HYDRO27864

• Permit No: C1981018
• IBM Index Class Name: Hydrology
• Doc Date: 7/26/2001
• Doc Name: June 2001 DMRs
• Permit Index Doc Type: DMR’s
• Media Type: D
• Archive: No

PERMITTEE NAME/ADDRESS (lnclyde Faciiiry Nane/Locofioa lDijjerenl)
NAME bLUk dJ118?AIti E'rf'R:,Y
ADDRES . I N ~ .
SDHSEAAUU `+LNE
36D/ CJUNTY BOAC 6Y
FACILITY RS NGLY ~ ::D N16119
LOCATION
TPN: JEFF UUti9£RT
PARAMETER
IL AND GREASE
iSUAL
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F'FLUEFf CRUSS VAL
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
DISCHARGE MONITORING REPORT (DMA)
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FROM
Y OR LOA[
MAXIMUM
Form Approved.
OMB No. 2040-0004
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NOTE: Read InstrucLOns,belD~6LOmDletinG thi;
QUANTITY OR CO
UNITS;.' ` II IMUM AVERAGE
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ANALYSIS
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form.
SAMPL
TYPE
NAME/TITLE PgINCIPAI, E7(ECUTNE OFFICER ICertiF/uMer penalrydlaw tluttha tlowmententl eM attachmems were TELEPHONE DATE
prepared antler my tlirecllon or supervis"qn h aaordance wiN a system dealgnetl
S C Q N 5 e to assure Chet rtuelifletl pereonr,el properlygatl,er end evNrgte the IMannetion ~ h
a,b-nltled. eeeedm ny lrpu4ydfhe personapenvona wt,o manage the system. j~
or Ihaae persona directly reeponalbu for gemetlng Ilia Inbrmatlon, the inbmwtion
L~1 / ~' L Ir submittetl ls, Wtha beetotmy knowletlge antl beiiel, true, eccuraze, end complete. SIGNATURE OF PRINCIPAL EXECUTIVE ~~ ~o7..S~~3~ 7
IYPFClA PiurPn Ism aware Nat there ere aigniMCaM penalties for submitting WSe lnformatlon,
:_..,.__.._____,.::,.._..____.:_________..__.__..:__.._:_.:___ OFFICER ORAUTNORIZEDAGENT ____ wIMRFR YFAR un nnv
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prm 3 9) Arevlbus a itio s rlSay be used. THIS IS A 44--PART FORM PAGE OF
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