|
PERMITTEE NAME/ADDRESS pnrludr FaciliO~NamrlGncpriun ijO~erenq Nq
<br />NAME plCtit'LiiIP.E FACCE`_`ING, LIC
<br />ADDRESSr~ t N i L X M I !i E C
<br />T a T i _a :, c ^ ~ ~ : r. r [ c r V ~ 114L2 l~ry4 • 5t~+)..1 nww((IILL
<br />Lyac~t ~t~• IN u77tt
<br />FACILITY ~ ^ K
<br />LEX.~ n h~,,,
<br />LOCATION ~ ~,r. G 4 ~ ( Y l V 5 1 L C r~ E 1 C -i I FROM
<br />:,TTN: -? cF:RhY, YANACEh'
<br />JAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOES)
<br />DISCHARGE MONITORING REPORT (OMR;
<br />(246) p ]. 8)
<br />PERMIT NUMBER ~ DISCHARGE NumeER
<br />(28-29) (30~3tJ
<br />hLI~~;
<br />(-LIEF °_E)
<br />F - FiAlI
<br />hUNCFf ECiC
<br />Form Approvetl. •
<br />OMB No. 20400004
<br />Approval expires OS-31-98
<br />tAr~_
<br />7/FLFGATC]FE FIit;~
<br />„'v tlMM$~Y~CEIAHGF ~~.I 3{{
<br />NOT .ead Instructions before completing this form.
<br />g~,i ~ ~1 >,• ~o ,~
<br />~
<br />~
<br />-
<br />'
<br />` (3 Card Onty) QUANTITY OR LOADING (<Cerd Ony) QUANTITY OR CONCENTRATION NQ. FREOUENC SAMPLE
<br />f
<br />ER
<br />ARA
<br />FAE
<br />1 (46-53) (54-61) (38-45) (4fi-53) (54-61) Fj( OF TYPE
<br />(3237) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br />(6263) ANALYSIS
<br />(64-6$)
<br />69-7U
<br />H SAMPLE X'S~r}QOfi Od3;fi#+} {{+'.0: 1 Is
<br />)
<br /> MEASUREMENT ~ ~ Q 0 ~ 1/~ =IUST
<br />'U4UV I 0 C ~ RCRMIT ~ i0fi ~.~ ';
<br />,
<br />' ~. ~ t;ll ~ - QaQ- ~--. ~~L~ .iT~~X
<br />cFFLUENT Gk05°_ VALLE HEOUI4tEMENT x"sy_-_
<br />
<br />_..,
<br />~6i+ -
<br />• ~
<br />i
<br />~xx~ ~~ u~
<br />l,,:~''~~ ~ ~
<br />~~~x;x~ac~
<br />~L ('
<br />~C,LIDS, Tt~TA1 SAMPLE ',{'A'"^ ,Apfi~ b00006 ( ]~)
<br />v :i 1 F N v c is MEASUREMENT _ (J ~ N A
<br />'US3u 1 U C ~pE}7 kT. ._ . 4R+P0~ 934 p 9COC06 °+~ x..~w~,,. Q ~',.y'YF'-. ~JI(:
<br />LFFLUtkS GkOS° VAiLE 'QUI9~14)E;f$T t06 `.,,•. ~=M FG/L ~'~~
<br />CLIDS, SEPTLFAPLE SAMPLE ''{'^''''`' :':0000 ' . .ce:;.~>} 606000 ( i~)
<br /> MEASUREMENT ~ p. Z Q l ~l G ILA B
<br />
<br />JGSU; I U L' ~ t}` ' ; # 4oCA s4~',,,~-. . A4 # p4 ~. ~`, ~..~- :-- ~ , ~1~4~::
<br />r.FFLUE~'T GROSS YALGE ~ ' afi 3. C{w~ t ti;..:,- '~,° il•, .^~,y.~k '~~".~,i~t II~'? MI/[ ~~ b-: "
<br />InCN, TCTAL SAMPLE gOLfififi 014OOCC 00060 ( LS)
<br />(A FE) MEASUREMENT ~~ ~IQ
<br />)IUati I u G ~ ft~~";
<br />~ ~ • 666t06 = c{; ~ ,~-;,, ~.
<br />~
<br />~4
<br />~ q~/
<br />~` t-4~M;~~
<br />FFLUEhT r;FtU55 VALGt ~Ul~~ EN~
<br />. ~ .' .`: t)~:i `"_ ,_ ,
<br />,
<br />,
<br />J,'~,~?~ ,G/L _
<br />~f'
<br />:IL f. tiC :, iY F:ASE. SAMPLE CKriGOC {•". i>;v0 :~~{000 100'0840 I I4)
<br /> MEASUREMENT G L Q I /1 G IAA 8
<br />~~5n~ I v G ~E~ ~ • :, ~ qua :: :: 6aa6#a~~ ~:~ ` ~ `~
<br />,
<br />~ x~ '>~]
<br />~f'FLUEti~7 GROSS VALUt ~~~EN~". '
<br />~.
<br />~ .~ *{0'i ;h ;.-
<br />1'
<br />A~ CG/I f `~ ~Y:~: ;.
<br />~•
<br />LUY, Ih GOtiDUIT CF SAMPLE 1 C3) ~~%{~'){C 6400 039{3>G
<br />f :NL' T'dtA'IiSENT PL6ltT MEASUREMENT N{~ Q, 0~b t~i TEST
<br />~UUSG I u G '; •'; _ y ~=.z X66 ~ ~-, ,,,
<br />~-
<br />~ ' >; ~ ~ 3j
<br />
<br />FYLUF~•.T GROSS YALUF
<br />~~
<br />~~~
<br />:
<br />~j
<br />rCL v ~
<br />+
<br />;1 u
<br />. r
<br />.-
<br />.
<br />'~~{ 1
<br /> _
<br />,._
<br />. .F; .a.
<br />Y
<br />., ,,
<br />JIL AtiL Gii :.A.`.E SAMPLE 00440 1 S'1) :: {::7:iY:T 0 OpCd CL{a{O
<br />4ISUkL MEASUREMENT O ~ Q 1,1 V(5
<br />
<br />Ff'Ll:6aI GROSS YALLF ' ~~~t?~~ ~'' ~, =- tiC=O ~ ~" S~`f' ~r: `" T°'
<br />; ti G{d{ I" ;
<br /> ~
<br />; .,,
<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WITH THE INFORM W TIiAT 1 HAVE PERSO
<br />ATIO SUBMITTED HERE NALLY EXAMINED AND
<br />IN
<br />AND BASED ON MV TELEPFIGNE DATE
<br />INQUIRY OF THOSE INDNIDUAL S IMMEDIATELY RESPON ;
<br />SIBLE FOR OBTAINING
<br />o A ~ ~ • ^' ~,•, + THE INFORMATION. 1 BELIEV
<br />O f / ~ • ,!'• ACCUMTE AND COMPLETE.
<br />PENALTIES FOR SUBMITTING E TttE. SUBMITTED INF
<br />I AM AWARE THAT TH
<br />FALSE INFORMATIO ORMATION IS TRUE.
<br />ERE ARE SIGNIFICANT
<br />N
<br />INCLUDING THE
<br />~
<br />
<br />POSSIBILITY OF FINE AND IMPRI ,
<br />SONMENT
<br />SEE 19 U
<br />4 1001 AND 33 U
<br />S
<br />C
<br />S O ~1~ p
<br />~ /}
<br />1 ~
<br />'
<br />I
<br />I
<br />IJ -r
<br />Z
<br />n .
<br />.
<br />.
<br />.
<br />. SIGNAT E OF PRINCIPAL EXECUTIVE 1 1
<br />`
<br />- L
<br />PED OR PRINTED maxi um~nnEanmem oleetwsen6m~wthsyeno'SUtle lines up to Eto,oo0 entl or
<br />p years.) OFFICER OR AUTHORIZED AGENT
<br />NUMBER ~
<br />YEAR
<br />MO
<br />DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerence all a(tachmentS here) - ~ '
<br />iU LAY AVEYAGE? 15 FICtt;ST F!CNTHCY AYGJF~~DUAIFG PEF:CC hLFCFTFG. GIL ~ GFEASc - ~Ei I.E.I.L.~.lF. S. 75 t
<br />;UTAL IfiGN LIfII;:i HILL Bt ~AIVEL, AND SET7LFAULE _°CLICS LIt"ITS AkFLIE[ FCb <=1GYF,i4BF P1tC7F EYEF9-`_F11.
<br />[rA roan JJ{,V+9 (Vp-Y~J„ rr9VIOg5 egl[IONS may DDL qe g5e0• , _ ~ rt \~' t'•fAVC.7<CI'A rVMM I-4V WrllVrl MAT hV I o~ vseu.) A rAac
<br />
|