PERMFILE58837 - Laserfiche WebLink

Home Browse Search

PERMITTEE NAME/ADDRESS (Lrr/uric ~Jeililr Name/Lormion i( di!lerenll NAME_'.s: .11 r:~s~~-' ~Ci ~.i _112`L~-•1~-I.)-r..~1--aim-- ADDRESS -• FACILITY LOCATION _ NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDE$J DISCHARGE MONITORING REPORT (DM11R) ' `I ~ ` (S U y fi 5 ~ ~ F{~r~r11Ap4roved. PERMIT NUMBER o sc..Awcc vur+asw : :, _ ~ ~ + iltAi OMB No. 2040-0004 31-94 Apprp al eJ DIr~S 1 0 5 ~ L= L r G ti [~ ~ f ` . ~ , r ~` Q L 1 MONITORING PERIOD , . YEAR YEAR MO MO DAY DAY YEAR YEAR MO MO DAT FROM ~~ l;4 C1 TO 9D 06 30 ~ ;: r,: ;: >::tr,} NL CI:;CHAnCE ~ an-zu 17?-?)1 ,?a u> ae-?7> Izs-a9l . /)o-)n 1 __ .NOTE: Read instructions before completing this form. (? Card Onl7•) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION PARAMETER (.Ih-5.1) (5l-6U (Id-~t5) (a6-57) (J4-6/) ry0_ EX FREOOUF NCY SAMPLE TYPE (i'-il) ANALV515 AVERAGE MAXIMUM UNITS MIN I M U M AVERAGE MAXIMU M UNITS i6_~JI IfiJ FN) (fig-101 [ it SAMPLE k': :1:}>~:+ v:L'.: ;}',./I ~ F~ / ~ '.t (t:i+x s}~ R ~ ( 1~~ O ' MEASUREMENT / VY/ ' / / ~~ , 1~L111U i l' V PERMIT ir:}j;7Q~s Yr}:}fJry:} Yi; s,`. (: 6w5 ;}4it~^J tJ t3,Q + It I;L/ 110 I r' r REQUIREMENT n :: ,_h V r . r ~( j T, rl. 1)~, TC'T P.L ~ SAMPLE MEASUREMENT 'J t:OtY >;: t} ~i~i`•)}:i it ;t :;t :"-'~~t %.: / ~( ~ 4 / /~ ~ ( 1C~ ~ I ~ :. N L ~, ~ / / / S FFF~~i ~ A l')JJU ]. ~. rr PERMIT it Ya sJ i4 Y.t h: 3?t>S lra s7 fi IJJO t}:+~. >;t Y,t +} 3G US ( NI.L~ IZA(! ~~ I v s~ . C ° l ' P i t' REQUIREMENT ~ s ~ ~ ,+ (; T (.i~. Ativ :a l: F. ~iSE SAMPLE :::}'}~'v si'rl'}Y~is ;% Xt i+sY ~s'J~ :~}ir.'s 'J it {% 1 /A/ ( IJ~ F.l.'.'.C. EY.Z[:-GRAY I''l,"F'{: MEASUREMENT /A/ }y III~~~ , 1 b v (J,(~rs "~)..~~ ~ i G .: , PERMIT >: L:,t lr o:r {+iYQYJ4y7 :r :i Y,: V`;t .'.t4let'•J ''T}~r YJ Rsa 1 G'i7IN NA8 :.FF'.JF.h' r.;RG:;~ Vp REQUIREMENT K, i s • • . ~ M(' t Lr~G, Iti CG~tUUI~l I~I~ SAMPLE ~J ^ ' ! 1 J ( 1. 3~ riVllM it %J ': Y,t~~t}Q'a At}:}yfi it J /7 _ s:1 :. ~I T!~,LATf1FNT I:, IN IIR MEASUREMENT S1~4.~ ~J V ~ ~J'•/~: 'J i (r r' PERMIT Ft .L.PGH HEPGHT =F f1, ls: (t XtQ JAa"L}~~ s}YJ ;}{t Y1;Y :~"+ Et:FLY NSTnti :.F'r111=:t•7 GRASS VA.LSJ~ REQUIREMENT 3GDA AVG UA Y rGD 'J~°~'} :: JI.I t/7, TGTAL SAMPLE -".'':;t yJ ;Y:: i+ t}'JV~~i: Lr it >Lt >•,r =J +t ( 19~ I :, i:i.~OLYiU MEASUREMENT / O D O _ 7r_',5 1 C ~ PERMIT nirr~»Y VA~ftA# ~ #~}:. S+t~9'.+fil~ GPTIGNaL HEFGnT ThLY HA6 i f F 1. 1i .. Ir ~l b ft (~ .J Y h t, U ;. REQUIREMENT - ;[:;: (t:;t ( Id G lit, eiiD GkERSF. SAMPLE MEASUREMENT .rt}C'%Y ~}:r O ( ~U~ ~:s;: Y,: 4`+ ;YV t}Or}Yr ::=}:}'.~\~~ O r .~, y SG /J .. .VL~V ~ G t~ PERMIT ~~O~Jfi'al>'J ~ ES=Z tJiT+'1.7L:~J ~Sli+ri¢O 9+t7#yC . 'x5r7 ~,u,'F:LY ISUAL LFFJ.U1'.tr~ GF.G°" ~ LUL REQUIREMENT _ v~(rwn SAMPLE MEASUREMENT PERMIT REQUIREMENT - NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY urvDER PENALTr of LAW THAT I HAVE PERSONALLY Ea AMINED TELEPHONE D A T E !~ p ! ~IL ~R~ a L /~~ ~ ArvD AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND DASED ON b1T INQUIRY OF TFgSE INDIVIDUALS IMMEDIATELY RES°ONSBLE FOR OBTgINiNG THE INFORMATON I BELIEVE THE SUBMITTED INFORMATION IS _~~ ( ' 9 / 7 ~ S.:L J . TRUE PCCURATE AND COMPLETE. I AM AWARE THAT THERE ARE GNrFI[ NT N MITTING FALSE MIFOR TION INCLUDVJC E F L g PE ALTI . SI S OR SUB MA rHE PosslBlurY of FINE 4ND IMPRISONMENT SEE IB use 4 IWI AND J3 use 4 r3I9 lPrnalnrs unJer rtrrse sr mfrs ma ~ inolude lints uC 1u SIGNATURE OF PRIN IPAL E%ECUTIVE ]O - a- ~ THO AREA TYPED OR PRINTED 510.0011 anJ or nu simurn rmpnsnnmrnr u! hervccn 6 monrhs antl 5 /cars) OFFICER OR AU RIZED AGENT CODE NUMBER YEAR MO DAY COMMENT AND E%PLANATION OF ANY VIOLATIONS (Krlerrn[c all dna[nmfnls ncrC/ - ( L +, IiE.55r.'--_Fp POJ;'rU:t: !/, FLG~ 1=. Form PrBVIOUS Odl(10r15 r112y IJO used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.1 PAGE u Li lrL'_ /911? `7-lc? 7 .: