|
<br />PERMITTEE NAME/AODRESSQwbi£rYyNr./lxmlw r/D~Irwr) NATIDMAI Pa.LUTANT DISCMAgOf EIIMINAilON 4Y8TW //N~ESI
<br />NAME S ;, '.r : l' & C 0 5 L '~ O ": P A F ! ~ DISCHARGE MONITORING REPORT (DA1RI ~ : A J ;r
<br />ADDRESS P•U. HOX oIU. [t„I (~~I ~ ~~'
<br />~ ~SUr.n JC)
<br />NAY . E N C O N 1 6 j `) PERMIT NUMBER ascri.AnaE erOMeER Y- f' i N A L ~t;i ,: ~,
<br />PERIOD ui_'~_nx:,~c -rte nuo:;mn,.t.r. ~.,;,r,~..~:
<br />w MONITORING
<br />.
<br />FACILT'
<br />YEAR MO DAY YEAR MO DAY
<br />LOG710NNFILCr7 l: ii 'iLJ:: FROM U/ TO Y 1G ,:;:~ y0 i,i:,C':Ai;:,:, IX~ ~~`~~'-
<br />A :: h : `: n t. G i, h I T.: ri E Y ~ ~ = N 6 h A L ;i A ?: A G ° R NOTE: Rud Meetruetlopr befor ,, eompl•tM0 Ihb loan.
<br />PARAMETER QUANTITY OR ~ ~
<br />Quality or Concentration NO, FRCOUERCr SAMPLE
<br /> __ .
<br />E Dp
<br /> X ARA<rse TYPE
<br /> AVERAGE MAXIMU ~ ~7)Sf ~ MINIMUM AVERAGE MAXIMUM UNRS
<br />OIL AND ,!•.6A~f~ SAMPLE .; ,. t: ~: :`;e x0444 rtCrt : ;: ;I r.'.-.;:; •. _
<br />VISUAL MEASUREMENT f~
<br />~
<br />H4U60 ] U U ;:::PERMIT:.",. :::rt;ra'e;t~:;: :..:i7I'`$J'~T
<br />~~ ~_
<br />i
<br />' 1 ~
<br />1C#4?1!:
<br />:~~ [:".~4t.~e.tPr'~t:..'.
<br />~ ...:..;:i.:=7K:~:~.: ..~Y 3. NC r~7 ~;_~l:,;
<br />
<br />- I
<br />trFLU~NT JkOSS ~r..•!I .
<br />'REQUIREMENT:
<br />:...:.. .. .. ..: ...
<br />.~'.~:
<br />..
<br />..
<br />... .. .:. ~
<br />2.?ly'f'.;:C:1X
<br />.
<br />'0=~ ;
<br />..
<br />::~
<br />_,
<br />~ t.ui
<br />:
<br />..,
<br />
<br />,;.
<br />~`~
<br />
<br />-.
<br />
<br />li!,;i.i
<br />
<br />
<br />,: .
<br />
<br />.
<br /> SAMPLE
<br /> MEASUREMENT -•~~~ -
<br /> ~::'~:~. PERMIT. ;
<br />'
<br />q
<br />~
<br />~ ~. .}E. .. ... .:
<br />.:.:.......:.'..
<br /> :pEQUIREMENT . ~~
<br />~ ~ ~ ~~
<br />~ ~,
<br />,
<br /> . . .
<br />.. e:::. ~
<br />....u .: .. ;. .. , ....:. .::: .:.:...:....:: .
<br /> SAMPLE
<br /> MEASUREMENT
<br />..
<br /> :::::.
<br />PERMIT...::. ~: ... :... .... .:. -~
<br /> .
<br />~.REQUIREMENT~ ~..~ :..::. ..: ...:.~ :: ~::~ .. ~ .. a~:s ~:fi::
<br />: ~,
<br />
<br />.:
<br /> SAMPLE +• ~ ~ . '
<br /> MEASUREMENT ~ '~
<br /> ~ '
<br />:
<br />'
<br />~
<br />~"
<br /> .REQUIREMENT. :.
<br />'.
<br />... ~... :........ ... ..' ::::
<br />. ~5~:'"":
<br />,
<br />.
<br />`
<br />' <
<br /> .
<br />.
<br />...
<br />.... ::
<br />,.....
<br />.::.
<br />v=:u ::;;: °?
<br />.,
<br />s,
<br />.
<br />. ....:
<br />,., :...:.
<br /> SAMPL E -.
<br />
<br />MEASUREMENT }
<br /> ;:::::.PERMIT :.::: ~ ~. ;; .. ~~~:-.;':::. .....: ~ ..
<br />~ ~ ~
<br /> :f1E¢UIREMENT: : ~.:: ~ ..~: ~ . ; ~..... .: ...
<br />... .~~..
<br />:.. .. .. .. .
<br /> SAMPLE
<br /> MEASUREMENT
<br /> ~~~:~~~PERM17:: ~:~ ~: :: .. ~ ... ..
<br /> REQUIREMENt :
<br />~
<br />~ ,
<br /> . .,. ..
<br />r
<br /> SAMPLE
<br /> MEASUREMENT
<br /> ..
<br />,
<br />~~ ~
<br />°
<br />
<br />:REQUIREMENT
<br />..::.' ~ ~ . .
<br />...-
<br />~
<br />~
<br />..
<br />
<br />^
<br />~ ~
<br />.. ...
<br />-.: :
<br />.
<br />
<br />~~
<br />; I....:..
<br />
<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I rtnlq. •r pn•ge Inw lh•I ln
<br />yreprttl under mp alrtcllon ormp l.dwmem
<br />rm •n nl•cnwrnu .rrt
<br />rvWn In •rteN•me wtlh u
<br />rem drl
<br />md 1
<br />1 %' TELEPHONE DATE
<br /> p
<br />h
<br />le mart Ibl gwlleN pnonntl pmpd~ plher •M rv4•le the Inremmllen
<br />mhmlllra. eda on m~ In9ulr~ N We prnn er pnom whe m•n•he IM arrlrm,
<br /> er Ihoe pools dlrtclll lapldh4 rx i•Iherlnh the Inrornullon, Ih• Inremmllon t
<br />a
<br /> ulhwllled 4 b IM1e Mal eI m~ hnewkdp •M MII•r, Irue. m<wnle, •nd romplel•.
<br />e.m •+•n Iha mrrt.rt tl
<br />mnom
<br />n.me r
<br />e
<br />lm
<br />ne
<br />mr
<br />n
<br />610NATURE OF -
<br />I I '
<br />
<br />TYPED OR PRINTED p
<br />p
<br />er m
<br />m
<br />n~
<br />e
<br />•Iwm
<br />•n.
<br />!mrmllw~IM p®IhIIIIl ornle•Id lmpll•rnmenl ror hno.lnp.lw.doa R
<br />Nq- EXECUTIVE
<br />OFflCER OR AUTHORRED AOEMT
<br />CODE
<br />NUMBER
<br />.YEAR
<br />MO
<br />DAV
<br />.. ,..... ~... _.•...... _.. _. ..... ..__.... ~.... I .......... ... ~............~., .,....
<br />.. _ inJd ..If;i:.. r+ILL i;t: NAIVEC ~ :ic: tL .::+LP: JOLIu~ LI'SI i ,lePLl l:ri ..~:I ~=1. 'l i •ZUN!? i>F.ECip EYEt.T~ :'.:
<br />L.':il LIY.f:_°. r1AIYhD FOk ~lUYri•14Ni( 4;:L'.,;"r cYE!:T ~U!+Jf:T 1'~ cUF~L'; :iF F'i..;t :': :. R.Z. OL1. S 1, #t}.A:.f. - SE
<br />E7A•F61Fn`73'10•I ~' "• - i • . • a • • PACE OF
<br />3/99j ledlods lUOns may used. I) U 17 I / OT~v 351ad4'~•'[$~a~~4{~^ "L
<br />
|