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PERMI7TEE NAME/ADDRESS Qnclude Fatiliy Nmnr/C«anon ijDgeeou) <br />NAME tlOYIE RRgpUP.C£S LI"1I7ED <br />ADDRESStlOiilt: a0. 2 "LFI~ <br />P.O. HOY 4's3 <br />FACILRY PA08IA r-~ 91029 <br />LOCATIONH O W I E C 0 9 i r4 29 <br />~1'T~: aILL7A`I 4, FfcAA JA., SISE 'SGR <br />NATONAL POLLUTAM DISCHARGE ELIMINATION SYSTEM lNPDES) <br />DISCHARGE MONITORING REPOAT (DMA) <br />(2-161 (11.19) <br />r PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM 99 Oa ~ 0 TO 7q p <br />(2671) (22-231 (2~-251 RQ2A R&28) (3631) <br />FOnn Approved. <br />~ 7 N n q OMB No. 2040-0004 <br />Approval expires OS-31.9B- <br />(SiJ~V Trc) <br />- f`ryA[. pELT4 <br />DS CF' cp/`1INE GANGT.O Df.F'R ?RL <br />NOTE: Read Instructions before LUAI leting this form. <br /> (3 CeM Ony) QUANTITY OR LOADING (4 Card Ony) QUANTITY OR CONCENTRATION NO. FflEOUENC SAMPLE <br />PARAMETER (46-53) (59-61 (3B<5) (46-53 (5461) EJ( OF TYPE <br />(32-3n AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />lb7dT) ANA-~1S <br />(64-68) <br />69-70 <br />iIL AND i:A F:4SF: SAMPLE -`~~`+~~ ( 94) Y'7rt3'.t? -?:tT.:or ,r, <br />C ~ • n:r <br />21SUAL MEASUREMENT ~7 <br />u066 I 0 D ~PE'RFAI at<," _ ~'~~ - ~,': C'S=I ~~ ~'~I >9r+-t~~'' >A##~: ~'~ ;~ ~~T . <br />FFLUCR7 G905S YALU REQUIREMENT' _ '° ,~." l10=D `~'~ ._ ` '4 ''t~ ~~>;4 ~:, rrT. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT; <br />~ ~ ~,~ i•,• <br />' <br />:: k <br />° <br />' ~ <br />~ ;,~ '~ '" °: "p ~~ ~`7¢,'&' <br />r S ~ <br />: <br />r ~`~- - <br />; <br />~ '~ .,L ~ '+^ <br />~~ <br /> REQUIR rPF , <br />" <br />...' ~x , <br />. , ,v <br />~ ~I <br /> SAMPLE <br /> MEASUREMENT <br /> PER ~~ - `4, - ~ a• k~,r ,4 LF, <br /> .REQUIRE N7 <br />_. r' <br />- - <br />,w - <br />- ~ ~"' <br />,..--_ - <br />._ .. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT; ;" <br /> REQUIREMENT ~' `t <br /> >^ ~ <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> REQUIREMENT - ~ <br /> s <br /> <br /> SAMPLE <br />• MEASUREMENT <br /> PERMIT- = - - _ .;. <br />' - - <br />~ - ,r= <br /> REQUIREMENT ~ - '_ _ . `~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - - . -~ - -. - <br />- ~ .- - - sx'~ <br /> REQUIREMENT - - - - ~ - - - - 1:~' <br /> T <br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSO NALLY E%AMINED AND TELEPHONE DATE <br /> AM FAMILIAA WITH THE INFORM ATION SUBMITTED HERE IN: AND BASED ON MY <br /> INQUIRY OF THOSE INDIVIDUAL <br />THE INFORMATION, I BELIEV S IMMEDIATELY RESPON <br />E THE SUBMITTED IN SIBLE FOR OBTAINING <br />FORMATION IS TRUE, <br />' <br />~ <br /> <br />i ACCURATE AND COMPLETE. <br />PENALTIES FOR SUBMITTIN I AM AWARE THAT TH <br />G FALSE INFORMATIO ERE ARE SIGNIFICANT <br />INCLUDING THE <br />N ~ / <br />> <br />, <br />~~ (r/( 4if ~p1 ~~~j j <br />POSSIBILITY OF FINE AND IMPR <br />4 1318 <br />(Penetti <br />untler Mesa , <br />ISONMENT. SEE 18 U.S.C. § 1001 AND 33 U.S.C. <br />Ml~fes me <br />in <br />l <br />tle Ilries <br />ro f10 <br />000 <br />d <br />SIGNATURE OF PRINCIPAL EXECUTIVE ^ <br />~~'~ <br />I~ s> > V <br />'r~ <br />CO <br />G Z <br /> <br />TYPED OR PRINTED . <br />es <br />s <br />c <br />u <br />up <br />, <br />1m <br />w <br />Y <br />medmum lmpdsonmerx or Dehveen6mon6e arMS}mis.J OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br /> D <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference ell attachments here) <br />STTLEABLi SOLIDS LIAIT sPPLLES O,rLP IF <=107 R,2119A P9ECIP ~'9F.ST S5 CLATnt:n. IF CLAIM AFFAOYF.D HS w,TC~N, <br />1':.5 S IRON LLMI75 GILL N07 9E: APPi.I.'.D TO P.EPORih:D !'IP.ASURR!"-7NT5-SFE I. S. 2, PG 5 FOF NU P.[+PN 4F PROOF <br />~P^ orm~ 26 0 - Previous a idons may noTbe used ~ ~ ~"' ( EP CES A F I~ AY O ~E § .) - ' ~' • ~ PAGE OF <br />0004'1/9aO;12-T2~' <br />