Laserfiche WebLink
PERMITTEE NAME/ADDRESS (1nA~6 FrdiryNaW Lana yDls..nq <br />NAME BOiiIE HF.S'):I~=EI, LItfCTEU <br />ADDRESS B D M I E :V D. L `. C K 3 <br />N.O. 97X 133 <br />PAD~IA .J 91'123 <br />FACILITY BDdIL 4ESDJR~3S, i.I.".Ci ~D <br />LocAnoN <br />w T ra' UT1.LT \ N l _ 4 ~'E u u _ D_ /1D:. . f DeC <br />NATIONAL POLLUTMT OIBCHMGE ELIMINATION BrBTEM (NPDES) Form Approved. <br />DISCHARGE MONITORING REPORT lOMR1 <br />!~-rsl n-ISi PDND D DSCHG Til P°+I~~-4'1!9a <br />' (SUBR WC) dVe1234~ <br />^ PERMIT NUMBER DISCHMGE NUMBER F - F I "~ A L <br />MONITORING PERIOD FIINOR <br />YEAR MO DAV YEAR MO DAV + <br />FROM yg D/ OL TD J J D #tic ,!.^ D~SCHAR~E )--i ,°~°~ <br />/zaz11 ozz31 nbz51 rzbzn /za-z91 13x311 NOTE: dud netruetions efon CMnp6tlnp this form. <br />PARAMETER l3 Ord Onlyl QUANTITY OR LOADING !1 Grd Onhl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE <br /> !46531 !56511 l38-451 1~6-531 /56611 <br />EX OF <br />PE <br />l37-371 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS rs:-sal MALres <br />164-5g1 TY <br />159-701 <br />P,y SAMPLE ::.?x:a x#xxx# ;=;:# #•'~ ( l2) <br /> MEASUREMENT <br />JU4D0 1 0 0 PERMIT ~~.`-:boo oxoxist+ ar:^ 5.5 +x~u# ~ 9.A 'EF:KLY NSIT <br />C F F L U t: N T G R 5 S V A q REQUIREMENT r o+ <br />J^1IUS, TOTAL SAMPLE ;:s~#xx oxaav# vox#vr ( 19) <br />;~P E N D E U MEASUREMENT <br />OD,3J 1 0 0 .:. PERMIT S;Y~, 91x ADC14¢+~ !p ## D~R.;r## 3S 20 ~ICk! ;RAB <br /> ~;pEQU.IREMENL <br />S:ILIDS, SEttLEABLE SAMPLE rv~5#x0 C4#xY'k C3xv#~: ( J <br />5) <br /> MEASUREMENT . <br />OOS45 1 D D PERMIT ##Wyl$#' axaara Y~#r GfF7rx:i# REPOT Ors RCti/ raAB <br />EF't-LU 'NT GR7S5 V U .REQUIREMENT #v„r ~, <br />Ia~N, TnrAL SAMPLE G~#:r #;`x3GX :,~r..:FG ( 19) <br />(AS FF.) MEASUREMENT <br />u1U45 1 0 J PERMIT t#ScC## #nyoy;: - :t.".;; 3icntk;i# 3.0 6r0 I NCF/ :P,AB <br />tFr LU T G U y ~U REQUIREMENT v rx: wr v <br />JiL AND GREASE SAMPLE -;xxrr:; rx,~r.-;: ,,,,ri:;c~ r,r# t:^ ( 1.1) <br /> MEASUREMENT <br />U3S92 1 0 D PERMIT 'S{sC3'#^.t CG#xG~ .. 'S#iVd# ti##~."- 4 20 DYT.I`3 ;~3AR <br />dF'FLUENT GROSS VALU 'REQUIREMENT #;:va <br />^ ^v1:r <br />FLJW, IN CDNDUI'T OH SAMPLE ( D3) ic:Afi:c~: #4# ## t'r#':.7.# <br /> <br />1 TRLATMENt PLA!7 MEASUREMENT <br />c <br />7 SU 1 U J <br />~ PERMIT REPORT RF;PDRT :rr4aY #### # #,G#'+F# : :;:h; ncvLY f.7STA!1 <br />cFFLUENT GRUSS VALU REQUIREMENT ODA. kV-a 0 ~ ~-:`-'•x <br />`.,JLIDS, TDLAL SAMPLE ;:S:QY:x G#ilri%^. ,; ;.#;:••.: /l di <br />'C/~c~ tq) <br />J1:iSDLYEO MEASUREMENT <br />701vS 1 0 0 PERMIT r•aa.pao vx#a#a ##a xvvv # dtPO T O.P'eIDNAL TR14 :4A5 <br />dFFLUEN'f GRDSS YALU REQUIREMENT ##,#r p ,. <br />NAMERITLE PRINCIPAL EXECUTNE OFFICER I CEATIFr UNDER PENALTY OF <br />M FAMILIM WITH THE INFO LAW THAT I HAVE PERBONALLY E%AMINFD MD <br />RMATION SUBMITTED HEREIN; MD BABEO ON TELEPHONE DATE <br />' IJ C n I~ Jr< <br />Imo' L L / r' N I A <br />MY INQUIRY OF THOSE INOINDUALS IMMEDIATELY RESPONSIBLE FOR <br />I BELIEVE THE SUBMITTED INFORMATION IS <br />E INF <br />R <br />nO <br />/ O <br />MA <br />N, <br />OBTNNING TH <br />TRUE, ACCURATE MD COMPLETE. I AM AWME THAT THERE ME <br />TIES FOR SUBMITTING FALSE INFORMATION <br />INCLIl01NG <br />T PENN ~ L' <br /> , <br />. <br />BIGNIFICM /~ n r, <br />9 <br />r ~ <br />7 <br />_ ! /J <br />( ~ F •r ~ t THE POBBIBIUTY OF flNE MD IMPRISONMENT. SEE 18 LLB.C. 1 1001 MD 3a SIGNATURE OF MEINCIPAL EXECUTNE / ~ d <br />J / / <br /> U.B.C. E 1310. //MYAY. uM~r ewr mroMr ArY iroArdl /Yra ye ro F/D,000 AREA <br />' TYPED OR PRINTED mewmui+wnAnPda'wlr+r a/blwrnemaNlra rN BVrrAI OFFICER OR AUTHORIZED AOEM CODE NUMEIER YEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS !Reference sS slTSCnmenla here! , <br />SETTLEA°LE SDLIDS LI'1I; APPLIES :)4 LL IF .= 1U-43, 24-H4 ~R.:CId ;,VpNT IS CLAMED. IF CI,aIr IS APFR~I'?D <br />~3Y N;)CU, T35 IRDY LI''?CTS WILL hit BF, APPLIED TO REPDRP?D :'Id6JUkE9EVI5 -SEF. I.9.1A, PG 5 ARD I. H.LD, PS. <br />For 3 = (5-95 PYa 'oJ IDOtIB nley 1 LACES EPA FORM T-0O WHICH MAY NOT BE USED.1 PAGE OF <br />- 0564/D7D81U-1535 1 <br />