: ':L: .: ::: ;; <br />': <br />:.:::;; ":".:.";:.." <br /> <br />aaaa .. <br />. <br />.. <br />.:":,:.-;:-.:~:": . <br /> <br />>:::.: Y+^ <br />.,. <br />:":"":"".::r"." .". <br /> <br />;;,". . <br /> <br />.:: <br />UiL AND GdEASE SAMPLE <br />U aaaaaa, aaaaaa Qa#~yA 4aaa#, ( 19) <br />~ <br />~" <br /> MEAS <br />REMENT ~ :. <br />63582 1 0 0 .;;;: PERMIT.:., aa~r... <sr•: <br />+~ , r-;:., a <br />,ztxr#A13 <br />aa# <br />a~.a"~a~di+ <br />~~ ::::.::.::: ::.: .. <br />X~ • r, <br />,~~~ <br />iJ4A8 ' . <br />F,FFLUENT GROSS YALU REQUIREMENT <br />... a t'•S• a#atr , r~-' <br />"" 1A t': <br />FLOJ1 IN CDNDHIT OR SAMPLE <br />MEASUREMENT <br />~ <br />C <br />1 ~ . <br />St v C <br />Z ~ p3) aaaaaa '- ~*la~aal aaaoea <br />Ttlkfi TRk:A TRlLT PLAN , <br />j <br />> b <br />J <br />SOUSU 1 D D •''.:'PERMIT :' ' R£P....sy; Fx."='" 3FDsa:': pa"014+e:a :..........::.......::: ::I...#f..:.:...'a:,"" ;91rp-0I <br />EFFLUENT GADSS ~ALU .........:. ......•. "$0.D1=~..~~` ;''~tLLt: !1~'i BGD ;,:.,r:Y:;S..;:::.: :i:::::::..::-: ::: +sOaa :.:i,~ ::~:'::..:.. .:.: <br />SOLIDS, TUTIL•"; SAMPLE aaaare" " aaaaaa ava#a:~ ,, ~ 19) <br />UI550LYEJ MEASUREMENT ! ~ <br />1 <br />70255 1 0 0 ::PERMIT".."::: <br />, . a#+~ga:~:~i;~ .%%~~~I/yii":: " aoa , it"kira4~k... <br />~AT~t]tlL'; _....:... ... <br />? <br />`:;'~t1LPQ~'!": <br />?; <br />>`: <br />::~:: <br />8it~':.".. <br />hIFLJENT G&DSS rALU .." <br />REQUIREMENT: .<s.~ <br />: <br />T : :..:....:.........::. aaaa ., <br />8't . <br />~ ~ . <br />: <br />a. „': .... <br />,~y;; ~' <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERnFY UNDER PENALTY <br />OF'LAW THAT I HAVE PERSO <br />AM FAMILIAR WITH THE INFORMA <br />ON SU9MITTED H NALLY EXAMIN <br />EREIN <br />AND BA ED AND <br />SED ON '~ <br />~ TELEPHONE DATE <br /> TI <br />MY INQUIRY OF THOSE 1NDIVIOUALS IMMEDIATEL ; <br />Y RESPONSIB LE FOR ~ <br />QU L. ~ ~u~ OBTAINING THE INFORMATON, 1 BELIEVE THE SUBMIT TED INFORMA TION 19 <br /> TRUE. ACClAU1TE AND COMPJ.ETE. I AM AWM <br />SIGNIRCANT PENALTIES lOR SUBMITRNG FALSE INFO E THAT THE <br />RMATION <br />IN RE ARE <br />CLUDING _ <br /> <br />` <br />{ <br />~ T , <br />I <br />I ~ HE POSSIBILITY OF FNE AND IMPNSONMENT. SEE 18 U.S.C. 1 1001 AND 3] <br />Pg <br />g10NATURE OF CMAL EXECUTIVE <br /> U.9.C.11]te. lPMIMdr+r+Mi rAi+++nArt++/.+Y I'rAwf+rn.+~.ro l10,000 <br />} TYPEDC PRINTED rls urn..x:..m:nwna~rrwirwaw..samalnawayra/ OFFlCER OR AGTEIOR¢ED AOEFIf ODE NUMBER AR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/ardgce ell~eftechmenrs here) <br />1'S~ 6 IRON LirfITS LILL RE NAI/ED AfD SLTTLeABLe 50LID5 LICIT APPLIED FOR C=10[R12AHR PAECIP ITBNT; TSS E <br />SROM LIMITS NAIYeO FOR >10iB,24H8 PsiECIP erlNr SUDJfiCT TO BURD£ii OF PR00! IN I.A.2. OIL & GARAS!-SEE <br />n n r ~ t r . ' <br />EPA Form 3 20-1 1 -9. 1 ~ Previoue a IQOn9 may a ue ~ (REPLACES EPA FORM T-40 WHICH MAY NOT BE UBED.) ~ ~ ,.PAGE OF <br />,, ;,...---~ 9IN~0,~2 1 <br />_ DD4>rit4BD. 3_' . <br />