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PERMffLEE NAME/ADDRESS ((nc(vde Faci(iry Name/Locafion ifD$errnr) <br />NAME <br />1!iNFfC, 1NC. <br />ADDRESSN~fiTH ?HC.".PSC11 C6E.EK NItiES <br />11Eb CGHFA5F L11-F, ^6'IiE 101'~~^~^'" <br />FACIL1TYGhANC JUNC7ICN CO tll`_06- <br />LOCATION <br />CAfibGBDALf .:C Nlri.: <br />...._,, <br />NATONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM MRDES) Form Approved. <br />DISCHARGE MONITORING REPORT (DMRI OMB No. 2040-0004 <br />(z-1s) frt- el <br />I V C N Approval expires OS31-8~ <br />PERMIT NUMBER DISCIARGE NUMBER F- FINE 1 F •~ 1 F h <br />MONF ~ GPERIOD CNFGNIC wE'I 7E:71FG FCF Ci1F <br />YEAR MO DAY YEAR MO DAY _ <br />FROM 7 TO 4Q !'S _ ~::; 6~.. (~.~_EGE_,_l_~L~_Y _~.:_._._ <br />A L1N: J• L• 71liY r:n lIP:~L'L~S Lit L+ i' :..,-pq ... ...~ ,____. ~~„~,~ :.~.o. ~,,,,,,.~ .._._. ..___.,f_-.__-.___________ __ <br /> (3 Card Ony) QUANTITY OR LOADI (4 Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (48-53) (54-61 (38-45) 48-53) (54-s1) EX DF TYPE <br />(32x71 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ~ <br />ryz-s31 aNa.rsrs <br />(84-68 <br />6370 <br />F.F F!'CT ~TATHE ~/CAY SAMPLE .•X>'74YIY +P4CS~~.y o dLCfiO: r,.;tii: ( i;) / <br />C!l it CCk:ICCAPt;NIA MEASUREMENT ` <br />_}FaOfj CJ <br />7CF'j.1 :, U U ~PEHM~i"'' 0><-q9~~+ ~ ~: t:a 16+~ ~ ~ii~~l)D~p+~=~ EF- s ,: <br />Ste CCA!r~FNT E LCW ~EQUTAEM~NT . ~". t0~irt ~'z° ~r 4. ..,~~. ~ c~ a;a- ~`` <br /> SAMPLE <br /> MEASUREMENT <br /> <br />~ r: <br />~ <br /> j~QUJ~IEjuiENT <br />~xl, <br />"aY 'Sv <br />.. <br />t <br />f <br />,4 ~: <br />f <br />~~i <br />' <br />~. lar <br /> 4 F Y` ~ <br /> SAMPLE <br /> MEASUREMENT <br /> ' P~h~r~ ~ ~ , ~ ~ ~^ ,~ rv,~ ~ ~ . <br /> r£ ~ A <br /> SAMPLE <br />~! <br /> MEASU <br />R <br />EMENT '~ <br />i ~y <br />~y <br />~' .! PM1T. ' -~ t~'4 {. <br />~' <br />. <br />~ ' iC ~ ~{ v~ n`. -C <br />'~" Y ..R Y i <br />k`'.+ <br /> REC~llIPCM~NT <br />~ A <br />. <br />,.. ... . <br />~~_i~~ <br />_ ~ } <br />.TM~si~~ 1°x"w ,. <br />'~' ~ :~ <br /> SAMPLE <br /> MEASUREMENT <br /> f~Idf <br />" _ F <br /> pf <br />~,r <br />vRE <br />Iu1P6 MI' i 'b - , <br />~ ~ llt, iS'~ ' <br />M+ ' A ~~n F~. ~ F }nfyi <br /> SAMPLE <br /> MEASUREMENT <br /> '° <br />I <br />~ n ~ <br />..~c ,w !` <br /> F <br />X s <br />.si~F'F,' <br />t <br />'"r` r iYy <br />a 'Y- <br /> d+ "-4 <br />+J <br />.c <br />f <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> t~ ,c;~. *~"~ :: - ~kg b Y" t~ i~,r:f!..~ il`- <br />, <br /> A~ t11RG <br />NT` a . <br />*Y"; ; , <br />, . <br /> ~ .r <br />NAMERITLE PRINCIPAL E%ECLRIVE OFFICER I CERTI FY UNDER PENALTY OF LAW THAT I HAVE PERSO NALLY E%AMINED AND TELEPHONE DATE <br /> AM FAMILIAR WITH THE INFORM ATION SUBMITTED HEREIN; AND BASED ON MV <br /> INQUIRY OF THOSE INDNIDUAL S IMMEDIATELY RESPONSIBLE FOR OBTAINING ~ <br />J <br />c <br />C`~ ,yl <br />J II ~+f/' THE INFORMATION, I BELIEV <br />ACCURATE AND COMPLLEET7E E THE SUBMITTED INFORMATION IS TRUE, <br />1 M1 AWARE THAT THERE ARE SIGNIFICAM <br />' <br />. <br />C. . <br />PENALTIES FOR SUBMITTIN <br />G FALSE INFORMATION, INCLUDING THE L <br />Q7~ <br />~ <br /> <br />~ <br />p ~ ~~ POSSIBILRV OF FINE AND IMPRI SONMENT. SEE tB U.S.C. 4 1001 AND 33 U.S.C. i J 1 <br />SIGNATURE OF PRINCIPAL IXECUTIVE / 7 v ~I J / / <br />TYPED OR PRINTED menmum~~mmen~ol ~!.ee n morKh~~d Sutl~Ilslnav up ro 310,000 aM a OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerence ell attachments here) <br />.: F. I.B.`. FGN ?E5T EFCCEGL'F.F. hPT RESULT°_ CF LE7F/IITY CEhIVA'lIC'P_ Af "+~tFFECT", GFC~7t L FEFFCCUCIIGN <br />CcelVd'iICN°, A_° "1C71IC1T_Y^. hPT LCWEST LFFL AT VFICH 57ATISTICAlIY c_ICh1F CIFF EETYEFF 7E:7 E CC[+TFCI <br />EPA"FOfT 33261 ~0&95)~Prev IYs edit ons'may`ridt be used. ' ^ ~~ /(REPLACESLEPA ~RMTICO INHIG411MAY NOT BE USE6.)~' ~ ~" • ! Y „ F C - Ip G C Cppb <br />CCG52/9907]:-],SCS 1 <br />