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,- <br />PERMITTEE NAME/ADDRESS (/naYb FsWryNer/fsemm dD/~.,.np <br />NAME pAKHID,;Z ERERGT IN.^-. <br />NATIONAL POLLUTMT QISCHMOE ELIMINATION SYSTEM INPDE$l Form ApprOVed. ~~ <br />DISCHARGE MONfTORBVG REPORT lOMRI ^'~~ Np ~~Q: ~4 <br />13-161 /I7-191 u e!en~ nn ~ 1en e• <br />.~ <br />~~ ~S CARBON J17NCiIJN 7IMR -R ^''~ /'^T "°°• "' " `" `'^A~$r`oSBI eA'N5s O5e3'1-98 <br />(SpBR SM) 12p345 <br />~~ 279 SA7TER DRI/E PERMITNUMBER DISCMMGENUMBER <br />~~ F - PINAL <br />~_ pUdANGO CO B13y1 <br />MONITORING PERIOD <br />/ <br />NIROA <br />m <br />DAKRI D.iR F.N ERG/ INCe YEAR MO DAY YEAR MO DAY <br />=Oi1N e5e~/iw FROM 00 07 DL TD Op 09 30 Ca0 NO DISCHARGE ~'~~ taa <br /> <br />tt9'CL P A <br />U I S R C <br />P R E S I D E e T !74711 171-131 171-15) 116.171 178-19) !36311 , <br />NOTE: Reed Inetrucdoru 6etors L~bMpletlnp thu form. <br />. <br />, <br />~~ PARAMETER /3 Grd OMyl QUANTITY OR LOADWG 11 Ord Onlyl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE <br />~ 1~6-531 15L61 138-451 !46.53 15661 <br />(~~ <br />137-371 EX A <br />5 <br />3 TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE' MAXIMUM UNITS rs7.s.T1 M <br />LY <br />1 <br />164-581 !6&701 <br />UIL Al7D GiiBaSE SAMPLE gy Oa~p ( 94) 0~4?k`;. :F4# AR C9f-6G4 <br />Y I SO AL MEASUREMENT <br /> ,.~ ~ <br />84066 1 U U PERMIT.: . :' <br />'REQUIREMENT ai'?-0rMlr:IF': <br />- ~ .. R6'PQRT <br />~ . LS=1 ~'#~ii3. <br /> <br />• ~~~ .O .'#~r~>e9~A: e~p <br />~~ <br />~~ ~.. <br /> <br />~fl <br />.. ~~ ; <br />t/F U6NT GR04 Y U . <br />....:.:: . . <br />i! , .:, <br />..::. '' : <br />:: <br />: <br />i' <br />; ' ~ <br /> .. <br />. .. <br />., . " <br />. . <br />. <br />. <br />. <br />.,... :..... ~ . <br />::: . .. <br />: <br /> SAMPLE I , <br /> MEASUREMENT ~ . <br /> :' <br /> „.. <br />{i~EQUIRENIENT - ~ ~ ~~ ~~ ~ ~~~ <br />:. ~ ~ "~ <br /> SAMPLE <br /> MEASUREMENT <br /> ~~~.: PERMIT ~ .. <br />.. .. .~ . .. <br />.- :~. ~ ~ ~ '. <br /> REQUIREMENT . <br /> SAMPLE <br /> MEASUREMENT ~'~ <br /> PERMIT ~ ~ - ~ ~ r 'f - <br />- ~ - <br /> .REQUIREMENT ~ ~ ~ - ~ ~ ~ <br />. <br /> SAMPLE <br /> MEASUREMENT <br /> ~~ PERMIT' . <br />~ ~ <br /> 'REQUIREMENT: <br />. . <br />.. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ - <br /> REQUIREMENT ~ ~ ~ . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ .~ ~ ~ . <br /> ~REQUIRENIENT ~ ~ ~ ~ ~ ~ ~ ' <br />NAME/TITLE PRINCIPAL EXEC NE OFFICER I CERTIFY UNDER PENN.TY OF LAW TNAT 1 HAVE PERSONALLY EXAMINED AND <br />AM FAMILIM WITH THE INFOgMATION SUBMITTED HEREIN <br />MD BASED <br />- <br />TELEPHONE <br />DATE <br />/ <br />J7- <br />~P {I V <br />-~ : <br />ON <br />MY INQUIRY OF THOSE INDIVIDUN.S IMMEDIATELY RESPONSIBLE FOq <br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS ~ <br />` <br />r ~ <br />' <br /> <br />/ TRVE, ACQUMTE MD COMPLETE. I AM AWME TNAT THERE ME <br />SIOMINCANT PENALTIES FOq SUBMITTING FALSE INFOgMATION, INCLUDING <br />THE POSSIBILITY OF FNE MD IMPRISONMENT. SEE 18 U.S.C. f 1001 MD 9S <br />t -~N`. ~ / ~Ly <br />~ <br />~ ~ 7 <br />BIONATUpE OF PRINCIPAL E <br />(ECUTNE <br />~ ~-y1h <br />~~ <br />,3/ <br /> U.S.C. E t3 <br />e. lAVeMes I.rW.r eew mlena nvr NcN.le fee. w ro JrD,OOD j <br />/ gREA <br />TYPED OR PRINTED .ne a~nesinl.n inprlerVrrTt a/Nlween e.lbnm. ere6 yeenl OFFICER OR AUTHORIZED AOENT CODE HUMBER YEAR MO DAY <br />r' <br />1j <br />1~ <br />/ <br />GUMMI:rY I S ANU GAYLANA I I VN Vh ANT V IULA 1 I V NJ IrtBIBIIODe e// eRepIO1BO (3 Aere/ / <br />SETPLEABLE SOLIDS LI7II APPLIES ONLT IP C= LU-YRF 24-NR PRE;.ir i:YdNT 1S CLAIMED.F IP CLAZtl APP ROY ED BI ,`~, <br />~`I:.D, 'ISS E IRON LI~ItS PILL NOT BE APPLIED !O REpORIEU !IF.ASUHEMENT5--5 E I.B.lA PG-5 AND I.B.1D PG 6. <br />h n 20"-T"108= 1 PreOi'due'editio a bd'd's E. ` e (REPLACES EPA FORM T40 WMICN MAY NOT BE USED.1 0 3 36 / 97 0 B 14-15 3 5 PAGE 2 F <br />{?~ <br />~f <br />