Laserfiche WebLink
PeRMIrreE Hwsselwo Dw[s! /Include <br />Fieiliry NlmE/LBelrbn ifd/fferenrJ <br />MAM[_.:a Fn7= Yi n:__.L. i i`~:, t, CU_tF. __ <br />wooR-t[1livtc, L1~_:,-_ u'~lli_ tCAt1A.V ?li__ <br />~~ ---- <br />___LhGLG bL70Ll ______ C~ ~1,i77 _ <br />~wcILITY________ _____ ____ <br />LocwTloM _____ <br />N ATIONAL .OLLV T,LNT DIICNI.RG[ ELIMINATION IYSTCM I/VTDE.S. <br />DISCHARGE MONITORING REPORT /DMRI <br />2 16 1719 <br />CG.;~2715u GJ3 ,: <br />PERMIT NUM"!R olsc.w RC[Nwlu <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAV <br />FROM ~ VJ Vi TO ~ ~-. VL <br />nanl nzTtl TTe. xI ne. nl nx±al , a lr <br />'' ' " Form Approved. <br />~ ~~ ~' •~ ~ ~+") OMB'No.$040-0004. <br />f' - k i :~ d L Approval expires 6-30-91. <br />17I~_ 1, .li'lt' :J 'LU 6~C:1 ':L „lu. <br />.. Nu L.SCN".(t,E I~I ~ . <br />NOTE: Reed instructions before eomDletina this form. <br /> (3 Card Only) QUANTITY OR LOADING (1 Card Only) QUALITY OR CONCENTRATION FREOUEy q <br />SAMPLE <br />PARAMETER (16J3) (]Ifil) (39x7) (16J3) (Nfil) NO. <br />E% OFI TYPE <br /> <br />(37-37) AN/rLY I <br />9 <br />/ <br /> AVERAGE MA%IMUM UNIT6 MINIMUM AVERAGE MA%IM UNITS 6163) r <br />I (M19'70) <br />,JNVUC1 iYlTY 6AMPLE Y[::[e}Y rq;: .4 y~;11,: ~:¢ ~ ) :;:Ix;: ,:Ir ~ 11' J ` <br /> <br />MEA6UREMENT <br />55( <br />5G <br />39~ <br />7 <br />1 <br />O / <br />nn.. <br />y [~/A~ <br />J <br />. z~4 1 L l ~ " <br />R <br />°' ~ $ °io~~~t[., ,' .xj sg~Y {~,>~<~ :r %P `? «,71:~e~F ,. <br />..<~ x'~~, ~ lx~ ~~`Z <br />i <br />' 21. <br />q <br />~./ ~+~~+g~'~°~t` '1~2,~> <br />3~''S <br />. <br />Y GNO~L '/ <br />rt'LU~ <br />L <br />: PE <br />M Yt <br />, <br />RE°4DIfleMert; 's ° <br />` G+ki;x: <br />^` <br />9 s <br />°uy qqpp ~° <br />°nkj{ <br />~ <br />( <br />~ <br />F <br />~ q <br />. <br />~ <br />~'$, ~ <br />~81 <br />° <br />R <br />I CL1 <br />' a <br />° a <br />_ <br />U <br />. <br />d ° <br />~ n , <br />,' • <br />g <br /># , <br />( <br />„T <br />9ce <br />` <br />3 <br />Y. ~ i <br />sba <br />~` fv <br />r J <br />.( SAMPLE R~i ~ .:: r ii'I LN ~i#,f ~ ~ Q <br />U/C .'S X. Yi ~i~ ~ o Q ~ 12~ <br /> MEAfiUREM ENT O/ (O U G~Ag <br /> 3C.. <br /> <br />L+ ~ <br />..} ~'~ i <br />~~ <br />' «` ~Pttai%~iT." ~ ° <br />:,L?'~~ <br />~'~a `' <br />;~:*:#Z[Wu~'1Er <br />` <br />#is i' <br />~ qm '. <br />'..'.: `'..:, <br />;r'~' <br />'m?. sea <br />~" <br />;+" <br />e" ~~, <br />': ° `.': °,- <br />4:i;J° <br />a!`.. 'E~~~ <br />~.1; ~7RS <br /> <br />' <br />l <br />' <br />' jREGUfREM~IiT <br />E > <br />•~ : <br />. s, . <br />' <br />' <br />;<a>r~ , <br />;~~t`J <br />~ <br />1 <br />'1'; :;~ <br />. <br />•fi'; as. „ <br />.` <br />`Y <br />p' <br />9~~41~QG' <br />SU <br />~r, <br />d , <br />~JEhT .;h <br />]:]5 4L <br />t <br />r , <br />V ~ <br />, . c <br />:1 <br />t <br />~ <br />~ J,< , <br />, <br />~ , <br />, <br />~LILIiJ~, lll'])lL 6AMPLE :14t~%}~~F vylJle~'+i ~ ? ;iliY##i:4 <br />~ <br />~/ ~ 19) <br />N <br />N~ <br />]Jjl'[, tiLLU MEA6UREMENT A. / <br />`~ O A <br />. t~]>J (J (. L Y."'P3ERMITs <br />g •~~~F ~.'>Y: ~R•° e'ArtY~(°J;~`i~~r `~! ##A~ A <br />"E'h~^f~~`~~..,e °~>~°~~ <br />©P~lip 4 <br />it^'.8l"~ <br />4f fi <br />f~,~ <br />a`'A` p <br />~~~F, <br />' D~a <br />'gr ,t6• <br /> REOU IREM ENT ` <br />a ~~ ~;; . <br />CiB <br />' <br />~°ii a <br />, <br />, <br />~~' <br />' <br />" <br />~' <br />` <br />L <br />' y <br />ce <br />~ <br />~s <br />'t <br />tl <br />..E l;Ulresr:IT~ i.GM <br />u <br />a <br />° <br />' ° <br />° <br />~ t <br />~ <br />:PF <br />~ .k3 <br />~ <br />' <br />~~, <br />1F hL <br />/ = t <br />. <br />l <br />:JLi Jam, TI:TAL 6AMPLE r,. T;.-.1i=rF <br />, 3«4: :::} { ) =r +'f Ai {: is ,'.-' l`. -_ ~ <br />( <br />~p <br />y ~~~ ( It') / ~~p <br />,JAL INLtU MEASUREMENT .`EF <br />K/ D <br />]J 1 ~ L <br />AJ:) as ^RER!!IT '.. <,~~K=a'E'~t~ea 'iy <~~ <br />,»~`;''d'~~~+ :~},: >`y.`F~,~~` '.~.'Pa `>.;°~~m `~'ti °iin'°s.s ,'" ° ..` ~ ~~ 't(a~~•. <br />, <br />- <br />` <br />' <br />' ' RE4UIRCM'EN , <br />° <br />+ <br />~ <br />i <br />-~Y <br />~ <br />; <br />' <br />~ <br />` , <br />~; <br />$ <br />° <br />S <br />~ <br />= <br />~ <br />1 <br />7 <br />± <br />^ <br />Y <br />LUS~29i ,iCiG~i7 ] <br />r+.1,~ <br />~F <br />I' tl~ <br />°~ ~ Y~ <br />=4 9 3 <br />,$' <br />~ <br />3 <br />b <br />i <br />r IS <br />.t7 <br />.1 <br />~ <br />7E i <br />;(:/i. . ~1 <br />"1 <br />: <br />- p <br /> <br />--ii-~li 7, .. L'L'T LL..~L: <br />BAMPLE <br />~i:::t:.::ii: <br />iY'-F~4' ',F <br />t ~ <br />:l i+%: I3 fj': ` <br />1 ( <br />~ <br />~ ~ <br />L / <br />\ 1~~~ /~ , <br />` <br />'V/ <br />t~1 <br />e <br />/ <br /> <br />MEASUREMENT 1V I~ /1 <br />, <br />E U ~A <br />I"~ <br />1" <br />/\ <br />)-]': ~~ U l " rgERMIT `' :..n rh°; °^ .p <br />gr <br />.'.~~ik~ ~ W <br />x "~ ~~M;~I'`% ' ° °~~~~~~ <br />' 1d ix~h ° s a °. <br />' <br />w9 .. p <br />~ <br />< <br />' <br />. <br />' <br />' <br />- s <br />R'Httu IREM 8t1T, ~ <br />' ¢ 9 ° °., <br />~ <br />~ <br />$ <br />) <br />°°1 <br />'` a <br />~ <br />~J <br />~~£ <br />;~ <br />Y <br />~ <br />" <br />'~ # ° <br />3 <br />P t <br /><' <br />Q <br />ITS .Li, <br />A <br />L.JI'It <br />,. f< <br />' <br />s <br />q <br />-, „ • <br />$91 <br />11E <br />, <br />!, <br />i < <br />. <br />. <br />s <br />X <br />' <br />~ <br />> 9L/L "9>~ <br />~Tt <br />: <br />-]i.1U~, ~~TTLi=::Li SAMPLE v~•+'%i:~ ~i::~:<< <br />: ) <br />~ ~u~~~ ICO <br />~ ~ <br />0 <br />' (~5) I <br />/ ~~//JJ <br /> MEAfiUREM ENT / . <br />~ O 3I 7'iO <br />~ Y <br /> K <br />115 U V <br />J ': PCRMI <br />T•; ~A+,%.Y{x5'-s~ <br />~ x°~~+~3R~~T »- Il y:.. .X A. <br />~°S4 i <br />YAeP~ trt <br />°s~~~~~'t" N,G y,e <br />IX"1 as <br />txd <br />~°4 ~~s ~~( <br />Ta <br />~ <br />' <br />' , <br />~Eastlacla EHT , <br />I ~; <br />,, <br />, , <br />tL <br />~~ <br />e <br />~ . <br />. <br />~ <br />;'Y ~~~ <br />' <br />• <br />'° <br />~ <br />~# <br />4 r <br />~ , <br />. 2 <br />r <br />LUiNT - USS f .' L - <br />° <br />° y f <br />. <br />~ R h :.x~ <br />x <br />t L <br />i 1 <br />3. <br />~ C.L/L s <br />~i <br />. <br /> <br />,1L A{IU 'r-'...Y:]C <br />6AMPLE <br />~: rs;::x ~::' <br />~::t:ir~i~ / <br />\ ~ <br />O%s;k %}: <br />: <br />~ :. ~`A Ar%r <br />~ tt <br />~ 1 ~] <br />~ / ,1 <br />N <br />;a'.UN LA.i:'-.inAV :.';'i]t MEASUREMENT q p <br />., ~ S a i n • . ; a ~:3?ksG=:~+i~; ° Kr{~~y~~ ~!•;•q Y ~ _:, ,•It~,~%6a ~#m; ° xrc~~li?K; ;; ° " ° `~ ; ~ ~ ' <br />1:i+ ftalf'~` Nt ~,t~'6 " <br />°LJt'. ".~:,3 Y-.LUj, 'RiCW REMEMTa <br /> <br />„ <br />•sxm <br />R <br />iv:f;ly: <br /> <br />& <br />°a.'m , <br />; ~dt,°•s~.'R~~1~gg. <br />M1;/L <br />. <br />'G <br /> <br />e <br />MAME/TITLE PRINCIPAL E%ECUTIVE OFFICER LAw THAT I HAVE PEI50NALLr [[AMINED <br />PENALTY oF <br />I CERTIFY UNDER <br />M FAMILIAR WITH TXE rNFORMATION SUBMITTCD HEREIN AND B,TSED TELEPHONE DATE <br /> AND A <br />ON MY INQUIRY OF THOSE INgVIDUALS IMMEDIATCLY RCSPON$iBLE FOR <br />MG THE INFCNMATIO V <br />I BELICVE THE SUBMITTED MFORMAnON <br />~ <br />~ <br />1 <br />E1 <br />)chard O'.1115 . <br />OHTAIN <br />IS TRUE ACCVRATE AND COMPLETE I AM AWARE iNAi TXERE ARE SIG <br />NIFIUNi PCNALTIES FOR SV BMITTINL FALSE INFpiMA rION INCL VDINL ~ <br />~ <br />E~vircnmenta' f:ian~clel- THE POSSIBILITY OF FINE AND IMPRISONMENT SEE IB VSC 5 IOpI AND <br />]J VSC 1 rJr9 rPrnnlbr. uMrr IArv Nalulr. nrav nrlydr /mrn uY !u ll4Mrr <br />r 61GNATURE OF PRINCIPAL EXECUTIVE (y7~ 870_77) I( ~7 9i' <br /> r <br />l M1.m <br />A <br />mA <br />nnd <br />i <br />rare A A <br />TYPED OR PRINTED . <br />. <br />. <br />.. <br />wn <br />mn <br />a•d•••mo umwl mrprrn..vrrn OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY <br />COMMENT AND E%PLANATION OF ANT vloLAIIVNS Inr/orn.r un L ............... .....r <br />. u~Lli tl l.l.a L1f)l a, r I •J.]! .L .f ~l .1 1 .. ilul.:{LN _ iY1VJ ~i,~JL rLt J I1 ':[L3 L)'li L if ~' aV-li, F. ~r-:In . •..LE V <br />(..:+iii L!rR 5E. is LlI;C~, Ei ln, [vr. diJ ',0 ~., Jt c _.,f tli.lUi-,C:.; `. 'l .iA L.1L ~ l:t L.IJt -'i E.^. fLGT nU'L ,: F/, i-~~ c,. <br />EPA Forh19320=1'(Rssv.9b8) Provlotis ed~llonsinay"bB L9Bd. "" ` "(w E~Lwces e.w'FOwAi' -IO WHICH MAY NOT eE OS[D.1 PAGC OF <br />