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PERMnTEE NAME/ADDRESS r]KAIar F.wryNrrtK.Ir.IYDIEGrw1J NAME 5°_!l ~~. ;i :.Oi:. CJ:.x !+'~'i ADDRESS F. D. 5 0 li L 7 U FACILRY L~T1ONHAYDF:N ,gyp B16 3L dTTN: ,;KEGS Y.LPCF!F: !r. ~:SF'aAG~~NialA:. _. NATIOMAt FOLLVfMT nIECHMOE ELIMINATION eY4TEM FNPDESI DISCHARGE MONITORING REPORT (OMR1 i (ICI"7 :~ ~ ~ U7., __ PERMIT NUMBER ascNMaE NUMBER MONITORING PERIOD YEAR MO DAY. ~• YEAR MO DAY FROM U 1 U 6 {,~j ~•TO O 1 ~ ~ j U F - FI:•AL r?OL~T1 .,': 'T: : "'.T TESTING AT 0109 µ • 6~' D7 iCHEB:;c ~~~ '•x jNOTE: Rrrrrd Imtruetlar Mfar~ eomplr.Unp thb loan. PARAMETER QUANTITY OR LOADING ~" Quality or Concentration f.10, RIEOUENCr SAMPLE ~ Ex w ANltarsts TYPE AVERAGE MAXIMUM UNIT 8 MINIMUM' AVERAGE MAXIMUM UNfTS L C'JD STATi'. Et 49.t r. Al. '~. SAMPLE UREMENT MEA :'. r: •i :: .. r;40Mt~. ~ (00 :aGl`#^:: ~1 "~ ~ ( .3) T CJ j ~ Y ,`.'Wi'n IU~Ai Ifl+Ih S ~(~ V~ TAM.f Y~ 1 U U :~..~PERMIT... ~.. .. .. ..: ;c :,: :.: ::; ,r .:: . .. ~s:h ~:;lt7r i~~' . ..+«, X144 .. .. ,l i.~ L(J £'. 4~1. C .t.:.:': =•'7~:ac:r:x: ; _ ...- ~ 'i. r" :. ]" ~i. c:F'FLIIF:`7T .,.+J5S YALE: gEQUIREMENT. .. .. .. .. ... ~ ~ .~:~ .~~. ~ ~.. ~ ~ypG :~[5N~ f~~AtaS~itl '.:.~: ...:'.~:..:.: ~. ::~: .: ~ . .I. SAMPLE. ?.'~1p MEASUREMENT ~ . ~. 'PERMIT. ~ ~.. ... . ~ ~ ~ .:........: :REQUIREMENT. ~ ~ ..: . ~... . ~~.i .s~~ ~~: . . , SAMPLE MEASUREMENT ..:PERMIT.: ... ~ ~ ~ :..: .. ~ . REQUIREMENT ~ :. ~ ~~ ~ ~,~~ ,.... . . . .. .. .... SAMPLE ' MEASUREMENT ~~ ,.., PERMIT. ~ ...:? ;` : : :.:.:... ... .... ~ ~ .... ; REQUIREMENT ~ ~...: . ......3 .: ~. e:: ..::, ,: ~~ J. ... ...: . . :. SAMPLE MEASUREMENT : ~ ~. PERMIT ~ ~ ~: 5:: ~: ; ~HEQUIREMENT. .: .: ..~ .. ... .~.. .. .. . ..... .~:i ~. ;~ :. ,. . ..~. , SAMPLE 'i MEASUREMENT " PERMIT... .. ..... .. .. . :.. ~. .. k . REQUIREMENT SAMPLE MEASUREMENT ' ` 'PERMIT : . ~ ... ~~.. ,. ~ . NEQUIREMENT: . ~ ~~ : ~ .:.. :'~ ~. . , a^::.:.'..... . :r . . NAME/TITLE PRINCIPAL EXECUTNE OFFICER 1 Rrlll) Y !r y1n. 1) O I.w IL.I Ill FRV.Ra Yne.rm)aI1KIlYY Yr vlp b aT1111t111.M .Y .11Kn111lnN wfR l.taon lY.Rela.K..lln.Y).IYR a.a Yw TELEPHONE DATE [ Io Ywrt IM1Y19uYllnra pemnM propYAl [Ylner YM erYNYle Ine InrermYllen ~ ~ Nhllall,a. Evaan m)Inqulr)or NrPvY Kr.rYrtn wno vnY[e lne ryYlYlry ~ ~ or moe va>ele mrtay RYVYwd9N rK [.mYnn[ u, InrY1,YYnYY. mY bmr,n.nYw n ~_,.. ` mEYau.a la b mY 4al Yr R) LnowYa[, .Itl Eeu.r. w., YrtvrtlY..ltl mlwvbN. Lm...RU.nnYR.rta •rnom m r S lm ma b eIONATURE OF FRINdFAL EXEd1TIVE ( n 1 ~3 y.n. e or.Y nl n[ n nnabn, [ TYPED OR PRINTED !MYaln[In. pYYanmy ornl..na llnpMOnnem brLm.b[.IYI.UoI¢ OFFICER OR AUTNOI(IZED AGENT CODE NUMBER YEAR MO DAY COMMENTS AND tAYLAN1911VN V~ pni vIVLXIIVNS /RIJa/I/1CI !///[[IC/rTInH hI/Il :Sr:. F':LIT I. A.4 Fur: J:lAiL.. LF ._~i P?JCk?~:n~. ".~?17L L'7~F:: JiLUTLu[+ (.: EFF'LU21.T) iiHICH IS LLIHAL f0 Su-'~ DE r:ar ai~.~ASI5,y5 (LC.~7) .Nt: A'!"PnG1 4~U:~:~ '~iYICi'! :~.,. F.':%uHT FDh" TJ Ut'R. CCIPIES OF ALL If+FiiEt!!ATION earllons may be used.