Laserfiche WebLink
PERMITTEE NAME/ADDRESS R.evO. FmMry N~/lasuen 1/Dr~I.ser1 <br />NAME KEftn COkL COt!PAFY <br />ADDRESS KEHS LU!, D~~IIT <br />P.U. P.u f773Ur,7 <br />S'I@A.:i:JAI' .SPA1!i~.; CG HJ477 <br />FACILITY <br />LOCATION <br />AI'I~: vi'.%hGr' Y, eAT78F.,(/v. :.IN2. t.r~ra. <br />~MATIONILL POLlUTANYbISCHAROE DJMINATN)N SYSIEM /NPDES/ <br />DISCHARGE MONITORING REPORT lOMRI <br />' (7-161 17-191 <br />r_OG950C36 0 A <br />PERMIT NUMBER DISCH/UIGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAV YEAR MO DAV <br />FROM Y 1 U TO 1 S 1 <br />176711 /77-731 /11751 /16171 /18-791 /36311 <br />- -'- -Form Approved. <br />S1aCI POND 20 ILL14~N1~°•?olaq-ogoa <br />(G t1 E P A W) Approval ~ p~r4es.05-31-98 <br />F - FIFAL L <br />C?NCR <br />'7Y'~ t+C CISCHAFGF ~x_~ ;::~. <br />NOTE: Rasd instructlam before eompktinp this lorm. <br />PARAMETER l3 Grd Onlyl QUANTITY OR LOADING I<Grd OnlYl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE <br /> 146531 (545/1 138-051 !0653 154-871 EX O T <br /> <br />137-371 LY515 <br />NIA YPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS (s7-sal (5e-581 15701 <br />i'H SAMPLE #++uf:#~~ #><::#k# t~ R i,T :<# ( T Z) <br /> MEASUREMENT <br />UJVOG 1 G 0 PERMIT #~•fxa.x #>x-fadt #;,r. 6,S Ct#~~# 4..0 EEF.LY ,'NSITU <br />L}'F'LUEN~r C:HO55 YALU REQUIREMENT. . #9#fi 'tINIEfL! [!AY CUl1 $U <br />:iULIDS, Gr.TTLEABLF. SAMPLE #ae$aa :;,#al~a# a#1a1:~a oa~oaaa ( 25) <br /> MEASUREMENT <br />iU~45 1 0 0 ".:`::;'.PERMIT ::: ' ',;D19Qr.OT'Cllp.... ##tf9i+7f7Y:. tr0# P'ili5f+00 AA4A#~ 0'.5. 171C:E1~ '. ; H <br />LFFLUe:NT ;,ROSS YALU :REQUIREMENT ?5>~G CAItl' !!~ RL/L ~lrlrf$:7'H :'i~> s# <br />~Ii AND vilEA:,f: SAMPLE .".#+#+= ~-f##:: CtCCAO OL;Cd'' ( j9) <br />' MEASUREMENT <br />3SdZ 1 0~ '~ PERMIT'' ':v##es+F #,^•#~:;<C . #C^ t'-0~}Av~? OO.a04 ).Q ( 'O:fTIN :FiAB <br />:: E'FLLiEhT GpC155 YALUF ~REQUIREMEPIT ~ .+C ;=a - .GAT iY Y, 7C CG/L SENT <br />'COME IN CONUU I'" Oh SAMPLE ( C3) CC#t.t Y, ~,;OOt~ t'?'~"~~:: <br />(tir.U THF.A1'11cNT PLA.`IT MEASUREMENT <br />;UUSO 1 0 0 .PERMIT JYTICNAL &FPOHT OAn>}t# GdvsS## o#a#z:~ : ,.~:~ Rr_F./ '6STkN <br />~fE'LJENT GAOSS YALUE :REnuIREMEPIT 30 DA AYG pAS.LY tIX '1 GL ~?:~:>~ PtON7ri <br />ULLDSE 'CUTAL SAMPLE r:Y/F#r~°~ #::>ra#~ aaat;t t;0y:.-: ( 79) <br />UL:i~OLY2D MEASUREMENT <br />1u29'~ 1 U U .PERMIT #'en0'fC #z1z<a~~~ #a': ala>anm ca>e;car fi.>F:ORT < TRLY iA'AR <br />tFFLUE:N(' ti;R055 YAI.UF gEQUIREMENT #YC:4 ~~EZY": }1I RG/L <br />./ L AND OXEASE SAMPLE r.%:'%-# ( 94) *.O~C :O SCACAd #lL~A#r <br />I S U A L MEASUREMENT <br />s4Ubb 1 U 0 PERMIT ^#=`%~~' ZzPUi2T Y E i=2 f'#DLA't. 0>;~OS+l. ~ 0'O#~:'## : #':~::- / 'NCR'/ 'I$I/AL <br />'}'FLUENT i:H05S PALO"[ REQUIREMENT INST ;SA1(. NC=U ~ ~::::t ;: !1 /)1.C'r <br /> SAMPLE <br /> MEASUREMENT ' <br /> PERMIT <br /> REQUIREMENT <br />NAMElTITLE PRINCIPAL EXECUTNE OFFlCER I CERnFr uNDm PENALTr of l <br />AM FAMILIµ WITH THE INFO ww THAT I NAVE PERSONALLY ExAMiNED µD <br />RMATION SUBMITTED HEREIN; µD BASED ON - <br />' TELEPHONE DATE <br />n~ L~-~.y.~ <br />tLLCa+dau A <br />• ~EIIII6011 MY INQUIRY OF THOSE IN <br />OBTNNING THE INFORMATION DINDUALS IMMEDIATELY RESPONSIBLE FOR ~ <br />I BELIEVE THE SUBMITTED INFORMATION IS ~ <br />j' I <br />~ / <br />. <br />a TRUE, ACCUMTE µ0 COM , <br />0.EfE. I AM AWAIIE THAT THERE µE . <br />.-~(~,.y/ <br />~ ~jn n 1 <br />- <br />Ylce Prfdderit <br />SIGNIRCANT PENALTIES FOR <br />SUBMITTING FNSE INFORMATION, INCLUDING . <br />~ <br />970 723-4921 <br />DO <br />Ol , <br />1}F <br /> THE POSSIBILITY OF FINE µD I MRBSONMENT. SEE 10 U.S.C. 1 1001 µD 37 / <br />BIONATUIIE OF PRINCIPAL EXECUTIVE <br /> U.S.C. 1 171 e. lAU,YW, uM~r NEr. mmm, mEY MrcF.d, F,rE up ro f 10,000 <br />TYPED OR PRINTED ,M armuim,n YnPrisvr,r,nre/MA,wn smantll„ndb yeera/ OfflCER OR AUTHORIZED AGENT ODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS Ixererenee sn srrscnmsnta ne(el <br />fh`:$T1'LEAtlLE SOLIDS LIHIT t~AIYED FOH 1G-YAE Z4-6R PAECIP EVE YT °CFJECT 1C PURCFN CF PROOF RY'~UIP.E?1fRT--; IN <br />?JdT I. S. 1. D, P. 6. STORl1NATPk 'IAgAGEM°NT PLAN DUE 1-1-9D. <br />EPA Form 3320-1 108-961 Previous editions may be used. (REPLACES EPA FORM T<0 WNICN MAV NOT BE USED.1 C G C I C / 9 7 C 9 2 2 -1 2 2 2 PAGE i OF <br />