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PERMIT'TEE NAME/ADDRESS pkluie Faillry Naine/laemlon ifD ffere.rq <br />NAME y ;.+" C'' '" - - .' >. , _ , - :. :"1? ~ , <br />ADDRESS~Irycr r~,:, -I;n~*I ~ .^v.•4 Pr' <br />. ~ <br />FACILfTY .o~~L~r ~..U~r ^~ 17755 <br />LOCATION <br /> <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM MPDES) <br />DISCHARGE MONITORING REPORT (DMR; <br />R-1s1 fm 91 <br />+,n ~-~-i~cn nn. <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM ~ ~ ^ 7 ° I TO '1' '1 "~ - ^ <br />(30-z11 (us31 (zazsl (zuzrl (zsz91 (36311 <br />Form Approved. <br />T OMB No. 2040-0004 <br />Approval expires OS-31-98 <br /> <br />.'.NOTE: Read lnstruc[ions~betoretompleting this form. <br /> (3 Card Ony) QUANTITY OR LOADING (<CeN Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (48-53) 54-51 3845 46-53 (54-81 EX OF TYPE <br />(~~~ AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />,wars/s <br /> lszml (B4fiB) 6370 <br />~' ' r <br />,. ::F ;C?' ,T.4;'~ 7~11v <br />C". C="-.', l)J.".^y`;f{ <br />SAMPLE <br />MEASUREMENT <br />~: r.. ..^.'k?!`- <br />:hrrn'r <br /> <br />~ ~dV <br />n... ~.,~,... <br />.. {~~,. ~... <br />~ •. Z, <br /> <br />/~ <br />I <br />/~Z <br />0 <br />C <br />1 l: ~ ~ i "? , n ^• PERMIT. - ~firtb~i)it~ }'DI Itl1CTlII~ + "-1 {}Q ~. - ; -'{klbf $' ~-. <br />a <br />~¢#~ " c r- <br />t' '~+~ ~~ <br />~: ° <br />i F • CO 1' .. - r ; rl : t <br />~ [r• REOUIREMF <br />NT -~~ r' ~ , s <br />, Z .. , x <br />r°F~C'^ ;~ATaP 7'1AY SAMPLE 4R ~R x~ O~rtpn ~ Atli^'s~ Cr!`~~t:t ~ T~) /I ~/ / <br />CII ii dI'O1"i4i.?G MEASUREMENT ~d~ I q9 <br />/Z 0/N <br />"LPk~C S p 7 . 3 _ERMIT 4fi#"d~lr ~dldOOlbr`~" rir.a ~ "r <br />tF+'~ ~ <br />' <br />' <br />c,o ,. <br />;''*' CO."' up,: OrL~,/ RI;QU EMENT ' -SCE , <br />„ ~ rl ,.. ,.° <br />;~ <br />*. / r <br />az , _ <br />^v~ * ~,, <br /> SAMPLE <br /> MEASUREMENT <br /> PER ~ . ', `.` , <br /> -REQUIRE ~ " ~s?~ " ~ i~t yl <br /> SAMPLE ~j <br />' MEASUREMENT ~ t~ <br /> PERMIT "" '{* - "~ *tt~~t <br /> REQ~I EME~JT; * - <br /> - <br /> SAMPLE <br /> MEASUREMENT <br /> Y ` PERMIT ~ '*°~i' ~':~ w.'~', xs>t,~k <br /> REQUIREMENT ".:r r <br />, ~ " ~~ . „ ~ <br /> * ,~ <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> REQUIREMENT " <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT "=*~ <br />~ -" <br /> REQUIREMENT " ; <br />NAMERITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSO <br />AM FAMILIAR WffH THE INFORMATION SUBMITTED HERE NALLY E%AMINED AND <br />IN <br />AND BASED <br />N MY TELEPHONE DATE <br /> INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPON : <br />O <br />SIBLE FOR OBTAINING ~~ ~ ~ ~l <br /> <br />~:Ichard ~"~ills <br />THE INFORMATION, I BELIEVE THE SUBMITTED INF <br />ORMATION IS TRUE, / <br />' /~ <br />/ <br />~ <br />/ <br />~wironmentDl 1'~:TBnCr ACCURATE AND COMPLETE. I AM AWARE THAT TH <br />PENALTIES FOR SUBMITTING FALSE INFORMATIO ERE ARE SIGNIFICANT <br />N <br />INCLUDING THE ~.~'~ ,~ ~",,/~J <br />~f .. <br />e~ <br />970-870-?712 rl <br />'v ~ <br />J~ (*C <br />J <br /> , <br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE 18 U.S.C. 41001 AND 33 U.S.C. <br />R SIGNATURE OF PRINCIPAL EXECUTIVE j ~ <br /> <br />TYPED OR PRINTED S 1319. ( <br />Snstt/es untler Urals sr4tuASS mry Inclutls Nnes uP b f10,000 entl a <br />madm~m impnsonmerU Of bsM9sn8monW end5ye9n.) <br />OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />V V MMtrv 1 5 ANU CAYLAIVN I I V rv V h ANT V I V W I I V rvJ (nBTe/anCe all aTRTCnmBnfS ^ereJ <br />$.,. I. 9,1 r'J' prr~~ ~~. ,... •II ;IDa. ;?L^ 7F f. -+mVaLI'.'Y ^c.^r7f •.r,Ta 4._ v-.-,. r. --. rr ,.n~Um, rrn ?.in.,^~r1*. <br />(`?~., reV i.*T~'~\~- ;, ,, •. ,, ..(„_., 1. ,,, 4~r • <br />LP:T ° "F. * v !* .,•^.r.v -rr.rr. <br />^L { 7 T'H T TC r)T^~- <br />n,. or. rr <br />'r r (-n..+ o..r <br />EPA Form'h3~2o-1 (OR-95)`~ Previous edi8ons may riot be used. " ' (REPLACES EPA FORM 7-40 WHICH MAY NO7 9E USED.) - ~ ~' ' - '~ ~~ ' ~ r ~ ~ PAGES " ~' OF <br /> <br /> <br />