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PERMITTEE NAME/ADDRESS 9+drd FrNry N~r/laaua+/Dt~innq NAME Rr.~{_, ^~AL .:J"?k'~Y ADDRESS M A K '' ~1 I v F. ~i~n ?.; ~WIv;; ~J ~U111 FACam LOCATIONi~L.;dF ~~ yQ.{j,) 4, NATIONAL POLLUTMT DISCHMOE ELIMINATON SYSTEM (NPDES) Form Approved. DISCHARGE MONITORING REPORT lOMRI OMB No~ 2040-0Q041; l7-161 17-191 Yu': l~ L/'; '?I'+ ~~~un.•L d.. L. ;' ~ .; .l S 0 03 7 V ~ A (S o f'. !~ ;' ,1) ~ APProvel txpiiy ~ 05-31-98 PERMIT NUMBER DISCHMGE NUMBER r_ c I ~, k L MONITORING PERIOD - ' ' - ' YEAR MO DAV YEAR MO DAV FROM J1 J~ TO ~1 ,:G ~~' '^~ ~ :,i ;l I,9C~(p,^," )%X) r: r: r~ nazn /n-z31 nbz51 /zw1 as-z91 136311 NOTE: Read Instruetions bsfwa comPlstinp thu 1wm. PARAMETER !3 Grd Only! QUANTITY OR LOADING /I Grd Only) QUANTITY OR CONCENTRATION Np. FREQUENCY SAMPLE !46531 !5461 l38~61 14663 /50-611 EX DF TYPE 13Z-371 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS lezs3l MNYSIS !64591 169-701 ''rt SAMPLE : ;: t :"::: .. . ~ .. .... ( ) ) MEASUREMENT IJ'iJU 1 ~ ~ PERMIT ;Ira',::+rs6 r,:r<;xCL re : .. 'i ~ ~ .. .. ~l.ry rr'.KLY S-I. _ '. t' P L U c :r : 'c J ~ ~.". C ~ L :1 .; REQUIREMENT ', '~.:.:: r I .. T V M 4 T n tl .. _ Iv LI Jar i''!fL'.F'-~Lr SAMPLE K''t^C';' ..:P': .... ... ( ~,) MEASUREMENT +1/5US Q C AERMIT `4!kktl L< RIICF'S 4 *.^).• 5: ;: '<L:v.,. ;_+.' ~~t: C ~`:f/ 1~°:' sFPLUE:+T ~G7';5 VALUi: REQUIREMENT :aryi:;: .,gTIy ,.T /L MoNTN :LL AND ;I:!R`. !-. SAMPLE ~:r, rP G~X .::: r,.;r.: ;: ~.... .. .:. . ( tc.) MEASUREMENT )~'~r., i i PERMIT Gs=4hi.`•t 17i..., S .. av;~c:.. .. 1f~ I<^ f_ ~Nftu: ~Af ~.r fLJ~:t+T ~~ 7?'c~ Y 4L'J: REQUIREMENT ':b V J.tI i.Y "V ~'~/L '~FrNP .aF 1'v ~U't. I)UI: 15 SAMPLE ( `1 T) 4~~F=. _ r: l::::. r; ;.:;: ,," I~ :i U 7 •~ c. n ~c ^ `:.+ ~ i 1. ~ ti I MEASUREMENT iU )SJ i 0 i PERMIT iF'FID.'[AL 5:?7*.;p vµ.,,q,: ;~ ;;: ;...:^. .. ;:IS :`. ;:.~~ .. :: fiCE/ K":pA/ :': LJr.t.'i .,~J:S UF.L,1~: REQUIREMENT 3-5^1 AYN DAILY `t Y."". "`_;~ ~ ~°-~F !IO.N'TH /I.. AMD .>.'. 1'.F.-. SAMPLE .. :r ;e .F': ( ,.J) :':.... ... .. ....:+ I '~ J A L MEASUREMENT ,H.:b6 1 U ~ PERMIT aae=.a;Ya S1 F.?]P.2 Y F.'=1 ~Y:=C~~-:: ;t>r'a..x ,~Ixc=c:s~ >: :ze:~: { :NEE/ ' IS;1K?.. :F~I.UE1rT li;i)SS YAL'ui; REQUIREMENT YMST HAY M1^=J :xaarF ."".OA"y SAMPLE MEASUREMENT -PERMIT .. ~ ~ ~ .. REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT NAME/TRLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENNTY OF LAW THAT I HAVE PERSONALLY EkAMINED MD AM FAMIUM WITH THE INFORMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE {{.~_~.~i U A• MU11ROfl I~SC MY INQUIRY OF TNOSE INDINOUNS IMMEDIATELY RESPON9BLE FOR TED INF IS 7 IrpY o.. YLCO cyoGidsnt OBTAINING THE INFORMATION, I BELIEVE THE SUBMIT ORMA 10N TRUE, ACCURATE MD COMPLETE. I AA1 AWME THAT THERE ME BIGNIFICMT PENNIES FOR SUBMITfINO FKSE INFORMATION INCLUDING ~" '~ / I' ~ "/' ~ 97a 723-1~33~ 01 07 09 , THE POSSIBILITY OF NNE MD IMPRISONMENT. SEE 1B U.S.C. f 1001 MD 93 .SIGNATURE OF PIIINdPAL EXECUTNE U.B.C. E 131Y. lhnNOr. udr N.sr morns m.r Y+rA.d. Arwa Iq ro S 10.000 AREA TYPED OR PRINTED .nso.n....inun inpnsmwnt o/Mnrwn6mone1aAM6yrz/ OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO pAY ~ COMMENTS AND E%PLANATION OF ANY VIOLATIONS !Re/erence ell ettschmsnts here! bl~~AUL'• ~:/!.:`3 L1."If .A:YLJ ~D3 :J-YEr :!1-;1R FF,ETIP 'VFf.f -;~LJ6~T ^11YD~:! )f' to•,•.•- f. ':r:_~'v*c re ~+AB~j..~.b.1.D, ~ 5. ?1~:cC43Tt;4 .L41/A~?"Eti* PLA1{ DU3 L-1-~77. ~.r i EPA Fwm 3320.1 108-961 Previous editions mey be used. (REPLACES EPA FORM TAO WHICH MAY NOT BE USED.! ~ Z 7 5 / r/ 7 ~~ N 1 O - 1 .' `. • : PAGE I OF