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PERMITTEE NAMEIADORESb (InrLd. Frwryx.wlncnlw dDli/i.w0
<br />NAME ~Ikdc i't. ~, 'L'•i:, .., -, ,..
<br />ADDRESS ~~ 4.4 F i' [. i.. ~ ? ..
<br />P.'~. f CIS 1~~7
<br />Ckhi.,
<br />i:J UlU2ri
<br />FACILITY
<br />LOCATION
<br />l.Ttti: a. ;;O7iD!)`, F.f~F.i, F'4F.'S/Gi.'1 C;,3
<br />NATIONAL POLLUTMT DISOHMOE ELIMINATON SYSTEM /NPDESI
<br />DISCHARGE MONITORING REPORT IDMRI
<br />l1-181 17-191
<br />co0~3211s clc w
<br />PERMIT NUMBER DISCHMOE NUMBER'
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM ~ TO
<br />/167!1 177-731 /7I-751 /76-77/ 118-291 13631/
<br />Form Approved.
<br />C 0.n ! I T C F. L K G U L2M~ No. zoaD-oooa
<br />(S U B R ~ w) ADProvellel~p;rag-05-31-98
<br />~ - fINl+i
<br />".INCF
<br />NOTE: Reed InstlVCtians bslors comDlstln0 Nis form.
<br />PARAMETER !3 Grd On/yl QUANTITY OR LOADING /I Grd On/yl QUANTITY OR CONCENTRATION ND, FREQUENCY SAMPLE
<br /> l16-531 lSL81 !38-15 !<8-53 151-811
<br />EX of
<br />MALrsls
<br />TYPE
<br />l37-371 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS re7~ss1 !µ88l l89-70I
<br /> SAMPLE ~ Y'k~~~ fi~Vrf:k'k ~'dfiYl9 ( 12) i
<br /> MEASUREMENT ~ L ~'/ O / '~"'F~~~
<br />'JU4UO 1 0 0 PERMIT?rii: ::':: $#IO:Qt i` '.fKT#ri..#fi ~ rtfi: ('is5.'.' 6e~>h4.1¢ 9,0' ~HKL iNSIT
<br />i FL'J£NT GROSS YALU REQUIREMENT. .' ,. 4LIa'# M1 A'xj4ilt~ '?!1k.X:}'FlUb! °U
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<br />~ , AL SAMPLE tkb G4k# #'71###AI #OOCOL ,L~
<br />~ ( 19) ~
<br />UG P E N D 1: U MEASUREMENT /y- ~ / D jD /A,CAS
<br />JU530 1 0 0 -:eERMI; .
<br />':
<br />: !`.: >S!~# i~?QA+~>•E-.. 33
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<br /> MEASUREMENT <O. / <O. / V fJ (x.9.4
<br />1iU54S 1 r~O' 0 ~ PERMIT :'.: ?t`. .#,L¢$Cz :kaT F+FDt1Ap C-FTIfE:~L ~~ $S~trq~'P'~ ~NCE! i~~'Ai'
<br />cF'FLUi:EiT G~U '_: VALUI .REQUIREMENT t.t~'Y 'CLA .AYE cR2'jY {'1Y nL/L t90ti:x
<br />, ~ ,, SAMPLE ;:: 1: •`..',::k (e .:: ;: ;: ;:{: 17it011{ ( 19)
<br />/
<br />(a s r>s~ MEASUREMENT ~/
<br />O.37 ,/
<br />0.37 ~ !J G.t'/VB
<br />JJ.U4j 1 0 0 ..PERMIT fiC:::#[:M ='s;>uk0'•k t:~Y' SrfiL>CE"• ?,' 7eO RCF'/ !E4t~•
<br />:F"r'LUEnT GRD55 YALU REQUIREMENT ~':=4 ?GCA IIVC; CATTY ~ :y,/L CONTt!
<br />I L a SAMPLE .;~r~'::,= ~~kE::k•'.::: i~OCOr,:y, r,tt#Y:C ( 19)
<br /> MEASUREMENT ///~ ///9 ~//J ~y/9
<br />I)35b1 1 0 .0 PERMIT.... : a q'„IG r,. :,i- »n ALn3~i L4?6 fi.13 .3. (,'.. AffTZN rKAf
<br />iFFL'JE`!T GROSS VALID .REQUIREMENT d^^G " I.K$4 ttAY' N.G/L `GEt+T
<br />R, J SAMPLE O3) '!L O,:f4 fi': >,0fifi 1t }.'rb
<br />;! HU Td£ATC ENT 2L R N MEASUREMENT p. UU3 p. vV~ U / /+~S1.1~
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<br />)L';.~.; 1 0 0
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<br />F...PORT S:fiO+kd: A.;?AIk+} ~ >pfi Lfir,:i . :>; =k is ~ "EBKLY
<br />1 I'ISTA!
<br />. F'k'L'Jt;tIT GROSS VA LO REQUIREMENT 30iiA AYG GAILY !17t ESGL - fif`~:#
<br />v ., a • SAMPLE 'F a+:~ : r;::A QI ( I ) /
<br />J i ~:, J L Y E D MEASUREMENT /080 /s.'d0 O v 4.Civ~'
<br />7U25`. 1 0 0 PERMIT •^ •:..,:,- ~'~':' ~. #9 s C. JVL TO T TRL ',HA13
<br />i.rFLJE:V'f GROSS.VAL'J REQUIREMENT qt4+ri CF.TE AYG LAII'.t4Y F1,/L
<br />ED oN TELEPHONE
<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER AM
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<br />SUeMITfED HEREIN
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<br />MI FORMATION
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<br />MV INQUIRY OF THOSE INDIVIDUALS IMM WIATELV RESPONSIBLE FOR
<br />I BELIEVE THE SUBMITTED INFORMATION IS `
<br />THE INFORMATION
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<br />4601
<br />98 7
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<br />W. Gordon Peters OBTNNING
<br />T 27
<br />HERE ME
<br />TRUE, ACCUMTE MD COMRETE. 1 AM AWME THAT
<br />President /Geaeral iNanager SIONIRCMT PENALTES FOR SUSMITi1N0 FALSE INFDRIAATION, INCLUDING
<br />THE POSSIeIUTY OF RNE MD IMPRISONMENT. SEE to U.S.C. / 1001 MD J]
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<br />snl or msai.xnr hk+baln:.':f olMrwwn lmendu.,deyAUAI OFFICER OR AUTMORRED AGENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rslsrlnes s// st'TecAments hers/
<br />',S~ ;. TUThL I30:+ LIriIT`~ HILL HE uAIVEJ, A`iG '~ETTLEAUL': S~L[L` LIn17 AFFLI°['~ FCF <=i0Y5,14Hr. Pk"r,CI' ~7`-.PT-
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<br />EPA Form 3320.1 108-961 Previous editions mey bs used. (REPLACES EPA FORM T30 WHICH MAY NOT BE UbED.I r, C ~ !, ~ / q ~ 1211-16'1 f, PAGE :OF
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