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JAL' n 7 aaa~ <br />i <br />i <br />j <br />i <br />m ate~Envvanm¢nui Pro[eamn Agency ~~ <br />~, Washington, D. C, 20460 Forrn Approved. <br />~ <br />~ <br />~ <br />® <br />~ <br />® <br />IVPI~L~ ~0PYlaI18i7C8 InSp@CtlOil RepOC Approvelexp~aso-e8 " <br /> Section A: National Data System Coding <br />Trans coon Coda NPDES <br />~ ~~ ~LJ =Lf01 I I i i r/mo/day Inspettion Typa Inspector Fac Type <br />I i I„ t~L9Jc~101~121fl1,7 ,5(~ ,9[~- Zd?I <br /> <br /> <br />1~~1nIPl~{/14~II Remarks <br />~iIpIFI I~IEI/Plnl/I7t I l l l l l l l t l l <br />l l l l l l l l l l <br /> <br />Reserved Facility Evaluation Rating <br />67~u 69 7t~ ~ 65 <br />RI ~ OA --•----------•----Reserved-•----------•---- <br />71u 77~ 7~~ 74 7~ I I I I I 180 <br /> Section B: Facility Data <br />Name and Loca[ion o~ Facility Inspect d <br />~~ijq /I~R/i1 ~ <br />l-3atk~B 9~ ~ <br />/d GvmP~~'lY Entry iime <br />AM PM <br />p Permit Effective Date <br />'A <br />LW s N tI N e <br />5 / exit Time/Gate Permit Expiration Date <br />~ <br />a.v~ /Z n /! <br />Name(sl of On-Site R resent ttve(s) <br />~/any ~o~ Title(s) <br />~ndi~~`or~mBrlf~ ~i~9/aec~ Ph tie No15I <br />~/9) <br /> ~ ~Z -- ~6 <br />Name. Addre of Responsible Official <br />~ <br />od ~~ <br />(rte <br />.. Title <br />p a/6e~S offs ~wr~a ~r <br />a <br />- <br />~Q, /,~Ox 3/D <br />CS~ /1 F-~.li/vS /Jr <br />' ~J /~ Phone No. r~Contacted <br />lfll Yes ^ No <br /> Section C: Areas Evalua[ed During Inspection <br />(S = Satisfactory, M = Marginal, U = Unsatis(ac:ory, N = No[ E•ra(ua[edj <br />S Permit flow Measurement I Pretreatmen[ Operations $ Maintenance <br /> Records/Aeports Laboratory Compliance Schetlules Sludge Disposal <br />S Facility Site Review Effluent/Receiving Waters Self-Monitoring Program ~- Other: <br />Section D: Summary of Finaings/Comments (Arrach addirional sheets it necessary) <br />spe. l"EPoi7` wed ~ohv>'v~~w~,hs - <br /> <br /> ~~ <br />Name(s) an Signa[ure(sl of Inspector(s) _ <br />- Agency/Office/Telephone s /6L/7G <br />FPS - Wir,frt. aha~erne~t v Oate <br />9 /I/6tiv-' 9z <br />~ -i B <br /> ~P~ - NPO~sp-,~~, sr~M -~- <br /> <br /> a~ a~~r-~ <br />Signature of Revie Agency/Office Date <br /> <br />..t_ <br />~. <br />UsE'PAt SW~/-G~~30~ ~.93-1~36 <br />/l z'f- 9 <br /> Regulatory ONite Use Only <br />Action Taken ~ ~ - - r- <br />- Date ~ Compliance Status <br />li <br />^ <br /> - <br />~ artce <br />Nonwmp <br />c <br />li <br />^ C <br /> - an <br />e <br />om <br />EPA Form 3560-3 (Rev. 3-851 Previous editions are obsolete. <br />