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PERMIITEE NAMEIADDRE55 pebi Fsi4ryN~/lxnrraw yD~....q <br />NAME 3;.:~cCA CDiL ~').~1';.\'( <br />ADDRESS P• 0• h J A 4/ 9 <br />HdYDr:F L;; ~~lE~~'I <br />FAafm <br />LOGTtoNr.a'L7d.'. CL ~loS~ <br />NATIDMK PDLLVfMT DISCNMOE ELMINATION SY9TEM NPDESI <br />DISCHARGE MONITORING REPORT (D R1 <br />CCOJUC72~; (li0 .I <br />PERMIT NUMBER DISCXMDE MUMlER <br />MONITORING PERIOD <br />YEAR MO .DAY''~~. YEAR MO DAY <br />FROM IJl U1 ~'~' ~TO UI. VJ tl <br />(S:/9R JC) <br />- F'IhAL ~U 'I <br />~E:>. PONJ USCHG TO GnA:;SY ChKL~ <br />NOTE: R~Ad imtruetlorr br+fan eomplHhp EhM form. <br /> <br />PARAMETER QUANTITY OR LOADING <br />QUa)ity Or Concentration <br />EX' RIfOUENCY <br />SA <br />M <br />E <br /> KV 'PE <br /> M <br />ma T1 <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />J.LL A4:i G-::~:,=. SAMPLE <br />MEASUREMENT .: Y:#I}:: ``~ <br />J <br />/ ( ?u) $0918## <br />~ 4:Fpirr.~ . . <br />~ <br />` <br />~~ <br />~ <br />C <br />V 1 i;7AL V / ,~ <br />~ <br />71. J , D i u 1 PERMIT <br />.. <br />;~r. «"0'.: <br />.. as }•~:(::'St ~~ ) - 1 <br />F:S- »., .i,, .. <br />S ~.>M:x ..,,: ... ;:. <br />,.,: :,., .3 .'... <br />.........:....~..::;~ ,.-, ; + ~ . ~ <br />.,.,,. <br />(7'i:`ri <br />re FLU~hi .:4Jj5 YnLJ: REQUIREMENT L1i".'? :~.A:• G=U x <br />.. <br />°I" <br /> SAMPLE <br /> MEASUREMENT <br /> ~~~ PERMIT ~ .. <br />.. <br />~ <br />` <br />~ <br />~ <br />~ ' <br /> ~REQUI(iEMENT ~ ~ ~. ~ ~~ <br />_ .: <br />.. <br />•' <br />... <br />.::.. ':; ~ ~ .. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT' :. .. .... .. <br />~ <br />~ <br />~~ .. <br />~~~ <br />~ ~~~ ... <br /> REQUIREMENT ~. ~~....:~ <br />~ <br />~ ~ <br /> SAMPLE , <br /> MEASUREMENT <br /> ~~:~PERMIT ~ :.~ ~ .~. .. .. .s <br />.:. :.:. ::.; :. ~ .. . <br /> REQUIREMENT. ..~ .. .~ .:. ~ ~ . <br /> SAMPLE <br /> MEASUREMENT <br />n <br /> ~~ <br />~ <br /> gEQUIREMENT ~ ..::~:: ~,. ~ ..~ :.: ~ ~~ .: ~ ~ <br />~ ~.~ <br />.~~..~:: >•.~:•:.:~~:. ~ ... <br /> SAMPLE <br /> MEASUREMENT <br /> :' .PERMIT : ~ .: .. ... <br />y.:, <br />.~,.: ..:•,:. <br /> <br />~ .. <br />~ ~~ <br /> REQUIREMENT <br />: .. ~ . <br />. ... ...;`.. .:: ~,: <br />~ . <br /> SAMPLE <br />~ <br /> MEASUREMENT . <br /> PERMIT ~ .. ....... <br />~~ <br />~ <br />,... . <br />~ <br />~ . <br /> REQUIREMENT .~.~~ ~: :: .' ~. .~ <br />~ ~ <br />,:::: <br /> <br />:. <br /> <br />. <br />.. .... <br />~ <br /> <br /> <br /> <br />~ . <br />NAME/i1TLE PRINCIPAL EXECUTNE OFFICER Irtnlry• ..prn.ll..•In.l u <br />prtpnN una•r m/ alr•cll•n •r wp h ea.mem uld .Il .n.dlmenX.•re <br />•rvltlon In waurtl•nrt .Iln . rltr~rl detl,nea TELEPHON E DATE <br /> b .mlrt Inn qu•IInM p<ronnN pwptll prh•r •M ntlune rhr Inform•Ilon <br />~ <br />~ <br /> wbrAllea. nuutl en m, Inqulrl of the Anon or perww whu m•n•Ee IM fNlrm, , ' <br />. <br /> •r lhow prrowalr.enr,awbb4 rw plheanF ln•Inf•nluUon, the lnr•rm•Ilon , <br />VVV(((fff~j~ 9~ ~ / <br /> <br /> <br />wbMnM4lo the bul or ml bn•~4aEl una belbr, W6nttLnl•.•M aemplrlr. <br />I .m...rt Nn inert m tl <br />lanum <br />•ntln <br />ro <br />b <br />im <br />nl <br />mr <br /> <br />~- <br />610NA <br />URE OF MINLD-AL E%ECUTIVE <br /> <br />~ ^ <br /> <br />/ J r <br />~ <br />D~ <br /> p <br />e <br />r w <br />n <br />nE <br />w <br />rmalon. <br />E <br />I T <br />TYPED OR PRINTED MUaInE IM p®IbDlll nrnne.na lmpr+wnmrnl r•.bm.lnE.lol.aona OFFICEq OR AVTHOSIIZEO AGENT CODE NUMBER YEAR MO DAY <br />GOMMEN I5 ANU EAYLANA l lun yr nnr vrv~n I IVNJ l/f1/1/InC1 O// IRlMRIMr! All/) <br />T ~J IRON LIyIi , r+ILL~^, a:11V~v i~`•C' Sr.iiLc'nNL'~ SGLZDS LI"II dPFLI?=L• YJR C=lUY&pk PR6CIF EY7!ii'j '' J. <br />i:r?h LI9['f~ whIYdU f'D >1~YF,1ut:;+ E.'.cCIi' FYENi SUUJk.('T Tu HUkUEN GF F80CP IG. Z•A GIL E GHFASi-te r::. <br />EPA'Foim`YJ20-1 (may' ) ~ <br />3/99 ~ PreSious'edktion's liriay Fie lised~ ~ J ~ ~ This isla~4,P~ rtdOr111 <br />~ ~ <br />~ <br />UUJ9u PAGE ~ <br />of <br />_ , <br />~ <br />~ <br />,p(1 <br />