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Fdm APPlo+ed <br />1F11MITTTE NAME/AOORESS RraA l.AyA'Yr~[rrlw yDrfiwr) Mwt1WILL Yo\tuyruYi alCMAlrof nIMIMAr10M >tinlA1 (NPDfSI '~ No 70~0.OOOa <br />NAME ~ - <br />I DISCNAAGE MONITORING] REPORT (OMRI <br />ADORE;S ~ ) <br /> PERMIT NUMBER asCY~Ant NtAYltA _ ; : F. ~~ <br />.. <br /> MONITORING PERIOD 1 r ~ ~ • , I <br />FACam YEAR MO DAY YEAR MO D Y - <br />L~TKK+ FROM TO 1 <br /> NOTE: Rr.ld Irrtructldr ~td• cempMt4p IM! tpm. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO• <br /> <br />E% rntoueMCV <br />Ol SAMP! E <br /> <br />T <br />P <br /> AMNYf! E <br />Y <br /> AVERAGE MA%IMVM UNITS MINIMUM AVERAGE MA xIMVM UNITS <br /> SAMPLE <br />MEASUREMENT <br /> <br />-- <br /> PERMIT - <br />REQUIREMENT ., _ p.3 <br />'' j t. i t! L+ ~ .. n: r : - <br />T. 3~'-! G ,. i ~. .. <br />__.-.__ ______ SAMPLE . <br /> MEASUREMENT <br /> <br /> PERMIT o.•• r c~co:-~- 1. <br />' i ~_'/ <br /> <br />REQUIREMENT <br />.1 iuR S:, <br />JL: LY ><r J <br />.. ... SAMPIC - l <br /> Mf ASUREMENT <br /> PfRMlT ,. - r :n VbO^ n pL•y._.. "~'. .rE~l•q ../ l <br />_ _ REQUIREMENT <br />-- kC LY ' Y <br />~ <br />-- <br /> SAMPLE - ~ ' <br /> MEASUREMENT <br /> PERMIT ,. .,~ ~: ... JD n lr.p GL~ ?. <br /> REQUIREMENT - r .q Y <br />_-. ~ <br />~-- <br />~~~ <br />-' ~ <br />~ SAMPLE .. <br />r ~ <br />. MEASUREMENT <br />-~ <br />-.- <br /> PERMIT _ ~,oa» a - <br /> REQUIREMENT __- _ .__ -__.._-__ <br />.. _J:2U: SAMPLE <br />• ~. MEASUREMENT <br />-__ <br />_ <br /> PERMIT k!CF' -4'"'c~• . <br />q g i REQUIREMENT i tir -. ~ t .., r • ' -' 'i <br />- <br />. <br />• - SAMPLE .__ _ _ - <br /> MEASUREMENT <br />__ <br />' <br />-_ <br /> PERMIT ... .. r . C~S <br />f _ .. ~,~ <br /> REQUIREMENT :~ "'- <br />f PRINCIPAL EXECVTTVE Ofi{CER <br />T <br />NAM <br />T ~ wnl t • • rn t • Y.1?V 9M N..M..Y IwO Y MiKnnMlC.fn TELEPHON E DATE <br />El <br />I <br />I DnMM .wM. nI /Im.Y.n M wpn•.Ye~ N ~eTYvn. .1111. nNYn Ya1~MY <br /> n Inu h.YMA KrwM Ynq.n• pu.. .n1 ..W.Y rY MIMw\IWn <br />n4~e1n.A !~Y rM ~} Wttl~ of M pe.`s w Y.YM vAn K.NF IIY II.YIr. <br /> I <br /> M PMr ,+ewM Jle+•+F ~F.°Y M. <br />w I.II.rAq MI tifr•.vM1ew.IM fn}MKKIM <br /> Y)Y~II~.Y 1\ W I4. De1 M n• \e..1K(..ti NMf 1~. ~.vN....t MI.FYY <br />. <br />Hn.,.l <br />l <br />.uuu.n. <br />wYn <br />M <br />S+ <br />Knn <br />41. <br />I.P <br />. <br />LL~ <br />EIGNA yURE OF MWCIAI IXEp/TNE _ <br />~ ' <br /> F <br />oru <br />n <br />F <br />n <br />W <br />I <br />E <br />r <br />er <br />s. <br />, ~ <br />TYPED OR PRIl/TED ..rraml id y.e.aYlt /n...Ml ..y.re.r.l F„ Un.IK .edYU.s OFFICER 011 AUtFMRIZED AMT COOE_~MDER YEAR MO DAY <br />COMMENTS ANO E%PLANATION OF ANV V10LATIONS lRingncrr wF ratt~c'Ammfs A~rN <br />. . ~ . . _ , <br />EaA Form 3370.1 (Ra. 199) Ple\nou. aeulona my ea YYIE ~ TT119 IS A 9 pdrt, EOfm PAGE _OF <br />