PERMITTEE NAME/ADDRESS Rry6 irWryNaw/!cc•nm r/orDi.nn)
<br />NAME CY~-`U_ ,.. 1 _., _ - ~__~.
<br />ADDRESS CI I'T'-~ -, , _ ).t 4 P ~,
<br />,~~ f3i'iC LE~'177 C~ .^155
<br />FACILITY
<br />LOCATION
<br />.,,..1. •7e r.7?aiS :!. Cc, ,.r LV- -;t. ..,YY
<br />NATIONAL POLLUTMT OISCHMOE ELIMINATION SYSTEM INPDE$l
<br />DISCHARGE MONITORING REPORT (DMRI
<br />Z-161 117-791
<br />"lQ^2~?~! ~^l
<br />PERMIT NUMBER DISCHMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAV
<br />FROM ~ -~ V TO it ,r /I (.
<br />tlnJrl bJ. JTI /JLJSI tl/AJ71 !JB-J9/ 13Q3//
<br />Farm Approved.
<br />u • „ c r, ••..- .~ -..~OMB,No>2040-0004c c
<br />r ApprovalI eXD,ires 06-31-98
<br />- r". " E f
<br />T:
<br />! NOTE: Rsed inetrucUDne belora eompletinp thle form.
<br />PARAMETER 13 Grd OnIYI QUANTITY OR LOADING !4 Grd Onlyl QUANTITY OR CONCENTRATION N0. FREQUENCY SAMPLE
<br /> 146-531 154611 138-451 11653 !54611
<br />EX OF
<br />TYPE
<br />131-371 MALrsIS
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVER
<br />AGE UM
<br />MAXIM UNITS rsJ-ssl !64-681 169-701
<br />i i:J !I, (A jA ~.... ,-O., .:.; .t ,~.. .. r.....r-. d
<br />o
<br />I$ p
<br />~1~a ( 'a) O ~
<br />~
<br />(/ ~KAB
<br />c~) MEASUREMENT ! .
<br />J
<br />11 JIL `J 1 !1 ') PERMIT Y:i't :: 'i'`• .''.H-#,k i,: r'T~ kw.t>.n« 3•ri 'T•() I .vrF/ :aAa
<br />;:FAL[)e:':? '~~U' ; VT.L7: REQUIREMENT ^-R? IDP,A A41' hSTT.T 'T )( F•„/T. N7'p
<br />~L_;i, fY CCLI :1 rlLr r1 Lj SAMPLE ~/ q
<br />~
<br />~'
<br />1 yy~~ {O,
<br />~2
<br />~ ( J3) t;: -':7^ kY,:=•: i,:.. ar t..:~: ~>-:.:~
<br />~
<br />~Q
<br />5/
<br />l'dQU 77, i:.i t'MFIIf PI,S9T MEASUREMENT r
<br />1
<br />1 0
<br />Vr ^ c
<br />~UUSU 1 U D PERMIT n:;[=BRA PTI~"3AL a###n# #c~Y-.#:~ ~aa'-C3 .: #t^ SBKCY 'MST+.'+
<br />..r PL;)Eh?' :s Y;?is V~LUE ~REQUIREMENT 3UD4 ;Vf; I LY MT
<br />D
<br />' .4rD ~ ~'<'kt
<br /> .
<br />.
<br />7LL AHD ;H°ASP. SAMPLE ra: .`•.^•;~,° ( .lq) ._.1: =`•rA ...,.. .-;: Lr: r; ::::~ jj~~
<br />5/
<br />V
<br />L
<br />r
<br /> MEASUREMENT ~ V .3' O ~
<br />~
<br />Y I ;UAL
<br />'i765 ~ O D PERMIT ..F.;c:Y 7 • °5=1 :;.x~....- :x>;"k#r'" c;:.,.t... 4 rv,:Lr ,r^npr
<br />:. r'•'LUEMP SRJSS v4r Uv REQUIREMENT ~ Tid S?' !IAC VO=7 -'°<:
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIT
<br /> REQUIREMENT
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIT '
<br /> REQUIREMENT
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIT
<br /> REQUIREMENT
<br /> SAMPLE
<br /> MEASUREMENT
<br />PERMIT
<br />REQUIREMENT .
<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENILLTY OF
<br />1
<br />E INFO UW THAT I HAVE PERSONALLY EXAMINED MD TELEPHONE
<br />RMATION SUBMITTED HEREIN; MO SHED ON DATE
<br />ti
<br />t;ichard iYtl'I$ AM FAMILIM WITH
<br />N
<br />MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
<br />OBTNNINO THE INFORMATION, I BELIEVE THE SUBMIRED INFORMATION IS -
<br />
<br />lt TRUE, ACCUMTE MD COMRETE. I AM AWME THAT THERE ME
<br />FORMATION
<br />INC
<br />UDING
<br />)7O 870-271J
<br />S
<br />9B
<br />anac~er
<br />Environmental , ,
<br />L
<br />SIGNIFCMT PENAlTlE9 FOR SUBMITTING FALSE IN L 1
<br /> THE POSSIBILITY OF RNE MD IMPRISONMENT. SEE 18 U.S.C. 1 1001 MD 3a SIGNATURE OF PRINCIPAL EXECUTNE
<br /> U.S.C. f tale. IAVWU•. uvr tler •Ynm• rr,rY lAr/W ~ a rp ro r10,000 AREA
<br />TYPED OR PRINTED •nsamvimnr brpianrTr o/GM••n smarN••rM6 vwA/ OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANV VIOLATIONS IRsrerence sn errscnmenrs Here!
<br />;, ;.1 "aVl'Cs L.".TT°, -r)r. r~i5, Tq~V >""'L°4RLE :7LZR^ fLD' '7TH v ,~.~Iv ~= r_~r,r rl_,~ ,~,-.CT' ,:cr^
<br />CT. i,j'!D• 5':, _.. •fE n' T.", FOI: tiJRDr'~ 'JF p?7~° 1°:•):'/LM'° .-~ nr• r -.r 9r _-. r. rr' `I ^/, ' ~•
<br />..?1 V T 1' ^r• ^r4^ rN-Tn~I~rr _r. ~r ,.. n+r ~r _
<br />EPA Form 3320-1 108-961 Previous editions may be used. (REPLACES EPA FORM TaTO WHICH MAY NOT BE USED.1 i IT„~ „ / ~ ~ „ r. _ ., _ , ~. ~ ~ PAGE ~ OF
<br />
|