Laserfiche WebLink
PERMnTEE NAME/ADDRESS O.ebi fniMiryNr'Lerwaw VDb..wq <br />NAME 5~,,,~~C~. C'OhL _i)`k'A~:' <br />ADDRESS ~ ~. d. ~ ~: ~. D <br />:+YC: ~. C3 ti163i <br />FAaLm <br />LoaTaNrt,Y,~c:~ Cn ,.,» <br />L rru• a-r r. L,,,,c 1. ~ci~ , <br />NATIONAL PODUTMT OIeCHMOE ELIMINATION SY9TFM ///JPDES) <br />DISCHARGE MONITORING REPORT (OAIRI <br />.-,~nnn~ IL ~~, <br />PERMIT NUMBER ~ .olscNMOE NUrdew <br />MONITORING'PERIOD <br />YEAR .:MO DAY YEAR ~MO DAY <br />FROM QD'~p7 OZ TO OO 09 j0 <br />.~. <br />.. ,~ <br />F - FINAL ;, f;}li <br />DISCHARGE TU SAGE C4i,E^ ~"'~ <br />r+~~. MO DISCHAHG6 ~ ~ °"''0 <br />NOTE: Rud kl[truetlarr Mlae/eomplnhq thb lam. <br />PARAMETER QUANTITY OR LOADING <br />b° <br />' <br />Quality or Concentration NO. fREOUENCr SAMPLE <br /> : <br />, <br />EX of <br />TYPE <br /> MAirse <br /> AVERAGE MAXIMUM UN TS MINIMUM AVERAGE MAXIMUM UNRS <br />~1L dldJ G(LAS•. SAMPLE ur,,x:::.: ~ ,q) R#4`•;:.tt .. .;: ±.~:r::: .. . <br />Y I S U A. L MEASUREMENT <br /> ~~ : PERMIT ~ ~; ~ ~ ~ ~ ~ ~ <br />~ <br />~ ~ <br />') <br /> <br />rj I <br /> <br />F~:; <br />~~ <br />"~ <br />- <br /> <br />..~ "~;.o ;i:ji: ;~:.:::. <br /> <br />otn +}rt <br /> <br />~ <br /> <br />:NC~:/ - <br /> <br />F:IT' L <br />. , ,. .. r , .- . , <br />_r F..I,r,T ...t,ls, l.:..I REQUIREMENT <br />.. ..... ...: .. <br />~~: <br />.. ~ ,: ....:.. <br />v,:: .eY Fr:.n ^ <br />,~:. <br />y <br />0.~rc,:.. ~y'y:z v:r:,u-'- <br /> SAMPLE ~ Sr~ <br /> MEASUREMENT ~+~ ~ <br /> ~: .PERMIT.: ~ .. ~ <br />~ .. ~ ,... , <br /> .REQUIREMENT . <br />~ <br />_ <br />, <br /> SAMPLE <br /> MEASUREMENT <br /> ' PERMIT. ~ ... :.... .. <br />~ .. <br />: <br />~ <br />~ . ,.. ..... <br />~ : <br />~. <br />. <br />.. <br /> REQUIREMENT .~: <br />~ <br />. ~ <br />. <br />.. ' <br />~~ <br /> .. .. . <br />.. <br /> SAMPLE <br /> MEASUREMENT <br /> :~~." : PERMIT... : ~ ~ <br />~ <br />~~ <br />~ ~ <br />~ <br />~ <br />~ ~ ~ <br />~ ~ .. <br /> REQUIREMENT <br />... ~ <br />~ ~ ~ ~ <br />.. ~ <br />~ <br />. ' <br /> SAMPLE "" <br /> MEASUREMENT <br /> <br />:. <br />.. <br />.. <br /> :REQUIREMENT .... <br />~~. ~: '.' .. <br />.... .. ... ... <br /> SAMPLE <br /> MEASUREMENT <br /> ..~~'PERMIT'. ~. ~' .... ... '. <br />'. .... <br /> REQUIREMENT :. <br />... <br />".. <br /> SAMPLE <br /> MEASUREMENT <br /> :~::'~PERMIT:. ~ ~ <br />' <br />~ ~ ~ <br />~~' ' <br />~ :.... .'~ ~ ~ ' <br /> :REQUIREMENT . ~ ~. . <br />.. ~ . .. <br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER ' °^"> ° `r w""> ° •w ln.r m1. d«vmenl LM .Ir.Urn~nnN wen TELEPHONE DATE <br /> Pnp..N °nd.r rv> alncn°n °r ww..uen I"...<ra.«. wlm n.nvn aa <br />«a <br /> [ <br />m men m.r yn.nn.e P.nenna v~n> nm.r.nd nLlv.o- rM lnronunen <br /> w,emlu.a. enwd °n m> Uq°Iry wm. Prnen «perm wLe rv.ny. a».~u« <br /> er lnu. prtsn dlrta1l>,«pentlLY! [nrLeAn[me lnrsrnuden, ILe lnrornuU°n ~ O ~ 1 ^ <br />' meMUM b. is the Unr °r m> LmwYd[e nrtl Leller. rive, w<vnle, and nmPNN. <br />r.....,. m.r men .n tl[tlnanr <br />n.lna rer nLinNtl <br />r <br />t <br />I <br />r <br />N ~ <br />610NATV1IE OF PRINCR'AL E%ECUTIVE Oe~ ~ ~ <br />U <br /> P <br />n[ <br />. <br />e <br />n <br />ermLl <br />n. <br />r <br />rwl <br />n <br />l Q <br />TYPED OR PRINTED « <br />n[I <br />. poele <br />lllTern«nntllinprlsmnnr rertmwln .IwLU°a <br />[ . OFFICER OR AUTNO <br />ED AGENT CODE NUMBER YEAR MO DAY <br />GVMMCNIS ANV pArLJLN/LlWrv vrnm vrvLn rrVNS lHITI/IOC/MIRIMTI/Irl Atl/F) ~~ <br />°'~` _'47:: ,.S';1TS .ILL `+_ '~.aIV_li ., ,~:'.'SLr:?.''.LE 50L:'; L["i: APPLI:,D !i?n <=1`.IY~/~411N ,"aC_F ~Vf:LT; T.55 b <br />.:~Jit 1.I"1'f' IlAi'Jc5 r"!', `: it iY. f: :. - _ i, c c^~ ~r^ pDpD°i~ U}' Fi;O~P i:d I. X1.1. OIL & Gii:ASP - CiLC. <br />EPA~FormV320-1 ~.~3/99j Previous'editioris Dia}~ lie'u`sed~ ~ This is a 4-part form. PAGE of <br />~ 00063/QUU'!IJ-1o1~ 2 <br />