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PERMITTEE NAME/ADDRESS (IM16 Fs1liryNawJ/,aenm dDlQfr.an) NATIONAL POLLUTMT DISCHMGE ELIMINATON SYBTEM /NPDES) <br />NAME .. _ DISCHARGE MONTTORINO REPORT IOMRI <br />:ASiS:i,. ~~-;~ _., ~Z;,'!~ T. ;, ', 1-161 17-I91 <br />ADDRESS t.A,£ T S I D C 3 i `. •. '-', r u c n nT a r I <br />P . U • H ~ $ / 71 ~1 ] 7 PERMIT NUMBER DISCHMGE NUMBER <br />SAN ANT~Y'_~ P:: 7J?1'1-17JJ MONITORING PERIOD <br />FACam .z]ASTSID:: ~'14L ~7'4rA:VY, LNG. <br />LOCATION YEAR MO DAY YEAR MO DAY <br />SIL2 C3 91552 FROM ,7 .) 01 OI TD .,J L_i it <br />:T^.: S?PPHF.y '~ L?_ 'cu~~.,a-i.!_Ql'Y w'aro ai. !'r%%i%--~ / l~rxvn Ivvoxl vs~wl l~le~n law-om canau <br />Form Approved. <br />OMB 0.2040-0004 <br />E:DI F',:ND 1 T'l !!A~v~l al FP <br />(:~ U "r 9 e C) Approvei zp3 4 S 6.31-98 <br />- F:.V AL <br />"LhOft <br />.~NOTEi Reed Instructions before ComolaUna this form. <br />PARAMETER l~' ~ <br />~ l3 rld Onlyl':f Q ANTITY OR LOADING /1 Card OnlYl QUANTITY OR CONCENTRATION ND FREDUENCY SAMPLE <br />37 <br />3Z i !4653 /5461 138-451 !4653 /54611 DF <br />l <br />- <br />1 EX <br />MALYAB TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS IeZ-e]1 /54681 /89-70/ <br />P,J SAMPLE #:ti a#aa a~': 5'•y iF ~:# <br />( 12) <br /> MEASUREMENT <br />DU!FU3 1 D U .PERMIT a#; :a~ 3a#..a #'.~# <br />5• ~ <br />#raC ;c <br />9. t~ <br />f E1a(I.Y <br />C'a5I29 <br />::FYLUi 1: ~RJSS VAL112 <br />~ REQUIREMENT #tam Y7 Ta1i A N!av ~Y M c <br />:iJLID`Jr <br />ii:TTLE°A3LE SAMPLE ttra:2Rr C#asm# Cri,'•##;< i•'-# ## ( 25) <br /> MEASUREMENT <br />UU545 1 U D PERMIT <br />M R91.St',Ka . #G#G,T.'2 R ##G 4#tra:•# ~:'.tt=~ Ys. D•5 iNCF/ ;BAD <br />: <br />FYLUCwi ;H]SS V4LUF REQUIRE <br />ENT , <br />. 0 <br />~ „ <br />Mr T <br />Y u <br />.:IL AND :,dEA7E SAMPLE ,,;:oar;; ~-:aaa# ,-...,., a;:--: <br />' ( 19 <br /> <br />MEASUREMENT ) <br />U3iD2 1 0 D <br />- PERMIT ;a#axa #:#,aaa ; *.:~y aaiF#;F :: .`~;=i..~ j,p :]HTIN i' <br />3A9 <br />FFLJEMT GRJ`:3 J.4LJ 'REQUIREMENT. :='xra .. <br />.a T Y M V' <br />yr• <br />n L. - <br />FLJw IN C~~NCI/i; DR SAMPLE-a1 n <br />i iia•i THEATlI'ENT ELF-y MEASUREMENT e <br />~GDbL` 1 O D PERMIT" <br /> <br />N ]pTIjNA <br />~.`. : <br />~ ,iFP0H1' <br />... ~'#t=a#;: ##;,r # 2R:>r.#~S~ • ~,':;,; YE'r <br />LY K5rAi1 <br />.;Fc`LUENT Gfl75$ YAL:f REQUIREME <br />T ;)D #'. lY :~ :.1 T 4 rn :~:;::~:::: . <br />S;ILIDS, TJPAL" SAMPLE y~2xya .~;Y2Y;c ~rr,r;- . <br />'-.p '-~' <br />G) <br />~ ~ <br />UI.iS OLV ED MEASUREMENT _ <br />7CLi5 1 D 7 PERMIT. <br />E ##:#;~~ ..^-G9--`,a ; #~:~ as::,#:; Y+>k.~:! :: Ftf.'POHT I '4:?L° 'RAD <br />~Ff LU EN'P GR]SS 7A U; 'REQUIREM <br />NT -~ ~ #y#r ~~~arTV My •I- T <br />:JiL AND -i FtEAS.B SAMPLE - a: a'~xx ( 94) +r#iF t:# ##$ #a ###4'#:c <br />VISUAL MEASUREMENT <br />;;lFl)bb 1 0 D z PERMIT.- <br />Q <br />E <br />~R :xc.a#a;: REPRR)• ES=1 ~ ~"#+'-:~## a### ;c ~-C:;YO## ! <br />~ <br />IY^E/ 'ISUAL <br />'3: PbUEN'P ;R]SS YALUE E <br />UIREM <br />NT ~ INST yAX NO=U ~ <br />+r <br /> <br />~ . } <br />: <br />A ~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT - <br />NAMERITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENN.T\' OF LAW THAT I HAVE PERBONN.LY E%AMINED MD <br />AM FAMILIM WITH THE INFORMATION SUBMITTED HEREIN <br />MD B TELEPHONE DATE <br />~ll ~ J <br />~/ ; <br />ARED ON <br />U <br />R <br />DIIn <br />E <br />G(//~~ L4/:• <br />~'~-~, OBTNN X <br />G <br />THE NFOIU/ATION <br />BELIEVE THE <br />SUBMITTED INFORMATEON~B <br /> TRUE. ACCUMTE MD COMPLETE. I AM AWME THAT THERE ME <br />BIGNIFICMT PENN.TIES FOR BUBMITTING FN.BE INFORMATION <br />INCLUDING <br />~i <br /> <br />~IY /X. G~ O~Q% oJ~Y~+ , <br />THE POSLBILITY OF RNE MD IMPRISONMFNT. BEE 1B U.S.C. E 1001 MD ]] <br />l <br />U <br /> <br />BIONATURE OF PRI 7~ <br />c,..~D ~~ lI <br />~TjO ^~~ <br />ULJ <br />lX~.. <br />/4, <br />_ .B.C. E 1 ]te. lli.rle <br />r uMrr IMAI rYfuM1r m.Y NrcMW l:w. K ro t IO,ODO NCIPAL EXECUTIVE AREA <br />TYPED OR PRINTED endwmuirvn inPrl•wnwrt arbMwn envrdx •M6yra1 OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />MVIYITCI.IJ I,n/C/~r LI,nI, 11V1. Vr lam.\. •.~~~::v,.vl/.v. o. v..:-. o.. s.~sG//I/IO/IN II./V/ <br />t.3h:I'LEAdL~ 57LIJS ..I"I' d=.: 'J~;; F].R LJ-f'!r 111-'tR PR%':IP 47~Si .iU_:JiCi iJ flURDi::I JF ?i'f?7F cc'rIIF"'I^~,T; T.I <br />P41:: i.Lt.1.D, ?~. S. ~TOi:i gA1f.~ti `i4 FA7E°$NL PLAK DOE 1-1-7d. <br />;EPA Flxm 3320-1 108-961 Previous editions mey be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.1 PAGE OF <br />~Z71./97091U-1.Sli 1 <br />I <br />s~ <br />