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PERMITTEE NAME/ADDRESS (rnclyde Fanliry Namr/Localion ifDlf/eraar) <br />NAME bL'Ji "tUUNTAIri ~NEF.GY, INC. <br />ADDRESSpE5ERA64 NINE <br />3607 CDUNTf RU4P 65 <br />FACILIttRANGLY CD tl164y <br />LOCATION <br />ATTN:.UCFF DOt1BBRT <br />PARAMETER <br />C5U STATAE 4yf[R ACL' SAMPLE <br />CEHLUDAPHNIA MEASUREME <br />A!f.lU L U U <br />FFLUEtJT GRp55 VALUt <br />C.SU STAT&E 96NH ACO SAMPLE <br />PI'IEP±tAL65 MEASUREMI <br />AN6C 1 U U <br />SAMPLE <br />AVERAGE <br />r(r r;~~: <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM MPDES) FOfm ApprOVed. <br />DISCHARGE MONITORING REPORT (OMRJ OMB No. 2040-0004 <br />"'IhUk. <br />(SOUR tlM) <br />IT NUMBER DISCHARGE NUMBER F - FINAL nr. L A Y <br />MQN~O INGP RIOD ACUT£ aET TESTING FUH 024 <br />YEAR MO O ~ ° R MO DAY _ <br />FROM p1 Q ~~~: bQ': I ~:. 30 '"`% tit DI SChA RG'•. ncd <br />n' NOTE: Read Instructions befo le~mpleting this form. <br />. ~,. . <br />Y OR LOADING ~ QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />EX of TYPE <br />MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYS,S <br />.'M'SG <br /> <br />Y,''t'1 <br />. ,I <br />r: r: c.1- <br />r ,~ <br />z:;e; ,, <br />:. <br />SAMPLE <br />MEASUREMENT <br /> <br />SAMPLE <br />AME/TITLE PRINCIPAL EXECUTIVE OFFICER ICertayunder penalty o<law that this document end all attachments were <br />prepared under my drtedion a superNSlon M exordance with a system designed <br />C D ~ / . L. ~ S }~ f- b auure tM qualified per6anrwl properly gaNer end evaluate the inlonnatbn <br />(~~~ r aulxnlttad. fieeed on my Irpulry W Na persm or penane who merege the s}stem, <br />- ~ or None pereorc directly reeponslble for pamMng the Inbnnatlon, iha Inbrrr~#im <br />DATE <br /> ~ )(~ , E y J submitted la , ro the beat of my knowledge and ballet, true, eccuraze, end mmpleb. SIGNATURE OF PRINCIPAL EXECUTIVE / ~ J 7 V '-' 7 <br /> TYPEDO PRINTED lam ewaratl~tltere ere slgnlACantpenalties for submitting lalae lnlomsation, <br />includh lhti slbui of fine andi risonrreMfor krawin Notations. OFFICER OR AUTRORIZED AGENT I,JU YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/d nce all attachments here) ~ ' <br />LiE PAST I. u. 3. P;; VIII, FpR DBTAI L3 OF ?::ST PROC EDCRF. °°PORT LCSG - ETA'°ISTI CAL POx ~ 65TItSATE wHi'::i <br />IS LETHAL TJ 50X OF TEST ORGANISTS, AMU AT7ACil ACUT; TD%ICITY TEST REPORT FOAO TO pl[>~ COPIF.S OF ALL <br />00¢4 <br />FORM PAGE OF <br />1 <br />