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PERMITTEE NAME/ADDRESS (Include Farili(x Nume/Locmion iJDBerenr)
<br />NAME
<br />CtP~US YAlIPP. VALLEY CGAL CORP.
<br />ADDRESS,I N!':S I, 2G] SGU:H, 6 Cri`4q!, i'!;
<br />`+lUli }.AST' r'INF;tAL CIhCLh'
<br />FACILITY Il .la 1.'nOUD CIS NCL55
<br />LOCATION
<br />k'('T(:: `~Ofr:~.IS M. Y.:iGLFY, GF:ttc FiAL ATHY
<br />NATIONAL POLLUTArlT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved.
<br />DISCNARGE MONITORING REPORT (DMR~ OMB No. 2040-0004
<br />(z-1el nr_ 9) A,; D , Approval expires 05-31-98
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<br />PERMIT NUMBER DISCHARGE NUMBER :~ _ F I `~ A L HU U ('"
<br />MONITORING PERIOD t'Il~d 1, aq,t; F ;G fGICLL CREL+'C
<br />YEAR MO DAY YEAR MO DAY
<br />FROM UCl US 71 TO UU US ]1 •"%'° 9D CI`,CdA 3GE '~""~`
<br />(za-zp (zz-z3i tza-zs) 1zs-z71 (ze~z9) 130-OIJ NOTE: Read Instructions befo a completing this form.
<br /> (3 Cerd Ony) QUANTITY OR LOADING Ic Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMEFER (46-53) (54-61) (38-45 (46-53) (5461) EX OF TYPE
<br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS
<br />L}?Cil SAMPLE :.:F'v;kF# rrari:k+`•~: ':>r##~'. ( 1~)
<br />TOTAL i.ECUYF,RAl:Lc MEASUREMENT
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<br />iISSOLY'Z7 MEASUREMENT
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<br />r,FiLUE4T U2D55 VAL'Jr REQUIREMENT ~ - a~wr '~g~~;, OK~#'7 ~ ~~ ~ ~, ~< k ' #DAILY r!g-. /L _
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<br />Yh.IGAN:?Sr, TOTAL SAMPLE ,rzt~^;~ ###:x::o 1;~jlNP## r ( 19)
<br />Ha;CUVEHA5L:•, MEASUREMENT ~ C- f('(,
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<br />PLUM, IN CONDUIT UR SAMPLE ( 03) >r##### s+t-^.•## ##4#4# "
<br />rHHU TkEATNENT PLANT MEASUREMENT
<br />50US0 1 0 0 "~E"TL~r z•! ~~~ RBF4A~'~s:.- ~~ "s~~~;~ i ~#64~~ a#=: ~ °~R).T' :1P57AN
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<br />USUAL MEASUREMENT
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<br /> SAMPLE
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WRH THE INFORM LAW THAT I HAVE PERSONALLY EXAMINED AND
<br />ATION SUBMITTED HEREIN; AND BARED ON MY TELEPHONE DATE
<br />
<br />Mill INQUIRY OF THOSE INDIVIDUAL
<br />THE INFORMATION, I REDEY S IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />E THE SUBMITTED INFORMATION IS TRUE.
<br />s
<br />Richard ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE SIGNIFICANT
<br /> . FORMATION
<br />INCLUD
<br />NG THE 97O-BID-2712
<br />Environmental Manager PENALTIES FOR SUBMRTING FALSE IN
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<br />POSSIBILITY OF FINE AND IMPRISONMENT. S
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<br />d SIGNATURE OF PRINCIPAL EXECUTIVE ^~ -T
<br /> nes up ro !10,000 en
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<br />4 1319. (Penalties under mesa statures may inclutle l OFFICER OR AUTHORIZED AGENT
<br />TYPED OR PRINTED maximum ~mpdsomrent of hetweenfimonrhs entl5yaera.) E NUMBER YEAR MO DAY
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerence ell attachments here)
<br />ALTEHNA'I° LICLTS FOR TSS 6 SETTLi.ABLE SOLIDS (LOC '0') APPLY ONLY IF <= 1J-YH, 2U-ri•. Ir;°CIP FYEHT IS
<br />CLAI.*Ev. SE'E I. A. 2, PG 1H, FOR F?UkuF'H OF PROOF RFCIIIRENEkTS. OLL E GkEASC-SEE F(:DTI:G.~. F/, PG 2.
<br />EPA Form 3320-1 (08-95) Previous editions may not be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.) OO OB O / OO O 4 O S -1 ~ U I PAGE 2 OF
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