Laserfiche WebLink
PERMITTEE NAME/ADDRESSpM:4 F~WyNr/L«mrm l/D~...q <br />NAME ~ " ' - ~ ~ - •- ~ n <br />ADDRESS ~ ~ ~ ~ o ~ i i . r ~ . ' ) .. <br />..11.1 -,~-• '. 1,' - <br />'. , . <br />FAauTy <br />LOCATION <br />NATIONAL POLLUTANT DISCNMOE ELIMINATON SYSTEM (NPOES) Form Approved. <br />DISCHARGE MONITORING REPORT (OMRI - -:~ OMB.No. 2040.0004 <br />11-161 I7-191 ' <br />-,-. r , - ~! - . ~ ~. ! Approve) azPirps OS-31-98 <br />PERMIT NUMBER DISCHARGE NUMBER ~ . <br />MONITORING PERIOD ' <br />YEAR MO DAY YEAR MO DAV <br />FROM . , TO _ . .. .. .. <br />!1611/ l11-731 !14151 !16771 r18-191 l3631J NOTE: Raad Inetruetions beior com atinq this }am. <br />PARAMETER 13 Grd Ontyl QUANTITY OR LOADING !4 Grd Onhl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE <br /> 146-531 1545/1 138-451 146531 154-5/1 OF <br />l32-371 EX <br />ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS rs1-say 164-581 169-701 <br /> SAMPLE . ., c r: t ' ; .a : - ^ 1 <br /> MEASUREMENT <br />I'• . I~ .. ~ PERMIT .. .n -: rr; ?r.;rs'<e: r . r <br />.' :-r. .. f' t <br />i'. ..~" - ~ 'r ,la REQUIREMENT .. - ->i,-r •te .~.- - <br />~ <br />- •r:,f ~.! SAMPLE t::t... ., .. .... ~ <br />, y~ <br />I; , " ; . .:. MEASUREMENT <br />_ - I '~ PERMIT ¢:':a ¢ss ..°t F, ?: r: ~.. Yt r i 's -'c~~r :!-[:7 •:+ Tp^ t.^^^ r v^z~! ~r^y^ <br />f"j••.. ^_ a•.(•, REQUIREMENT ~~~.:: -jnn,r ]p~ r•,.+te ., ;r 7l an,ymy <br />-.•,I.:A ;I''- SAMPLE ~ n::^`. ( .,~ <br />. ~. I'.:~ MEASUREMENT <br />~"~7( 1 O ) PERMIT i:~.•~gy:Y ':r~;: r:±: r ~ ': •,. "C Z r . ,:/ ,r.~r <br />',`:Iii GF~^. ;a .' <br />' REQUIREMENT ~-^`r 7' ^.''i <br />• •• ./r a~ T <br />r '~ <br />. . <br />` <br />,~7:.: .)=~ -^TTL?~ r SAMPLE ~ .i.;:¢': .: .. ., i ` ,i <br /> MEASUREMENT <br />JL ,r: ,. ft ~ PERMIT .~ ?r. ..KF i-r:. :reR g , ... ~ - ~.~~ -- -. r :C' r <br />NT- - REQUIREMENT r.7`•.: it ,. I r~ r•, „y ,~~ , /, I, •, <br />:I;.. ~ ..~:?'[. ,t SAMPLE .._ ^: r: :r:; ~ ~ <br /> MEASUREMENT <br /> <br /> <br />I PERMIT .. ... :[• ;ra; t:c r: .. .'<< .. ... ,,,y, _ ;.n <br /> <br />F~ <br />• r .r _.~ -. <br />, <br />,- ^" ~ <br />' ,-! 'I <br />' REQUIREMENT r•.-it •Ir ~ ,r ! :; ^ nF <br />> ,r ,. <br />. <br />. ~ <br />! ,. ? u ~' SAMPLE •:rtni r..: ... ~ ~ ... ( <br />O\ <br />_ ., y - ~. ,. - ^, - " ? T _ MEASUREMENT <br />", • .~ f PERMIT : r; r: ^: • 1 'y (::` r= •. .. .. ; ,^..:-•. .. ,....... t •+, / `1 ~ •. ~ ~ c. <br />'~. D~~ ~~ ~~ ~^ T ° ~ - REQUIREMENT. T,•• •~ <br />'! <br />/ <br />r - <br />~F -.. ... SAMPLE - ~ .~.i .. .. .. / ''i <br />`^. F-I MEASUREMENT <br />J1 .L.' .) .PERMIT ::: r: r,, •x r,- :~C~^C•~;r ., ..... ._ ..r. .... - ,.,, <br />/ <br />1; <br />- CG.' ° ' : '. REQUIREMENT .. ~ ~ •. { •.n -~ y n - ~, " r+ <br />'f: <br />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER I CERTI <br />AM FA FY UNDER PENU7Y OF UW THAT I HAVE PERSONALLY EXAMINED AND <br />MILIAR WITX THE INFORMATION SUBMITTED HEREIN <br />AND BASED ON TELEPHONE DATE <br />` <br />D rd <br />I~IC <br />~ lll$ ; <br />R <br />IIA <br />I <br />~ <br />E <br />E <br />:I <br />. OBTAIN MQ <br />THE MFORMATION, <br />BELIEVE <br />Sl1BMITTED <br />TNE <br />NFORMATION <br />S <br />f,~ <br />~nvlronc.~-it~I Y8'7)` ~r <br />' I TRUE. ACCURATE NID COM0.ETE. I NA AWME THAT THERE AqE <br />SIGNIFCANT PENALTIES FOR SUBMI7TIN0 FALSE INFORMATON <br />INCLUDING ' <br />7FYI - , <br />THE POSSIBILITY OF NNE MID IMPWSONMENT <br />BFE 1B U <br />S <br />C <br />! 1001 AND ]] n7c r7[]_~753 T 7 ~~ 93 <br /> . <br />. <br />. <br />. <br />U <br />S <br />C <br />1 <br />t <br />M <br />4 SIGNATURE OF PRINCIPAL EXECUTNE . <br /> <br />TYPED OR PRINTED . <br />. <br />. ! <br />] <br />B. I <br />Wr <br />. vW~r N.r mllmu nNY 1nCM~dA AMa Ip b f 10.000 <br />AM armv4rNnl inAVlAanwnr orMwwn emonN. rweYAerA/ <br />OFFICER OR AUTHORIZED AGENT <br />CODE <br />NUMBER <br />YEAR <br />MO <br />DAV <br />wmmcn I a nlvu cX.rLfLnA I Ivn vt• nlrT vlvLn I Ivlvo Irnrsrence an srrscnmenrs oars! <br />_ _ _ <br />r ~ <br />i v r r~ ~ r f <br />EPA Form 3320.7 108.951 Prevloue edltlone may be used. ^ (REPLACES EPA FORM 7.40 WHICH MAY NOT BE USED.1 ~ , , 7. _ ~ ; PAGE OF <br />