PERMITTEE NAME/ADDRESS pwdr47arWyxwW(ennaw IjD(Sirvn)
<br />NAME
<br />~r-. ^.U'i rUl_LS CUALf lf,U.
<br />ADDRESS ~ ~ ~ I „F i :_ L :1 . ~ (,r'
<br />L;.ACni:Ul. LL ~ULL'J-:%Ydy
<br />FACILITY C.\LltUt I-ULLJ t.:i~tLr L:.L.
<br />LOCATIONT LUr(C N(:L GJ UUa.LO
<br />.:Tis :~~•,~ l I_ CI'. .;'F. lP-I:N.reTl. :a•
<br />NATIONAL POLLUTMT Ot3CNMOE EIIMINATON SYSTM /INPDESI Form Approved.
<br />DISCHARGE MONITORING REPORT IDMRI pMB No. }}040:00041
<br />1-l6 17-191 r',~IYU ~.-'~V N~.fr 1. r'T r,.L :'I1 .v.: 1
<br />-'s 'd` !;, '~L,L ~'. u:.. APprovgle py4s O~-31-88
<br />PERMIT NUMBER D19CMMGE NUMBER ~ 1
<br />(- - r 111 :.L
<br />MONITORING PERIOD ' ~' L ~"""
<br />YEAR MO DAY YEAR MO DAV
<br />FROM j J4 vL TD Y9 '~cr 1Q t'kti' Gv ~LSLr1A,ot 'S'#•'
<br />116111 117-731 111-I51 11E-771 I79-29/ !34911 NOTE: Reed Inetructlme before completlnp thb form.
<br />PARAMETER !3 Grd only! QUANTITY OR LOADING !1 Grd Ontyl QUANTITY OR CONCENTRATION ND. FREQUENCY SAMPLE
<br />
<br />131-371 la653 151-611 138-161 !16-63 16461
<br />EX of
<br />MALr315
<br />TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS (rSS91 r6q-661 I69-701
<br />%h SAMPLE
<br />SUREM i 044bi• t~4t~M •f C~
<br />~ 'k #.r t. ti.µ
<br />- iC
<br />'
<br />ICe~
<br /> MEA
<br />ENT /
<br />~ L
<br />R. I Q1~
<br />
<br />G4Ul/ l l' Q ..PERMIT:..: ,:.
<br />...
<br />$rY##aDli
<br />'!~~J It'pl## ~.
<br />#Y
<br />111#1«#Ir[Q. :. .. . ~ ..
<br />_FF LUtiil „<.Lj'~ VALU~ R..EQUIREMENT:
<br />~~~~ ~: .. ~~ ._ .. ~, ~~ {. ~,y ~~. ..( ~.~
<br />. ~ ~~ ~. .i~t:37^.~~ :1
<br />.. ...
<br />.
<br />ULLUOI lUI AL SAMPLE Y4#YMF 9yd YY#if ~{~~~'«$ Lr/ ~
<br />L ,1.-:.:V`V MEASUREMENT ~ ~ 7 ~
<br />l-
<br />M,Miyl , 1
<br />< rn ,
<br />/L'~JV 1 t. G ~;~:PERMIT; :,: -:.'Ylif#41*~:.::'.-,
<br />~ ..8434Y+~w .~yi. g.. ~ +F.dC(s#*~fk~~~~ frj ~ ~ 7U ~ ~ ~~~,
<br />~
<br />~ :~ ~AT~~
<br /> REQUIREMENT ~ ~ ~~ ~~ '
<br />. .
<br />.
<br />..
<br />SLL.LuIf ~:.TTLCAyLC SAMPLE vt#M44 {•M1Y tl'#N ar i•k~F4+f r
<br />~"~ ' `~
<br />r ~ ~ ~~ ~~
<br /> MEASUREMENT ~`" ~
<br />J(,i•.7 1 L C .:J:..'PERMIT: ~~: :. $#I#N~~4~~:.: _: .~..:'!#'!I w'i*~ 4F #f: ~~~~i'a.#+~*!~~~.. ...FT ~.L~~. ~.
<br />netzt:M7 ~ ~1
<br />:~:~~i !'c~#I~~: .
<br />
<br />:FF tUtr. T GROSS VA UE EOl11REMENj..
<br />:$. '
<br />
<br />......
<br />
<br />$K`rA .
<br />
<br />, . . .
<br />' '
<br />k~l., TuTAL sAMPLE fAIY##,ka v####a ~t•#1(.•klA L•) !
<br />A J r t ~ MEASUREMENT - ~. ~' ~ Z 1 ~ / _+t}( ~ `L-G ~~
<br />
<br />/ iU `.7 1 L 0
<br />;-,:::RE;MIT-' .;:.
<br />~ ~ .#'6.~d~+Y~R:#~~~' ~:
<br />~: .:~+k~v1#Nrr4 rl!-
<br />#~
<br />~:~ lk'ii.~>r Yf.~ ~ -
<br />.!
<br />~ e~tJ ~
<br />~
<br />C>~::;~:::
<br />~
<br />.t4~~71~T5 ~.
<br />
<br />_FFL.utr,T ~kLISS vALJE REQUIREM.EM7~.
<br />-.: .:....~_;,..,..-.... ~ . ~ :. .. ... .. ....
<br />,:..
<br />
<br />.
<br />~~~k , .. .
<br />_
<br />
<br />., A -. ,
<br />,1L ANA ,, :<LA SL SAMPLE b$#~p •A tr v,r ~kk
<br />#tt #{r#4+k{• +v +ndir ti'{` I I
<br /> MEASUREMENT rl /rte
<br />)' ~..G L l: G '..'.'::: FERNIIT::'..~:: , ~:!p##?Ral!4, ~ .. ~:~.4#1~#ILt~ilt ~ 4t• ~:~~ #91 A:?9MP+il ~
<br />~ ~ ~tf~~k W.~N ~
<br />~ ICJ ..r:.. ~ ~ ~ • ~~~:P1~~"11.~ ~~M:Ti~~~ .
<br />
<br />Cf rLL,tNf ~ri'JS:r VAL'UL REQUIREM .N.T~
<br />
<br />,..., .
<br />..:..
<br />~ ~ . ~ . ~ ~~
<br />~ .. ..: ~ ..
<br />~ ~
<br />~- -~ ~~ .;
<br />~ ~ ~.>... ~~
<br />^.`~~;.T..' ..:
<br />:::.::.:... .:.
<br />L~.,F i,\ Lt;NuUIT L•r SAMPLE
<br />MEASUREMENT
<br />~ 03 -h####4
<br />~ 4%~hir {r ,;. ¢.}pr. ,,,.
<br />L
<br />[~~
<br />l
<br />I
<br />~
<br />~~t
<br />I~~.~ T:~tAlr•,tr:T YLAIrT ~ Uc{ ~~ c.
<br />-
<br />-
<br />h %
<br />/nS
<br />l.u... i v U ::.:.:~:PEAMIT..::: :?.' . ":R~:~~Ci.k3 ~~..
<br />~ ~ :: .:it~~PLa~'T. '. ~:.;y AlnR.+YYf ~.
<br />~.. ..~ t.'b {r R.t4:.:
<br />~ .. .M?lti#~~ti.~ i ., t. ..~ _ ~ I~~.L 1'.~~~~:~ i51Jt TA~rr
<br />
<br />_rrLt,Llri un,i~S VALUL REOllIliEMENT~.
<br />....;:: .:.;:L K. .
<br />:~Ui1~::AYv .: .
<br />':f3AI 'Y }!i~
<br />Gu .:: ~:: .. ...
<br />.:;:;:.., .. ....
<br />;•e•::~
<br />'
<br />...
<br />'
<br />~~
<br />~iL AIVV ~Rta;,L SAMPLE 4i##A~~I yy ~}.}##+A4 #?~>}4 V{~ ,. :. t. ., .;. :. -
<br />t ~„AL .
<br />MEASUREMENT U ~ - !1{-~.1 ~:I~ r.(r.
<br />~ti~oc, 1 u 0 ::.'?ERr~itr,:--. : _~i!~~I~~r ~. :: A~W~tf<T.''Y ~.; 1 ~lF##QI~A . '.'::#;QI+C~'R.~r1Y .. :' .~~'F.SrMMIF":'fl' ~ 4Y
<br />•~L. iv.~
<br />rrLUtNI uxU55 trALU- f8E4UIREJdENS:; .;~. ~-~- :::~~•!'tS~~
<br />--tlA
<br />Il
<br />'
<br />> U U -
<br />-
<br />. '?
<br />.
<br />'. ... MIFY4
<br />.
<br />_ . ...., gyn..... :. ..:::. .......:. e:........ .
<br />:
<br />.
<br />. ..
<br />.
<br />.
<br />!
<br />~~
<br />~
<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I cERn FV uxoeR PENALTY OF uW THAT I HAYE PERSONALLY ExAMINED MD
<br />I TELEPHONE DATE
<br /> AM
<br />FA MILIM H. THE INFO RMATION SUBMITTED HEREIN; MD BASED ON +
<br />) ,
<br />MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR 1
<br />~ J ,
<br />K IG ~fd-~ /L/I IJUTs,jo-~
<br />- OBTNNINO THE INFORMATION, I BELIEVE THE SUBMIT7 c0 INFORMATION IS I ,
<br />'-
<br />! TRUE. ACCUMTE MO COMPLETE. I AM AWME THAT THERE ME
<br />SIDNIFIQMT PENALTIES FOR SUBMITTING FALSE INFORMATION
<br />INCLUDING ~t r ~µ{r '>Q 1 _ ~r;
<br />/
<br />~
<br />~ ,
<br />1 9001
<br />TY
<br />FINE AND IMPR
<br />SEE 10 U
<br />S
<br />C
<br />T
<br />S
<br />F
<br />O
<br />ENT
<br />D 33 _ 7
<br />/ ~
<br />~
<br />~ ~ /
<br />~~
<br />t
<br />~~
<br />I/ I [ ~~,
<br />~ ~ / - -. ( .
<br />.
<br />.
<br />HE POS
<br />IBILI
<br />.
<br />IS
<br />NM
<br />.
<br />M
<br />O SIGNATURE OF PRINgPAL EXE(alI1VE - - ~ `~
<br />TYPED OR PRINTED U.S.C. E 1710. /nwWeY. ulMr rMw Nnrn, rnrY icAd~ rw. w ro f 10,ODD
<br />x
<br />M
<br />rae
<br />r
<br />r
<br />n
<br />ss
<br />d
<br />l oFFlCER OR AUTHORIZED AGENT C
<br />DE NUf
<br />IBER Y D
<br /> .,I
<br />...~
<br />.
<br />r..n
<br />rlb
<br />..,
<br />d,e..
<br />M~Ylun
<br />F..r. O . EAR MO AV
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRelaence sl/ ercscnmenrs DeYe/
<br />T5~ s. 1L,iAl lRGiv LIMITS HILL t~ bAlYLur Ahu ST.TTLtAcLL o;iLl.;~ LIMIT AIPLILU i-ai. 1tiYkF~tiri!<. F'.c•.;Lr' Lv=.i-
<br />:,L~ nL,rtu~n Gr i'rZI,L,F nkUU1r:~FttNTS UNOLK I.A.3r P. O. uIL ! „h~A]c - ]tL I.d.l.c,. ~G .,aY Ay~YnNC 1,
<br />r c r r
<br />EP Form 3320- IQ -9 Preeoue a itloM 1OeY bf Ue _ E 'CES EPA'FO -4 ICM MAY NOT BE USED.) PAGE OF
<br />
|