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PERMITTEE NAME/ADDRESS pnc(ude Faci(iry NmndGorarion i/Dtgcrenr) <br />NAME <br />Y~Ihi•.c. I~r_. <br />NATIONAL POLLUTAM DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMH~ <br />Form Approved. ' <br />OMB No. 2040-0004 <br />Annrnvnl aenirac OS31-Rflr <br />AUDRESSACft: F' TdCtPSCA CFEFfS !'IHES ^^^ ' ^^ ^ {SOLE MC) <br />i ~) t d C C C F A 5 S L F I Y t: , SUITE 1 C] PERMIT EIUMBER ~ DISCHARGE NUMBER F- F I It ! L F I,T <br />FACILRY~hANL JUhC?IGh CO E1506 MONITORING PERIOD FCST-HIIIDG FCECr: 5tC7 FCFC <br />LOCATION YEAR MO DAY YEAR MO DAY ~ <br />~ ~ <br />CAFt:CNCALE CC f.lr~~ FROM ~5 C7 G .TO VS S ~ <br />I ~ <br />alp ~ [~:Ck1FCi-/(](Ly,/;»L <br />this form <br />s be letin <br />V <br />B <br />rzo-zn ne-ze) (f0.711 <br />.+ T 1' 9 : J . r . 5 T G Y E it C C !. 5 U L T I h Gr ?, ` . t~z+) (zaz ( (24-15) ~' <br />~ . <br />g <br />UC <br />On <br />O RBa Ins <br />~~ <br /> (3 Card Onry) QUANTITY OR LOADING Ony) QUANTITY OR CO RATION NO. FREOUENC SAMPLE <br />PARAMETEfl (46-53) (54-67 (3B<5) (46-53) -: 5't'6T EX OF TYPE <br />(32,77) AVERAGE MAXIMUM UNYT MINIMUM AVERAGE'` MAXIMUM UNITS <br />(ezml ~~~~ <br />(64-68 <br />69-70 <br />E'i: SAMPLE %•;»r,-»r Ctr: ;: :: r. i a4><C:r; ( 7i) <br /> MEASUREMENT <br />UCUUL 1 9 C FERMI] . <br />ea#* ~~>~ t ,• ~+pjl <br />,~ <br />>~-. <br />r: <br /> <br />EtFLUF.h7 GHOSS YALCE <br />FiEOIiIAE FNT , <br />~ ~ <br />~: ~ <br />:,. . <br /> <br />< <br /> <br />~r <br /> <br />`cili)5, SFTTLtAtilt SAMPLE ;ca»au »tcaaaa ( :`) <br /> MEASUREMENT <br />iif•7+15 I 0 C :~:-~FEHMI'f.~-. a04 ~ .. ... :, :.:~ <br />t F E l U t :+ T G d C b ~ Y A t ~~QU•IREI~ENT _ ?.~ - - - w T - <br />C,IL ±• GGEASE SAMPLE .;~K:»t7 »;»t~»tG ti'~'.~: :: ;t:;1.. ( ]5) <br /> MEASUREMENT <br />UOS56 1 U C ~,`~p~RMl~ si9# r +p~?F~>O~rS +Ot#+il@9`, Q,~'~" <br />°_ F F U[ N G F. U S` Y A ~OUIRE~v1E)JT' ,. t .:: <br />n r - <br />F1::4, LR CONDUIT C(I SAMPLE SCH ~ >da4t»zr t.ttC;',L aea0aa <br />': h n L' T N F n T M E'r T F L A EI 7 MEASUREMENT O D <br />n <br /> <br />S U U S L 1 U C ai:~:~C~Mt7 F~ ~ I[~ a 4i6¢d~ ~z= ?44tl=` v- ~_ t t t <br /> ~C]GfFiEMENT ' °; <br />_~CLIC1, ";CTRL SAMPLE L£Oaayf aYti~dt .;tC~~; ( ]~) <br />L I S `_ G L Y E ii MEASUREMENT <br />7 U c y 5 1 U C ~ PE~M63~ +O a ~. !~i ~ r C " ~D A:a+Q tf 4 $ $ jF+C ~`L ~~+~`~ ~ ~~~ <br />~ <br />- ~ L ^! T a ~ v ~4B1REr~iCNr ~ ,~ _ ,. , . , ~" <br />ALL dllL GFEASF SAMPLE ,tva»a 1 4u) :; t,. .; ;:; ~;.',tt:•; 9tr,tLa <br />Y S v U M1 L MEASUREMENT <br />CuU6D 1 G C ^"`P,CRMIT~ "O VQ~, T~ r".~ E_=1 ~~4~fa+! 4~ea a~- ) A~"9t3k tF~ r uaa <br />i_ F F L " 4 0 ~ V p AF;OUI)3F1d~NT - z - r - r. <br />_ ~ ~" ~ ~ ~ `"' <br />SAMPLE ~ <br />MEASUREMENT <br />v, a'.,~ <br />p <br />N7 <br />~lSl]1 <br />' ' <br />~ <br />~ <br />~ <br />'i <br />~"xi. <br />R <br />~ <br />M~ <br />~ <br />..: <br />~ <br />~ <br />'6~r. <br />i <br />' <br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF lAW THAT I HAVE PERSONALLY EXAMINED AND TELEPHONE DATE <br />AM FAMILIAR WITN THE INFORMATION SUBMTfTED HEREIN; AND BASED ON MY <br />INQUIRY OF THOSE INDNIDUALB IMMEDIATELY RESPONSIBLE FOR OBTAINING <br />SUBMmTED INFORMATION IS TRUE <br />• <br />• <br />THE <br />FORMA <br />N <br />I <br />EV <br />T <br />~ t ~ <br />( <br />~/ <br />IN <br />TIO <br />, <br />, r <br />BELI <br />E <br />HE <br />t AM AWARE THAT THERE ARE SIGNIFICANT L <br />ACCURATE AND COMPLETE <br />. <br />PENALTIES FOR SUBMITTING FALSE INFORMATION, INCWDING THE <br />L• S I D t POSSIBILITY OF FINE AND IMPRISONMENT. SEE 1B U.S.C. 5 1001 AND 33 U.S.C. IGNATURE OF PRINCIPAL IXECUTIVE ~ V ~ <br />0 ~) <br />TYPED OR PRINTED ~mu~mlrmp s+mmerrtadbe~nse'nBm~wMms entl blu~~nea uP ro ft0,o00 entl a OFFICER OR AUTHORIZED AGENT NUMBER Y R MO DA <br />COMMENTS /WU EXPLANATION OF ANY VIULATIUNS (HBlBIBOCB Bll ed9COmBn[S RBrBJ <br />SET1'LEAE'LE SOIIUS LICIT YLLL iiE ePIY,°D FCn %1C-YP, Zu-r;i FFECIF EVEA1-SiF I.A.i, FG lY, ECF FFf,LIFEI'f111S. <br />~EiTHLY SACYLIFG IhS1FLCTICfiS-I.C.S, p1 IX. 3G CAS AVC 7' LIGeE~T fC~'fFLY AYG CCF7fG FEE3CC EEFCfiTEi. <br />hl <br />EPA Form 332o-1 (08A5) Previous editions mey not be used. (REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.) PAGE OF <br />00055/94CiIi-3~C5 I <br />