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PERMITTEE NAME/ADDRESS (lndude Facdiry Namr/Cacaiinn i~Differen0 <br />NAME <br />THAPFhA CIRiHI, ]C:C. <br />ADDRESSL ItApFiPA LINE <br />P. C. EOX 1H1 <br />FACWTYCAnIG CC E1616 <br />LOCATION <br />r.'i`Th: >r. GUkCCh 'rE'IEEf. Pi1E5/GF.h AlGb <br />NATIONALPOLLl1TRNTDISGMARGE ELIMINATION SYSTEM (NPDES) Form Approved. <br />DISCHAHGEMONITORING REPORT (DMR;9f OMB No. 2040-0004 <br />I! I N C A Approval expires 0531-98 <br />^ (SUPA hi) <br />PERMIT NUMBER DISCHARGE NUMBER F- F I h! I M C F A T <br />MONITORING PERIOD FCiC i3 1C FILLIP FYEA7T CGICN <br />YEAR MO DAY YEAR MO DAY <br />FROM UI:; Gi UI TO GG G3 J +''f~ AC LI.~.CELIFGE '~~ tt: <br />Izo-vl (12~Y91 (zass) (ss~zr) (zfi-set l~o~a1) NOTE: Read Instructions betor mpleting this form. - <br /> (3 Cerd Ony) QUANTITY OR LOADING (<Cartl Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-61) (3a-45) (46-53) (54-61) EX OF TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />lss~wl ANALYSIS <br />(s4-sa) <br />69-70 <br />'IL Ahu GErEA5E SAMPLE %'%t'^~~%%' ( 54) QO1600>p 1GCOO:3 33ii{~ <br />I S U A L MEASUREMENT <br />+1066 1 U 0.~ It <br />~ ~ 031]61trF# afGPfSlt~ FS=1 !i'#~'~I~l1* ~ ~'t~~~ "s ~~~~~"= •=• :.~ {~7 <br />I 3~ <br />~'~ <br />'EFLUEhT GAUSS (YALOE , <br />:fl _~f3JABINENT ~ - )i S !t Y FC=C M~-t>• '•' '' ~'~ ~'~ /+~`~`«`.~ ~,x,~'~ 300 !;r , '- <br /> <br />. I, SAMPLE <br />' ~' ~MEASUREMENT <br /> <br />~ r <br /> R <br />UI~E.N7 - ,~,~ n ~.° <br />. , z ~ ;~~ <br />, .,. ,~ <br />' <br /> MEASUREMENT ~ <br />~??V// ~«/f , <br />I <br /> S Y ;~ <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> - 4 ~, ~ ~ -. , ; . . <br /> F') UI~iMENi <br />:-' '~ I,. <br />~. ,. <br /> SAMPLE <br /> MEASUREMENT <br /> - ~~ <br />, <br /> E~1T, r- <br />1 ° S '~ ~,' ~. r+s t <br />, <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> <br />~ <br /> <br />~ <br />t.. <br />, <br /> <br />~ J <br />4 <br /> y3e1y _ (d t~ a~ a. a "•t At L '- <br />t ~ r <br />~ y <br /> SAMPLE <br /> MEASUREMENT <br /> ,~. +t- ,",~.. ' i a'tr~~` ) ti <br />~: <br />T"~}t ~-~*~°i ~tf I ~+-: 4t ryy~.~k( yr r'~i~ ir <br />`~~ '"~` 't:i:: <br /> w. <br />yy e ~ <br /> r <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMILIAR Wm{THE INFORM IAW THAT I HAVE PERSONALLY EXAMINED AND <br />AND BASED ON MY <br />ATION SUBMITTED HEREIN TELEPHONE DATE <br />- ~ WOUIRV OE3114$E INDIVIDyAL <br />MATIO <br />I BELIEV <br />THE IN ; <br />S IMMEDIATELY RESPONS$IBLE FOR OBTAINING <br />E 7HE'SUaMITf INFORMATON 15 TRUE <br />~- <br />FOR <br />N. <br />GOtdon Yetera ACCURATE dN6 GOMPIETE. <br />Id <br />- . <br />I AM AWARE THAT THERE ARE SIGNIFICANT <br />I <br />TH <br />U _ / <br />/ <br />/q/ G 970-824-G401 QO 0~{ Z <br />. <br />FOR SUBMITTIN <br />PENALTIES <br />6 6 r POSSIBIUIV OF FINE AND IMPR <br />' <br />' G FALSE {NFORMAT <br />ON. INCL <br />DING <br />E <br />ISCNIMENT. $EE7e U.S.C. § 1001 AND 33 U.S.C. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />under these sletwes mey mcWde lJnes up rn 570,000 end or <br />ies <br />§ 1319. (NrwA OFFICER OR AUTRORIZED AGENT <br />TYPED OR PRINTED mevmum imprisonment orbeMreen 6rfrmths ends yxars.) NUMBER YEAR MO DAY <br />I~,~ <br />;r'.I <br />`;=', I <br />a <br />.4 <br />`}I~ <br />.,y <br />,.ItiM, <br />If <br />COMMENTS AND EXPLANATION VF ANY vIVLgTIUrvs (Hererence au anaenmenrs nere/ <br />ftiS f. 'ICTAL IFCN IIEI9S YICL HE MAIYEC. AND SETTLEABLE fC1ICS lICi1 AFFIIED FCF <=l0YF,24EF. FFECIF FVFNT- <br />5 ": E. bUNL'PN CF PACCF bE~UIkEAENTS UNDtR I.A.Q. iC; MCNIICFING - I.E.S. CIL E 6FE!`E - SEP l.E.l.~C). <br />A orm 33 -7 -) Pr wous e i l ns may n e se O I A USED.) C C G 5 5/ G G C I 11- I C i 4 PAGE L OF <br />