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FERMITTEE NAME/ADDRESS /1 Irb FinaryNs/lamron /D~r.cnJ <br />NAME LA:. '_: -. '.: - .: .. : .!PF d%. <br />ADDRESS N . i : ~. J . f. .'~ i, " <br />I Dfr( .. .- r .... .. n <br />Li: 1:.: T i:~ . ., .., <br />FAauTv <br />LOCATION <br />NATIONAL POLLUTANT DISLNMGE OJMINATION SYSTEM /NPDESI Form Approved. <br />DISCHARGE MONITORING REPORT IDMRI <br />S h' i <br />~ i i ~ ~ OM .No; 20gp-0pQ4 <br />~ <br /> l1-161 l17-191 ' 1 i i)? . . <br />,. <br /> -- , __ ? ~ 0 ,.3 ^ Approval sXpifee 05-31-98 <br /> <br /> PERMIT NUMBER DISCHARGE NUMBER e~ _ : • ~ ; p i <br /> ~ <br /> MONITORING PERIOD ! ' ~~~ ~~ <br /> YEAR MO DAY YEAR MO DAY _ ' <br />FROM ~! - ',~ TO ., i ~.: ;. ~,. :... . . ,r. `. ' <br />re <br />~ <br />1161/1 711-731 !/4151 116171 l19-191 1343// NOTE: Reed Irotruetiane thie form. <br />befo <br />eomple 'nq <br />PARAMETER 13 Grd Onlyl QUANTITY OR LOADING !1 Grd Onlyl QUANTITY OR CONCENTRATION NO• FREGUEncr SAMPLE <br /> 146-531 150-s11 138-I5/ !1653 I5I-611 GF <br />/31-371 EX <br />ANMYBIS 7YPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS Is3-sJl 16458/ l5A701 <br />I SAMPLE - F :::- :::: ': ~ I ~ ) <br /> MEASUREMENT <br />, JJ . _ i) PERMIT F:: ;: 7,:F :=?;-L= L': ' ... C ~ <br />~ .. :y 4,(,~ c.', s ~/ pr ;;Irn <br />. .J'.'. ;+: ..i t° i VAL; REQUIREMENT r: :.'rC:~ '1I hiGu.1 `A YIIY .-! . <br />,._:r~, 5:.:., ~ A~iL'°, SAMPLE ..., .. c= ... ,+CI'~ ~::v,:~:;- .. ~ ~~') <br /> MEASUREMENT <br />. r~S ~ .~ PERMbT:,: :y r; ;'x0?~ ~v0~~~^,F. Sr :: ,~ DCt ;:33R ;l ii :.+~= '.. l:. :Y ~'L/ ~1?~H <br />:. U L:i ! :. J:'. ' 4 A L'J :' REQUIRENIEN7 a,}(I 'j J 1I - 1 "g / ~'1K <br />.,. AIiJ .; r,? 4 ., SAMPLE - .:: rt::: <br />~ ~ ~ . <br />~ ^ ~ <br />( 1 ~t ~ <br /> MEASUREMENT ~ - _ <br />~,'.1 i L` ~ ~.. PERMIT i:~ .. ,.:G. <br />, ~'. :r<: r `'-. ;~>, ~. .1r ~'T+ ' :1. :1' ~..i ti=. <br />~+ f G F ~ ~ ' 'V : <br />') - <br />L J t REQUIREMENT r% <br />.... " <br />, <br />.. ` .. <br />, <br />.. ., ~ , i 'i C ~'i I 'I , ~ SAMPLE V L~' ( :~~lr ..~ . ....•,y <br />;i C Y <br />a :% " " <br />T 9 MEASUREMENT " ' <br />. <br />. <br />' 1 ,. i U ~ .PERMIT `t' i' I. 'i ~ e. ~ ~: P L'! F' .- . .- . Y ~ . , :. <br />~ <br />1 / <br />^ ', T I, ., <br />..'i r.'".. SFJ~:. ~ _! REQUIREMENT SUDS B.d"i OiL t.LY `Y <br />., ;t ?: : r <br />_ "y <br />!:, nhJ ., tEP. ~;= SAMPLE '}-. ~ <br />~'1) .. .. .. _. . <br />j -, .; ;, L MEASUREMENT <br />~li.L, i ., i PERMIT .. 'A rf ~t ;1 ~. '!' Y f~.'=i VR:. 'Y :;[ .:~G:'3 F~!: :?~. r .~: l .~ITpl <br />c <br /> <br />i. „' 1 ~ : i ~ ~ - l' '... <br />REQUIREMENT <br />- ,'" ,A Y <br />Y 0= J <br />'., _ ^ t . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMERITLE PRINGPAI EXECUTIVE OFFICER I CERT FY UNDER PENALTY OF LAW THAT 1 NAVE PERSONALLY E%AMINED AND - <br />. - "~ / TELEPHONE DATE <br /> AM FA MILIAR WITH THE INFORMATION SUBMITTED HEREIN; AMD BASED ON _ <br />/- . <br />~ <br /> MT INOUIRV OF THOSE INDIVIDUALS IMMEDIATELY gESPONSIBLE FOR %~ <br />~ <br /> <br />. <br />OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATON IS .~ ~ <br />- <br />~ _ <br /> <br />' ~ TRUE, ACCUMTE AND COM0.ETE. I AM AWARE THAT THERE ME <br />SIGNIFCANT PENALTIES FOR SVBMITTING FALSE INFORMATION <br />INCLUDING r } F ~ <br />- l ~ <br />~ <br /> <br />- , <br />THE POSSIBILITY OF RNE MID <br />MPNSONMENT <br />6 U <br />S <br />01 AHD S <br />SEE <br />C _ <br />` 1 /h <br />~ ~'- <br />( <br />7 <br /> . <br />. <br />. <br />I <br />i <br />. 1 10 <br />] <br />t SIGNATURE OF PRINCIPAL EXECUTIVE . <br /> U.S.C. ! tG <br />G. IArIYtl„ I,Ww IMAr mllm, nI,Y bcAwN A+„ w ro SIO,000 AREA <br />TYPED OR PRINTED .+s wnrrim,n Ynpl,cwnAnrW MewArnsmma,w sY,ua/ OFFICER OR AUTNORI2ED AGENT CODE HUMBER YEAR MO DAY <br />COMMENTS ANU tRrLgNA I Irv Ur rem V IvLN I was lnnerence a/i errsrnmenTS nere/ <br />-LcA:`.L.. ;7Li - _Ir.. .,'~ ,, c ..-'~'t, .-.~ _ :'I~ T7-.. ._-..... .l .. ~ T' '! <br />~.. I. a. 1.'~~, r` .. ,'i .. ._wi;-I 'd.H~-:"'. :. :I .'LA'•, ,. 1'1-i:-. r - - - ' <br />EPA Form 3320.1 108.951 Previous editions mey be used. /REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) i : , 6 / :- 1 " ~ i ' ~ - i , '~. - PAGE t OF <br />