Laserfiche WebLink
PERMRTEE NAME/ADDRESSpwrI,6FrNryN~WL°rnlu yDGbewrJ ~ NATIONAL POILIlfµTDISCBMOF ElIMINATON~'SYBrDa rArPDf$) <br />NAME ; L ": ":'o' ~ r r p ~• ~ DISCHARGE MONITORING REPORT (D RI <br />ADDRESS:''I`1°; 1, L';] "i 00 °. ~r ~'~.-.tq •~ - ~ "I'i' f^ X77 `. .' n ! ~t- ...) <br />1') S 1 ~ H, H p 2 7 ) ' . P RMIT NUM dseHAROENVMe r~ _ ;';" ^" <br />FAdlm i:) 1!./ ~~ ~` RINGPERI - ~ r TO tOID°i. ''F?'."F: <br />LOC,E~, AR. MO AY YEA DAY ~~' -- <br />.qv C9E°r ^_~ a;;9 i,7 FROM n (:., ll TO ^1 ~ ''~ \J uISC~,J~~jj~,~~~t (~ ~ :}r <br />4 :` f `! ; " i C'! A °. 1, f ' I n !. (! .. - c .; K r c r r ^ • ~ ~ NOTE: Rud InsN~M.bdarA eo'mDMtlnp thb form. <br />PARAMETER QUANTITY OR LOA <br />Quality or Concentr NO. rREaOENCr <br />of SAMPLE <br /> EX ys TYPE <br /> AVERAGE MAXIMUM ITS MINIMUM AVERAGE .~ .~ 1MUM UNITS µKr <br />~~rtvtrr <br />MEASUREMENT <br />~ ~ <br />b <br />Rd <br />~4 <br />h <br />~~b <br />O <br />~ <br />. <br />/ <br />, <br />( <br />'~ <br />( •) <br />/'A <br />~ <br />2n <br />V <br />(~v~l~ <br /> ~~ . <br />J <br />)0;)'+1 ~. D ;::,:::.;PERMIT..::::: ~:~ :~~,y r<: :-. ~~. •- ..::w i..r{.i( "C2 <br />>- ~, y <br />. <br />v <br />l <br />~f:•/ <br />F~C~:N. <br />ER, e <br />'~ <br />~~?'.L P`~:'F)"':" jj <br />yy <br />~~y <br />v <br />~ <br />, <br />crf <br />:::Y~~!^' <br />~~: ru )/ :•tz <br />: f I <br />. <br />'r1~:F` Ti4 r. <br />- ° F L V `' ':' i "; H 0 S 5 V A 1. I' . •REOCIIREMEN7t <br />:. ..::. ..r:': .: :. <br />.. :.::' ": y,'r .• . <br />~ t" . <br />:.:..'". , <br />. <br />. <br />~.. .. <br />f.Yl J. <br />T'r <br /> <br />.. <br />~ <br />:,~T~i, <br />'! SAMPLE <br />MEASUREMENT - r: '-y <br /> <br />~~ <br />7, aq r±.y .. <br />8. l ~ ~• <br />( ~ ~,) <br />(~ <br />"~/~C <br />.~n. S~'(i <br />J .l1JJ 1 U U :~'; :..PERMIT.::::~ >'~x!'.ri 0r9r~T,;~ <br />: ~. <br />u.uh'P <br />.!.. ^: r: <br />tr ~,"; <br />v` <br />.~:>.:~ ~ ~ :i~.~t:nnf.rk ~.""~.3.~'r .'.'. '~F~v1'. f.Y )'),. ~: <br />f ." F U: F:' ' ' .°, 0 S S V .4 L U ::REQUIREMENT . <br />.:...... .:.~:'~":6"rr, .." ... ~11 <br />~r <br />Rt:'.'. ~ <br />..... ^ ~J - <br />..:: ~.. <br />..: <br />:.i L1'"", .'.~"iI. <br />~ <br />,~ <br />' ~ SAMPLE <br />MEASUREMENT rs,t ~asq :. r:a^.. r<raan.a e <br />N 1/ <br />~ f <br />P~ ( ?r1) <br />NA <br />lV ~ ,,//~ <br />I <br />.: ~, <br />; t <br />: .V I I y /y 17 <br />j :1 7 j 1 . ~ <br />.. <br />. <br />•-~ <br />c *>:: PERMIT::::. <br />REQUIREMENT ~ ~.•;,-:: ar rs " ~ <br />;, <br />~:.. <br />~ <br />~ <br />~" <br />~: <br />" ~" ~ <br />. <br />~ <br />;'R~.. I +. ~ <br />" n ~ I ' . p ~. <br />. <br />. <br />. <br />.: :. 1: : <br />: .. <br />~ <br />~ <br />..: <br />: <br />. <br />;- <br /> <br />'4 ... <br />r <br />~ <br />~ <br />~ <br />~ <br /> <br />~ ~ <br />:,,r". :.. :i~iti +r <br />~~!LI;i ',, T'7T4:. SAMPLE y:f Y,.hRR•, 6 rJ r..; ,. q<} <br />~. <br />~ ~' <br />S , ( 1)~ /~ ~ G/pj <br />j') ; ~ L ~ ;, ~~ ~ MEASUREMENT <br />.. <br />. /. O Y' 3v <br />n PERMIT .. ... ':"tt'fi?!<' tahi;e r: x <br />" , .•: ••;•. Y;;;. ~:, <br />'~ <br />: s;~m; <br />.7(:~,::.~r:::~~'s":i.:.•::. <br />gs r.C/ <br />'~x. _:: fl _[.). <br />~. .. r REDUIREMENT ~ <: ;k ~ <br />.i ~:;..:.: .: .. <br />..: : <br />- ,~- ..:T y„ SAMPLE <br />MEASUREMENT .... ,.R .. r.n,, .. .. ..... .. .. ,. ,. ~'. `.) <br /> .: <br />!] .~ 5'1 `. '~ 7 0 ':: ~::';QERMIT.: ~:. .._ :>'t'.: ' ..^f <.~'::'rY _ .: Q <br />.."y <br />a w~ . °•. G~Y.'~,:.: :. ', z•.:r' R::::?Y:.:::. 'n!:,:-i.:-:: <br />, <br />~ .::r 17. ~ ti .4 tl . <br />. ,~ „ ~ •. '1 .:.'J T S R c L'? d REQUIREMENT ": ." . ... :; ,. ~ :. " .. ,. , .~~*~~ ~ ~ L / L ' ~'E,~'R,A ~ . <br />'LI~' :i}:PPLEA-L., <br />r SAMPLE ~ Oil01~C4 .. ~ <br />~ ?r <br />( 1) <br />/ <br /> MEASUREMENT 6. f ~ ~ (r /A`j <br />..` . ~ 1 ~ 1 J U :::-:!PERMIT::... •` ~:: ^~,. -r. x .. <br />~ '.::..: iY~i1i, :?R' . t •-. ~': t :.., .,;. <br /> <br />:~ ~ ,.,: .. _.. a. a; ::?:^ n: .. <br />• <br />.~12T .;1 <br /> <br />. .~: }: <br />{` /~ ~ <br />. "? <br />;H;• <br />°"L' ..dJ55 YALU. REQUIREMENT . ~. <br />;:: ,u.•, ~ .. ~ <br />!`I..I."l: l4X< !1L/), httMTu <br />,' <br />- <br />" <br />' <br />' <br />~- <br />~ SAMPLE <br />MEASVREMENT .. nyf.r(•,. - ~ ~ „ <br />~: < 5 <br />n 3S ( 1'~') 2 <br />3Q <br />G rGi <br />. , <br />~ I. <br />~ t Y h <br />~ A i <br />.. <br />J'. i ~ 1 J 0 `;:i~:~iPERM1T:~... .r v .~~.~;.p...?S " ~ ~i.~P:YPEF~C:~p~ 0 ' .. .t': >:•.. .. _ .,, ::} •: r3 t~:~ - <br />~ ~I'~r-i'/ <br />~ •: r. o <br />. r~•!„!' I: .;kU ;5 VnLq-: REQUIREMENT- "" .,.y ., ~ ~ ~~.I , r.y; .~.."v. <br />u." +~r;.r,F <br />~u <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER "'^'Ir° •I re"•'r° `.in.I lm. aervmenl.,W .n.Il.cnmenb.en TELEPHONE DATE <br /> pnp.,M undee n/ m,e°n°° °rmFinir°n a .roo,an,e..iln Sgeiem eearma <br />P,1r'. i~lclulr Mllls 1°.~.nlna,..nn.e,.~°ml„°,.,,,,.In...we...n,.~°,n.~"r°.m.n°n <br />' <br />' <br /> nbmlllee. npetl °" m/ Inqulq <br />°f mepnen p p,vr .h° muge IM ePlem. _~ , / <br />' <br /> <br />1' y~ <br />1 r <br />/~ <br />~ <br />~ <br />I /~~ <br />~ <br />ainge prromelredry mp°plbM!°rpmetlnj the lnrmnnlon, Ibe lnr°mun°n <br />~~'r f! <br />. i;~'",' 'I/ ) <br />'I ~.' 6 /U ~~, <br />~ <br />, 1 y <br />I ` I r/'1 <br />/' <br />~ <br />' W bMllee h, 1° IM1e bpi °r m) bpwlNbl.Id belle(, Irve, aa,nle, uM romplel6 <br />r.m...n up inen.na <br />.~nonl <br />ntlllp r <br />b <br />iln <br />I <br />r <br />n <br />r <br />b <br />tIDNATURE OF -RINdEAL E%E `j , /,~ • . <br /> <br />ED OR PRINTED r <br />p <br />°r,° <br />m <br />e <br />° <br />nr <br />° <br />°r"rI <br />", <br />b.nwi <br />lb <br />ubnu <br />rn drrNE <br />TYP nr <br />e re. <br />r° <br />°e.°a lmy,lgnmenl r°.bro.l"r .la.u°Ip OFFICER OR AUTHORQED AGENT CODE NUMBER YEAR MO DAY <br />..vmmo. r ~ nnv enr er.nn ~ w,.... .+... .,..~.. , was Irtn~rmc~ Ni ~rr~cnmmra nn~/ <br />=, )'4 L I'•I ~ ~'U ~' I,. f..r: 1 ( T., . ~.. ] GS' '/ I <br />•Ah .. :,) (!._ 1 ..Y - ~ l_ ~ 7 , i <br />- 4-I'd I ~, <br />:'J .1' '1'T ~I). <br />",°:? AS:?' i.~.J.~ ,('. ~' F':)~ i1UnC:F ^F "'.~~~' .-;+IIT"' °i' ~' ';1, 5 - '.F:L ?.'i.l.C, PG° 11. <br />EPA Fnm 3320-1 ~. 3/99) Previous editions may be used. ~ 6 n 1 ~ ~ / ~~h;5;15~ ~ 4,D Lrijform. PAGE i F <br />