PERMfrIEE HAMFIADDRE55 parr+F.eNgN~/t«.na. ynb...v)
<br />NAME `iG4;,l:A CO'.L Cur,FhF.Y
<br />ADDRESS P. U. Lt O X G ~I U
<br />NAYf~Ph UG d16t9
<br />NATIONAL POLLVTANT DISCNMOF RIMINATON IYSTW //NPDESI
<br />DISCHARGE MONITORING REPORT ~DA4R1
<br />_~:~
<br />C-re' U n A ~`,JI~r JC)
<br />PERMIT NUMBER ' `blsc AgDE NuMeLR - F I fl A L
<br />e
<br />nG .,
<br />MQ ~ INGPERICID Ir1JG11AtlbL 7u LnAD/urt1 ~r.~::.r.
<br />FAaLnr
<br />. Y. 'MO YEAR MO DAY -
<br />LOGTIONHAY:~~y CO HI b3U FROM ~ ./
<br />~ ~::.::..:
<br />:: TO i1 3 !y# ~U2 $CiIARC: ~
<br />.
<br />__
<br />A !' I ':: :, 'r. ~: G ; R I 'C :::i E N , G `. t~ E k A L N A 4 A G E H - - ~ ~'n " ~~Ad krtmctlofr bda~ eompltllnp thb IOrm.
<br />PARAMETER QUANTITY OR LOADIN _
<br />Quality or Conce
<br />~i on NO, , arEOUENCr SAMPLE
<br />
<br />y of
<br /> p ~ µY49 TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br />.iiL Ati) ik'.A `i^. SAMPLE 3+k rk«Rt :t ~ y~j~ ,.:•s"::k'~ ++~Y:'4'r :., S`+~## ~ ~
<br />'/ .
<br />~
<br />7 I ~' I A L MEASUREMENT
<br />' ' '.c.. _- ~ 7O v
<br />ti40ob U 1 ~::::PERMIT>::::-:i :.:~.p'rast#}171 ~:~ :::.,. .
<br />-
<br />.•:
<br />TI~~7` ._
<br />5 1
<br />~~ ~ ..
<br />~ ~~ 31'll3p:!? :. :iv:.y.::#-7::~;. ~ :~:7k'O<.10!30:
<br />:'.eL~
<br />l,~ # ~~8~~/ 3U~at
<br />~Z
<br />F. F M' L U E ti T G'.0'' S 'J A t
<br />
<br />
<br />r ., :REQUIREMENT. ":.::: ~ ~;~: ~~~.'~: ~~ . ~ ~ . :
<br />:.
<br />~: - •,.:::~::... ` .:
<br />I?.~...HA. . c
<br />NO D tt ~ ...Vacw~:.~a;..'
<br />
<br />
<br />~.. .; : . ~ ~ .
<br />,.
<br />'~~ 4# ##
<br />
<br />,; :.
<br />::~ ?I ' ' T y .
<br /> SAMPLE
<br /> MEASUREMENT r'
<br /> '....:PERMIT :.::~ ~ ~
<br />~ :...
<br /> ~REGUIREMENT: ,. ~ .~.:.: ~ !: ~ ~: ~ Ibft~i:. .
<br /> SAMPLE
<br />1
<br /> MEASUREMENT .
<br />',.2;: ~~
<br />
<br />.
<br />:{:.:::.PERMIT .: ~.
<br />:
<br />: ~:
<br />~~ ~.:~~.~ ~ .. ~
<br />~
<br />~
<br />~ ~
<br />iii:: ~.: :~~<~x.: ::::~~:;:~.::~:.:~~~~:~.;:..
<br />~
<br /> ..
<br />.....
<br />... ..
<br />..
<br />~REQUIREMEt'1T:~
<br />,. .
<br />.
<br />~: ~~ : ~ ~~:.:.::.~:
<br />~ ~.. ... ~ ~ .
<br />.
<br />~~..:.~ ..
<br />
<br />,. : ,,
<br />;, :.. ~:'
<br />':';:.y::. ~:::;
<br />:,.:;.:4 :. .
<br />::::::..: .:
<br />~; ~..~-:1":::~~ : ..:::::::.:: •'~:~::
<br />
<br />
<br />....:
<br />
<br />
<br />
<br />
<br />~..
<br />
<br />
<br />
<br />
<br />...:.: ...
<br /> SAMPLE
<br /> MEASUREMENT
<br /> '.: ~: ~:~:PERMIT~:.: ..
<br />
<br />~
<br />~ ... .. ....
<br />:..
<br />~
<br />~~ .. ,: ~::::::::: ,:.
<br /> :REQUIREMENT. ~ ~;~
<br />~ ~ ~ ~ ~ ~ ...
<br /> SAMPLE
<br /> MEASUREMENT
<br /> ~;::. PERMIT:': ~::.. .... :... .. :.,.~ ~': ~.: ~: ~::.: ~'..:: ~..:
<br /> `REf1UIREMENT~ ~.~::.. ~~.':.:~:~~ ... ~.
<br /> SAMPLE
<br /> MEASUREMENT
<br /> ::-;':.:PERMIT..: `: ~. :~::.. .. .... ...: .. .,
<br /> `REQUIREMENT.. .. .. ...,~. ~.. ~ ~ ~ .
<br />:...
<br />,:
<br />..
<br /> SAMPLE
<br /> MEASUREMENT
<br /> •.:;.:~::PERMIT:.:.~:: .::.:.:. .. ... .:
<br /> ,REQUIRE7vIENi: :'?.; ~ .. ..:: ~ . ~ .
<br />' '
<br />
<br />
<br />,~
<br />
<br />.. ..
<br />
<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFlCER Inmvr e. pen. qr L. ma un dwrnem .na .u .n.cnrrru rrn
<br />/ TELEPHONE DATE
<br /> prrpu.a uMn mr dn..non orwpnunn m...r1a.„n.un •.nl.m aelLnM .
<br /> m srn In.1 gr.nn.a p.rwrnd p.oprnT F.rn,r,na r.,h,o- In, mr.w.non
<br />,
<br /> wnmllua. e.ra on mr 11pmn .r 1n• canon or plum +M nun.Le tl. q.l.m, '
<br />~
<br /> or mm, pmrw al...nr 1aw~Mr rx nrn.nnL m. rnro:,n.non. mr mre.m.non 1 / \ /
<br />~- .
<br /> wnmluea n, a m, nC11 nr m> L1gwMapr.M wn,4lwr. rnrnle..1M nwplel,.
<br />I,m vm N.1 lnen m apnlaonl prnrltlu ter wDminl
<br />hne Inform,uon /
<br />610NATURE OF -RINCO'AL E%ECUTR/E ~~ '
<br /> q
<br />,
<br />IM ~
<br />TYPED OR PRINTED ualnq ll:e pumLllll>Of Me nd lmpMen~nl fa YlprlnL .lol.ueia OFflCER OR AUTHORIZED AOEM CODE NUMBEif YEAR MO DAY
<br />CVMMGH I5 ANU [AYLAn/.1 can yr nm .1vLn I wno rrur~nnn sn rrrncnm~nra nnu
<br />.:_~ Ia~A LI"1 T5 A'ILL :... ~AIYhL A>:: S~;:TL:.11.LF SGLI./S LL^LT dT'E'LIc~ FJY: ~=iUYR,:'4NE~. PRECIP E4 ENT'; '1'S, G
<br />I:.J~ L1i~i'P_ AATYEJ FU:t >1JYP.,lUNn l::r:Ct: GV!`:i SUNJi'CT 1'0 cUi•:DEh OF PHCOF Itc I..4.2. OIL 6 G86A~L-5.:.
<br />EP'A'FoJl.i Y,iYO.1 (R'~S'3/99j fe5io5's itions may ~e usedi ~ J ~ UOIr 5 ~ / OTlh;3~slad'L~a~ ~fofm. , PAGE of
<br />
|