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PEpMITTEE NAMEJADDRESS//Mloae NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM /NPDES) <br />Farfliry Naar/LOnllw UdlO'rrtnU I DISCHARGE MONITORING REPORT (OMR1 <br />rME-~$.I~~LU 6.L5 ~"~1t~~Fi.: &?r.:Q-_ (1'I6l 117-19) <br />ADDRE 05 URDAN .,TREE STE 3 ~ p~~ ~ COU03n07.u ~ ~ 007. R <br />--~~~ ;. ~ ~` -iiA!%~ t' ~' PERMIT NUMBER ~ P .DISCHARGE NUMBER <br />----t---•---1,L-~=-T---~~.,~:^ y MONITORINOPERIOD _ <br />FACILITY __ ~ ~ -'.3. ::,•+. YEAR MO DAY YEAR 'MO DAV <br />LOCATION___'__ - FROM TO <br />A'rTH• nnN ncR Vnnbrr----" ----- ~ :wean n>_ea nuu O2aA AlJO /i2i11 <br />i.- FINAL• <br />DP-1 SF POND TO SCULLION GUL <br />` ~ v 1` •. <br />• ~ ~ r. ~ <br />NOTE: Read Instructlone belore eompletlnp thls form. <br /> • /3 Card Only/ = QUANTITY OR LOADING - /Card Onlyl 'QUALITY OR CONCENTRATION -' - <br />0 FREDUENCY <br />E <br />S <br />PARAMETER ;y lIbJ3/ '~ '1316!/ ~ (38-ISl (I6J3J ~ /JI-61/ ~ Ej <br />(' OF ryPE <br />131-~7/ i ~ - <br />• t• .AVERAOE~ < MA%IMUM UNITS ~ ~' MINIMUM AVERAGE MA%IMUM I UNITS <br />161-63 ANALYSIS <br />/61-68/ <br />169- <br />7 <br />01 <br /> <br />PI{ .e ,.. _ <br />.y " '~ <br />^' SAMPLE :.~ <br />~M <br />•`.yy~(`###~`#^ 1.a~' ~~S~t##~$F <br />m . O <br />L:' <br />1; rr <br />a <br />1`' <br />_ 7C ~1 ~ <br />~. #i~ff-i5`'i`n <br />~ M <br />~ <br />.• ~ :i <br />"'' ' <br /> <br />O <br />_ •, ~ ` <br />1 <br />` <br />~I Il~~ <br /> EASURFlf1EN1.~. 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K _ +V+ I`.Id- D <br />-~ y <br />/J0• ~F/ <br />GlJ45 I <br />.9 , 0 <br />, YPEflLi >r# t I: ';~' 6'$ AB <br />' <br />_ <br />_ ~ <br />FLOIia IN -zON.DUIT OH ~ SAMPLE ~~ ~~~~~"~'' r Y,• <br />~~ <br />0 - _' _ '.##~3Tt'.r# <br />- ~,_~ g>(~r71M`# ,. ###G#~~ <br />t o <br />'O. <br />., /~ <br />~ <br />r <br />ftIRU TREA'1'!16'NT PLAN MEASUREMENT' .~/ <br />-. <br />. _ li "• <br />~ „11 <br />50050 1 =" D L'G = - ~'~#z` s° STAti <br />- <br />• ~. . <br />~. <br />~+ ~' <br />.,OLIQ$, 'EU2AL a. ~ SAMPLE ~. <br />` ~"~#~L>~t'~'A• C~ ;Y,s¢#t.aY# <br />N W( '• i,#•'J#i:4# _ #%~%}%:# O <br />PO <br />r- <br />O <br />D - <br />f'J , _• <br />U <br />J ~IK II`1 <br />` <br />l <br />DI350LV8D <br />~ .-. ~ MEASUREMENT ~ r ` <br />~ .~ g~ . <br />. <br />7;)l9$ 1 P ~ G = <br /> <br />] C -PERMi: <br /> <br /> <br />- ~ <br />Y :•. <br />.. <br /> <br />~ <br /> <br />, <br />• <br /> <br />, <br />_ <br /> <br /> <br />` ~LY 6tREi <br />,F. .N , <br />> ~ + E EN <br />E~EOU :. '. .:•., :.a.M1a .. .~ S ~ <br />: il(~/L ~ 7tl <br />NAMERITLE PRINCIPAL E%ECUTIVE OFFICER I CERTI <br />AND A FY UNDER PENALTY OF LAW THAT I HAVE P <br />M FAMILIAR WITH THE INFORMATION SUBMITT ERSONALLY <br />ED HEREIN <br />A E%AMINED <br />ND BASED ~ <br />^ TELEPHONE DATE <br /> <br />' <br />/J <br />r ~'•C CrVr~ 0c <br />+ <br />ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIAT <br />I BELIEVE THE SU <br />OBTAINING THE INFORMATION ; <br />ELY RESPONS <br />BMITTED INFO <br />IBLE FOR <br />RMATIO ~ ~ <br />_ <br />~A <br />/ _ , - , <br /> <br />,. <br />- '" <br />/ <br />( '• ~ ~~ '_ _ <br />Y <br />' . <br />IS TRUE, AGCURAIE AND COMPLETE. I AM AWARE THAT THERE ~ARE 51G~ / <br />~~IT ~ <br />~ <br />~ ~ / ` G ~ ( <br /> <br />~~I'• F <br />-I' I ._ <br />Y +nA 0/'~ <br />'NIFICANT'PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING <br />SEE 1B <br />7001 AND <br />' <br />I <br />FI <br />N <br />MPRI <br />NME <br />T <br />S <br />C <br />3O <br />(P~ )'QY~ <br />/ <br />y' <br />~ <br />/~ <br />~, :; ) <br />_ <br />VV I / • U NE A <br />D I <br />SO <br />. <br />. <br />. r , <br />THE P0951BIL <br />TY OF <br />N <br />U. <br />ad <br />+A <br />•mrvre plo <br />arcloar Ran o <br />+o t10.a06 <br />17 U <br />S <br />C <br />1 1318 <br />W <br />bb SIGNATURE OFFRINCIPAL EXECUTIVE <br />TYPED OR PRINTED- y <br />p. <br />. <br />. <br />. <br />. ( <br />m <br />V <br />n <br />m <br />.anaor marfmom lmP~+aonlndraJ6enaen 6nlonrkaond Jfevrxl OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY <br />COMMEN7iAND EXPLANATION OF ANY.VIOLATIONS/Rgfnannall aflacArnenrrhae/ <br />~FOId OIL AND GItEASEa ISES FOOTNOTE, F/ P11GF .l. `EYTL°PALE SOLLUS TEST R~~lt1IHt:D ONLYL.I£ <= i0-YiiP 211-ii.. <br />-yP~k-Ey}CIF EVENT CLAIMED. SF.B FdOTNgT^:S J/ AND K/. TF CLA[ft APDRCIVF,D ;Y w2"I), TSS E TRr1N LI^TTS Vii. I. °'ir ' <br />Ep/{ F/~.{'{. 'j0.7 !~. BBB) P~ YIOU! oO/IIO/IR AIIY DS UdOE. (REPLACES EPA ORM T-AO WNICN NAY NOT l1E USED.) PAGE OF <br />)JJ.I J/9UJ1%2-174ra. 1 <br />