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PERMITTEE NAME/ADDRESSO~bFxugNa.rL:ala.l/pd6,.,,rl
<br />NAME CYPNDS YA??A VALL°Y CJAL C09p,
<br />ADDRES$.nI NHS 1, 2'.3 SOUTH, f, ECA:MAN PK
<br />;100 FAST NINEPAT. CI3CLF.
<br />ENGLF.Y00lI CJ 90155
<br />FACILITY
<br />LOCATION
<br />ATTh: rURRIS i+, RFGL£Y, :;E1fF.RAL ATYT
<br />NATIONN POLLOTANT DISCHMGE ELIMINATION SYSTEM IIVPDf$l
<br />DIBCHARGE MONITORING REPORT lDMRI
<br />1-161 17-191
<br />000027113 OAS q
<br />PERMIT NUMBER DIBCNMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY ~ YEAR MO pAY
<br />FROM ~TO
<br />17671/ l27-231 1747 5A"„ ~ !7677/ 17B-I9l /9631/
<br />Form Approved.
<br />..T ~:, T - .~rl r pr,OMBINo~2040.OQ04rv
<br />(~ 7 ~~ ? h `I) Approval expfi~c 05-31-98
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<br />NOTE: Reed inetruclioru before completfnp this form.
<br />PARAMETER l3 Grd Onlyl QUANTITY OR LOADING -~rd Only/ QUANTITY OR CONCENTRATION NO. FREQUENCY SAMPLE
<br />131.37/ 146-53I /SbeEl l3B-I5l !4653 546(1 EX OF
<br />ANALYSIS 7yPE
<br /> AVERAGE MAXIMUM ~U MINIMUM AVERAGE MAXIMUM UNITS IBI-6J 164631 16a7o~
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<br />FFLU B':T GRJSS YALOP REQUIREMENT 3DDA 4YG DACGT f1X I1C7 ~ C3d^
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTI
<br />AM FA FY UNDER PENUIY OF L
<br />MILIM WITH THE INF01 AW TNAT I HAVE PERSONALLY E%AMIN
<br />1MATION SUBMITTED HEREIN
<br />AND BA ED AND
<br />SED ON
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<br />- TELEPHONE DATE
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<br />MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY gESPONSIB IE FOR ~ / -
<br />Richard MIllS OBTNNING THE INFORMATION, 1 BELIEVE THE SUBMITTEp INFORMA TION IS J
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<br />THE POSSI81LIlY OF RNE AND IMPRISONMENT. SEE 18 U.S.C. E 1001 AND ]] O
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<br />TYPED OR PRINTED wwm,.rirvn MFdanwrr,tbtw,ul6 month, Il/1.6Y~ra) OFFICER OR AUTHORRED AOENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRe/erence sll sttechments hers/
<br />'1LTERNATE LI~T1'S FOR T55 ;ETTLA9Lii 51L7DS (LOC '~') APPLY r;NLY IF <_ ?~-NA, 2U-NR PRFCIP ~VRNT I..
<br />CLAIMED. SPP T.A.2, PG 1N, FOH NURDEH JF PROJF REQ;IIRFM?iT,S, OTI. ~ ;oEAS'•--SSE FOO*NOTP.. P/, PG 2.
<br />EPA Form 3320-7 108-951 Previous editions mey be used. /REPLACES EPA FORM T40 WHICH MAY NOT BE UBED.) OO T L ~ /n p OU O 7- L O 3 O PAGE Z OF
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