Laserfiche WebLink
PERMITTEE NAME/ADDRESS ((nc(edeFaci(tryName/Locar,on Jageent) <br />NAME <br />n:.rJE 9OU'.'"ki!: E6h:iGY, i4C, <br />ADDRESSiI ; ~ p a A ~ l) " I '.~ c: <br />HA4CLY <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />e*:;~- <br />r <br />PERMIT NUMBER ~ -~' ~1 ~ ~~ ~ ) <br />.E DISCHARGE NUMBER 1. - C I I% .~ I. <br />Form Approved. <br />OMB No. 2040-0004 <br />~'• L A I, <br />FACILITY ~ ~ .. " ' = •) , .~ MONITORING PERIOD ' . - 1 :.O'I' '. T!: '; A'.'. L ", I: i::• . TI ; t• <br />LOCATION YEAR MO DAY YEAR MO DAY <br />_ <br />FROM ')? 1 TO i J5 ',+'.,.: •J J'~C!'F:,;c II .:~,: <br />trT"JT '£FF vii ;..,rrm <br />NOTE: Read Instructions befole tltripleting this form. <br /> QUANTITY OR LOA QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER EX of TYPE <br /> AVERAGE MAXIMUM S MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS <br />`ll SAMPLE r.,y?':n .)...:i«~.oi {:::ru::rt ( 1.') <br /> MEASUREMENT <br /> <br />U'IdUU 1 U 1 <br />' <br />' "~ " <br />~°Y` <br />~ <br />tE <br />:~• . <br />a~tt¢+@p#Ar;t" <br />+r~ <br />~~r~" <br />~5~;~'`. <br />r J F1.Ut; <br />, <br />f i;li:.,SS VALU. RE4 EMENT '~ ;~.~ <br />~~r: <br />,l <br />. <br /> <br />.., <br />~~L; US, T. CTkL SAMPLE •' .: r-~ y .._.._,_.: ~~ni ~ OI?4tt ~k r: ( <br />_- r~P F6'.+:.F MEASUREMENT ~ <br />, ` ) <br /> ,.. . <br /> ~f ~~/~ <br />~ <br /> <br />: <br />; F:,oF••'i cross v1tiL J: <br />~' +4 ~} <br />i'~ Tl i~.^ - <br />. - <br />... r <br />~'i.IuS, SF.TTLF.Af:L: SAMPLE r,~ :.,~::~: ': r::~pgr,. ( 2`) <br /> MEASUREMENT <br />r <br />' <br />' <br />~ <br />~ <br />r <br />^ <br />`"~* <br />' <br />t L0E <br />,T GrO55 VALU ~Nj : ". Y :, <br />.: <br /> " • . w <br />... ,. ::tf~6SE SAMPLE .. .r_p <br />r~.'s0 4trOC:kD ~ It+) <br /> MEASUREMENT <br />` ~. o i U O *#AeR!dr #o44#rt t9r e1'#40O :_ <br /> <br />:?Fi.JF:`'P GHO55 VALIIt <br />~ , <br />. <br />~ <br /> <br />6:. <br /> <br />; <br />„r a t x' <br />L •.J++, TOTAL SAMPLE :...:. .. ..-..•.:...:. ~ ( 1) <br />1 A ~ F E) MEASUREMENT <br />.I : ~ ~, 5 1 u o ,}: °~`~'~`~`p <br />':I ~~e~a,r<a+~ .., ~aom+~~ ~, o . a ~_ <br />,FFLIi}'.f .:(LOSS YAL'J - H <br />_ f .+~ ;: N,. "~. ",.' <br />L~~:, I h ~OfJ iIUIT R SAMPLE ( .. ~) ,. ., ~ :; a::: ~: ~~ <br />i '`:;, - .~.A'i HF, N'I' PL1: !. MEASUREMENT <br />"Jv')U 1 IJ U <br /> <br />" <br />' '; . R~'Q$~:~~. •. Aq OCtaRria ISOry.`4+3 qr 44j,tdV4 r, •.y K ~'~ <br />~. <br />'~^ <br />r <br />LJt:'•T G8.7SS VALU` ~ ;~,;y ~^ .". <br />"li- A!.V G:;EASE SAMPLE <br />... , <br />t~: .b i;, ... ~ ',4) <br />~;. <br />.. ..... ..: ~t <br />y I g U p ;, MEASUREMENT <br />: Jb! 1 U U -y - `~,~. ' _ ;B~1bir~ra}(s ra4dW4rk M` 4## <br />+~~~. r arFn ~ <br />j <br />l' ISE#Il <br />r"°LJ` r, 1' OF:OG° VALU= ~„, , _ - <br /> <br />~ ~, _ <br />'~;~ ppr,: <br />. ~•. ~ <br />, <br />. - <br />NAME/TITLE PRINCIPAL E%ECUTIVE OFFICER I Certiy under penalty W law Nat Nls document antl all attechmams were <br />prsparetl under my tleeaion or superNSion in accordance wiN a <br />stem tlesi <br />ned TELEPHONE DATE <br />ry <br />g <br />~-y / <br />9 <br />/ <br />~ <br />j <br />~ <br />Cr <br />to assure tl,N qualifetl personnel properly gather end eveluaze the infirmation <br />~r { ~ S <br />l <br />L L ~ / / <br />" <br />submitted. Based on my Irpulry of Ne person or pereom who manage 0e system, ir- <br />~ - i <br />- <br />{_ ' or None parsore dlrecLy respmsible br gathering lha infomwfion, Na IMOnne6on <br />) <br />/ aubmid <br />tl I <br />t <br />th <br />b <br />t <br />f <br />k <br />A <br />tl <br />d b <br />l y i <br />_ f <br />7 <br />~ <br />~~ ,.., G <br />/ <br />e <br />s , <br />o <br />e <br />as <br />o <br />my <br />nw <br />f/ {- ~ <br />e <br />ge en <br />Nie <br />, true, accurme, ontl mmplele. <br />I em aware Nat (here era slgniArem penalties for submitsn <br />false inbrmellon SIGNATURE OF PRINCIPAL EXECIfTIVE / L 7r <br />/ G~ r' <br />g <br />, <br />TYPED PRINTED inclutlin the ssibili of fne entl im daonmerrt br knowin Wolations. <br />OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />a nrvu uru:rvr, l lvrv yr nm v1ulA l wrv~ ptererence au aaacnments Here) <br />f5 S fJTdL I~J'J LI.~IT5 PILL ~". +iIV ~:., d'+:I `:T'ILLA!; i.P °.ULIG:i Ll"1? AP;'i.? ', 'r"S. C=1GYY,„24HR PN°CIf' ':'v'!•'i- <br />_F;F- I.A.L, YG V, FrJa ''~UIF°"F:tiT~. )ILo ;}iF.A:;i. 4°'~O~TT": C:-.;~.~", I.:'.1.1, P; YII. t;3TtiLY SAPFLIFG <br />EP rm R 3 ~ Pre"vbus a Ilion may be used. THIS IS A 4-PART FORM PAGE OF <br />UUb15/UJ~717-1.350 1 <br />