PERMnTEE NAMEIADDRESS pneri fsWry N~/Ixal., yDleirwr)
<br />NAME Sc~E~.C i1 :. (i ,~L '.. ;J~iEA.':f
<br />ADDRESS (~ . iJ r ::.'.) !I ~ ~/ U
<br />HAYii~'S CO dlt:s:
<br />FAaLm
<br />LOCATRIN H A Y I c !; ~'0 b.„ :..'.
<br />:,Tl'r,: .:.r::G Ri: :tiEp, GENBR !JAl,r:a
<br />PARAMETER
<br />IL RND GhlASc
<br />I~i1A[.
<br />4 UuD 1 U 1
<br />F r'LJ~4YT GHOST
<br />AVERAGE
<br />aaaaaa
<br />:NT
<br />N7
<br />NATIONAL FhILUTANT OISCNMOE EIIMINATON SYBTEM /INPDESI
<br />DISCHARGE MONITORING REPOIIT (DA1R1
<br /> „ I •J i ~ S
<br />n (;;ric JC)
<br />IT NUMBER a;4 a' UM[DR c- F I t/ A L NC ;; T;
<br />t
<br />MON OBiNG PERT • T +~".:,rla[ TO THI6 /FISH Ckr. BR F~;r
<br />,
<br />YEAR MO ...DA~ ''YEAR MO DAY
<br />FROM U ~'
<br />~~ J , - !~~ DISCH6HGt ~__~ #AO
<br />~~ p - NOTE: Rnd InrrWctlo,r Edon eompbtln0 thl[ loan.
<br />TY OR LOADING
<br />Quality or Concentration NO• FREO°ERCr SAMPLE
<br />
<br />EX Op
<br /> ARA1~519 TYPE
<br />MAXIMUM UN MINIMUM. AVERAGE MAXIMUM UNITS
<br /> ( 'fu) aaaagUlr:
<br />I,
<br />ao'}'FO::
<br />.~. ..
<br />.. .:.:< O 1{ ~
<br />Iha 1 /,
<br />V
<br />tl ~)ytlfTc'1':.: $ 5 =1 rs,;vyets.rgiF ":' '•:. lir~y~,px; -' 4!x>X:{c ~ ~::" a c o ': ~.f~ C i J f S II A L
<br />
<br />,p r
<br />
<br />:,: ;.
<br />
<br />,;-
<br />
<br />rata
<br />
<br />~ .:.
<br />
<br />,,y C1 !J.$f!
<br /> SAMPLE -,;:
<br /> MEASUREMENT ~. ,
<br /> ..
<br />.~.PERMIT:~: ~.
<br />~
<br />~
<br />~ .:
<br />'~,:.... ...
<br />: .. J. ~ - ....
<br />...
<br /> :REQUIREMENT ~
<br />~ ~ .
<br />er~d~ I,:: ::.: : :: .
<br /> . . ,[,
<br /> SAMPLE
<br /> MEASUREMENT
<br /> :° ~' ~"PERMIT~ :.~:.. ~
<br />~ . ~::::;:q.:.
<br />' ~~~ :: ~ .~..
<br />~
<br />~+1
<br />.:;: .:':
<br />.:. t
<br />~::: ~.: ~:. ':.: ::. :'::s:.;:^:zll:s..
<br />::i:~.:.:
<br />: ':':!;:
<br />:~i:
<br />:~
<br />~~~
<br /> iREUUIREMEN.T: ~.:::. .,...::,.. ::~
<br />:.: .~;:: .. . .
<br />.
<br />:
<br />::
<br />:
<br /> SAMPLE •
<br /> MEASUREMENT
<br />'
<br />. ::.::'PERMIT.... ~ ~ ;.:.~
<br />~. ~:~~:~ :':.,, ,
<br />.;'~~~ ~~ : ~~ ~' .•::~ ~ . ~~:~::. .:. ~`:'.~;:.~~~:.;.:: ~;;:~'.:;-:::
<br /> .
<br />'
<br />REQUIREMENT
<br />
<br />~ :
<br />.:: '.::
<br />~ ::::;
<br />~
<br />:'L~. .:
<br />:
<br />va
<br />"`~
<br />::
<br />..:I ....
<br />..
<br />~ .:
<br />~
<br />~:...:::'.I::......':.'i'
<br />:a:;:.:.
<br />:::~'1.~:.:.: i.'i:::.::.. ...'.
<br />
<br />'
<br /> : ..... ..
<br />.
<br />.: .
<br /> SAMPLE
<br /> MEASUREMENT
<br /> :::.::: PERMIT~i ;:.: ~: ~ .~ '. ~~: .~~:: ~~:r`. "F.3 ~. .,,i:r;@z.;:!:'; .:. ~:':.. ;~:~ ~
<br />•
<br />,. ";:IZ3,`f~3::`~:`:;~':.:;;a:":::
<br /> :NED.UIRENIENT~ ~.:..
<br />.. .. ..:.. ..: ...
<br />
<br />.
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERM ......: ..... ..:.::~:: .r
<br />
<br />SAMPLE
<br />
<br /> :: <HEOUIREMENT~: .:::.:~~:~. ~~.~~~:'. :.~::: .. ~.:~;•:: .:.. .:. ,..::. .~ ~. .
<br /> S, ~,~ ~
<br /> NAME/i1TLE PRINCIPAL EXECUTNE OFFlCER Ireniryu erwn,I)e I„mrl u D aarvmem,m,u nl,tnmenU.rn TELEPHONE DATE
<br /> pnp.M UNrr mr al,«nen er,uw r.faenm.rr„a.~...un.q,lrm edDnre
<br />
<br />to sun ma yunmN w„enmr pruwAr pmrr .na r.eh,le me mromn.ngn
<br />wDmllled. [sa en mr Inquiry of Ne w,en M p<,~e who mrnr[e Ilw,],I,m, ~ ~' DC~
<br /> u IDa,r wmm alncnr rvw~NDk fa [nnerln[ Ine Infor„uaon, IDe Infwmnlon
<br />
<br />aDmlll,a 4 la IDe Den of mr tmwYd[e end bend, Irve.,mnlr..M ranplele.
<br />I .m r.,n ua men.n p[nmom wn.ma ror wbmlmn
<br />ra: mrosm
<br />
<br />610NA~ RE OF MINd-A EXECUTIVE ~ O
<br /> OR PRINTED [
<br />n,
<br />Innuam
<br />Ine
<br />r n
<br />~bllll
<br />a l
<br />M
<br />r
<br />t H
<br /> TYPED [
<br />pa
<br />r o
<br />ne,n
<br />mp
<br />Onmenl
<br />nr
<br />m.Int HWrnold OFFICER OR AUT
<br />OR ED AGENT CODE ,NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRd~r~ncrr aJl dfichm~nh hrlrrll
<br />,._.- LI;1IT GILL di wnIJFC ndU SETTLEAfsLE ~Ji.IL~ L1F'i: n?iLI', :, ;'Jk <=i0Yn,24un PdFCIP'~Y)tYS; TSS ~:
<br />.;r.tTLrAiiLE SOi.lii° LICIT WAIVcD FOH >lIJY:t,~NkM PH2CIe' E7g!J'T
<br />~~ :iC9J°_C'; TO UaJtH OF .,Qa600F I4 j ,.i.i.. OIL :,
<br />EPA urm'3320'-1' "3%99 PieSious`eb~i Loris ma`
<br />~• ` ~ ~- - ~ ` ~ ~ ~ j ~ ~ ~
<br />~(~' ) y~ieused.
<br />6Z/OT7~';i
<br />'
<br />sl~-4-tw~~°
<br />OO
<br />F"' PAGE F
<br />1°
<br /> .
<br />Q
<br />a
<br />.
<br />
|