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PERMI7TEE NAME/ADDRESS pwri,4 FsWry Nsa/Lorana dDl~arann
<br />NAME n~.'c ~.1hL _':)!L(:',Y
<br />ADDRESS CIA^•~ Y~I'+~
<br />5;:~.5PJA?' 1.F'9it:':~ '.:J J~71
<br />FACILITY
<br />LOCATONGpy„~t: 1.J Ht)J 3'1
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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) FORn Approved.
<br />DISCHARGE MONITORING REPORT (OMRI
<br />l1-161 17-l91
<br />i ~ ,; I/
<br />f / •f i 1 ~ .. OMB,No 204Q-0004:
<br />C_r. I i :. 1
<br /> Approval expires 05-31-98
<br /> -
<br /> PERMIT NUMBER DISCHARGE NUMBER , f ~ I ~- L L
<br /> ~
<br /> MONITORING PERIOD I y'~
<br /> YEAR MO DAV YEAR MO DAY
<br />FROM .,1 III J TO V. ~o .1~ ~'~"~' ' i:r 4l :rllir,' :. Ix I ;, ;: ;:
<br /> nnorl no-om ndncl ,~4~n vgagl Iso-su NOTE: Raed Instructions 6etora compbtln0 this form.
<br /> !3 Grd On/yl QUANTITY OR LOADING /1 GN Ontyl QUANTITY OR CONCENTRATION I,{D• FREQUENCY SAMPLE
<br />PARAMETER !16531 /5L-611 138-161 !4653 15461/
<br />EX DF
<br />TYPE
<br />l3i-371 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 161691 ANALYSIS
<br />/µ5g1 /53701
<br />~'t SAMPLE ;~{: ::":4 ~.. ... ( L7)
<br /> MEASUREMENT
<br />:UUvJ . r' r, PERMIT rS:41.RC ~R?p.rF ti : ,. i,c ,.;:::::. 4.J s'F:KLY ti`:IP'i
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<br />!(i',a5 ;; ~ PERMIT ~ 13•^.•O R~fR nFrF 4~GR rt :, :::r,: G:k i=I 'v :. 4-`..'v`.::< ., 0.5 ! 4,'"F/ ~ ,1411
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<br />13:71 L ~' ,. PERMIT r::~p;:•f; r::.-:<:, Q ' .. pi~3V;:. ~. :e 1•: r nNrl~' '~!r,i
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<br /> SAMPLE
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<br /> SAMPLE
<br /> MEASUREMENT
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<br /> REQUIREMENT
<br />NAME(TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
<br />ANI FAMILIMI NATH THE INFO LAW THAT I HAVE PERSONALLY E%AMINED MID
<br />RMATION SUBMITTED HEREIN; AND EASED ON ~ TELEPHONE DATE
<br />Aic(16Td A. I1Utt G071 MY INQUIRY OF TNOSE INDINDUMS IMMEDIATELY RESPONSIBLE FOR
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<br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMA
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<br />V1C9 PreBShcutt TRUE. ACCUMTE AND COMPLETE. 1 AM AWARE THAT THERE NiE
<br />ITTING FALSE INFORMATION
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<br />SIGNIFICANT PENN.TIES FOR SUBM
<br />THE P055161LITY OF FNE AND IMPRISONMENT. SEE 18 U.S.C. 1 1001 AND ]] BIONATURE OF PRINCIPAL EXECUTIVE
<br /> U.S.C. f t 310. IAa,W~tlaa I.wr bra. mnma may McNda rnaa ,pro 6IO,OOD AREA
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<br />TYPED OR PRINTED
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<br />OFFICER OR AUTHORIZED AGENT
<br />CODE NUMBER
<br />YEAR
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<br />DAV
<br />,COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rs/erence Ell etteehments here/
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