|
~
<br />i
<br />'
<br />PERMITTEE NAME/ADDRESS RM.6 fm01ryNwi/Locrtlon lfD~...np NATIONAL POLLUTANT DISCHMOE ELIMINATON 4VSTElA (rNPDESI Form ApprovsE. .- -
<br />NAME (:hc kGY NUtL$ LL:ALF 1'vL. DISCH1 R6E MONITORINO'REPORT /DM91 PLIHI, a~HlNE NT+< TLOM~~Io~.I,20~0-OL0~4
<br />rov sx vss0 31.88
<br />-
<br />'
<br />~-.)' ~I pp
<br />"
<br />ADDRESS SJU TN~lcLJ H1YL
<br />~UL1F. 5t 1L~4y
<br />PERMIT NUMBER' DISCNAADE NUMBER F - FIfrAL -
<br />i05 S. tJNIuN IsLVG.~ ~UiTL 46G
<br />LAKtwWD GG bU2L8-04d9
<br />M1NUR
<br />MONITOR7NGPERIOD
<br />FACILITY tl~[Rt,Y FUt-LS L:,AIE INL.
<br />YEAR MO DAY YEAR MO DAY
<br />LOCAnoNF.Lu~C/:(L CU b`J ._lb FROM 1' TO I 6 .j rA&# NL, lil~l.HAitL[ ~ ###~
<br />::iTn JAHk~ T. LG.: iEtki VP-GPt:HAT IONS rzaan 122-2311z<-~5~~ n6n~ rss-asl r3asn NOTE: Rudinstruetlau bsfon eomplrrtlnp thb form.
<br /> PARAMETER 13 Grd Onlyl QUANTITY OR LOADING ~ !<Grd Onlyl QUANTITY OR CONCENTRATION NO. FREOUENCV SAMPLE
<br /> <5.531 15661 138-15 1663 646f
<br />X OF
<br /> lsa-371 E µ,LLYys TYPE
<br /> 'AVERAGE MAXIMUM UNITS MINIMUM AVERAGE ~ MAXIMUM UNITS ret-say 15+581 l5&70l
<br /> ~iL Ahil lrk[ASt ~ SAMPLE "~ .#op~#ti« .. y4 u##•#V 4####fi #####JF
<br /> I }t/HL MEASUREMENT
<br /> ~4JOb ! V ~ 4i>«:::Q£HMIi>.ir~
<br />
<br />RE :;r!Ig1~1I+:". ..~:,'...,
<br />~'~' ,~ :....:::: .: :.".
<br />~. ~~ ~;
<br />` - -
<br />~ 1 ;5.....:..: ..,_.,d.!~ .r
<br />>R$>kARi~EA ...,......::..,::.,..
<br />+~##~~~ :::-:.::.......:. ::::;~
<br />'~#~+1~:?Ik'~ -. .~ ..
<br />. # . ..:.:::. .:.......
<br />~~`
<br />,T"SkiAti
<br /> _1rLUth( I,F;Vy VALUt nUIREMENT
<br />~
<br /><. ..: ..
<br /> SAMPLE
<br /> MEASUREMENT
<br />-
<br />:
<br /> <,..<~ M:.::~::.
<br />
<br />
<br />
<br />
<br />REQUIRfiME~Lf.•:: :...
<br />
<br />
<br />
<br />
<br />~..:,..:..
<br />:
<br />~ ..
<br />..
<br />....
<br />
<br />... ~:x~ ~::::
<br />:.~..
<br />x;:v
<br />;::"~::
<br />'r•
<br />~::
<br />:
<br />,..:
<br />,.,: .
<br />
<br />.;
<br />..:::... ..:....:
<br />:::
<br />~
<br />
<br />
<br />
<br />
<br />..
<br />
<br />..... ......
<br />
<br />
<br />e.. :
<br />....
<br />.
<br />.
<br />~~::....:.~ ~. .. ...:.:
<br />.... ,. .:
<br />.
<br />:
<br />.
<br />..
<br />.. .... ... .x. .
<br />-. ?.,::. :.:
<br />,.
<br />
<br />:.
<br />
<br />
<br />...
<br />
<br />
<br />::x:.~.:;.... .
<br />
<br />
<br />;,,..:~:;
<br />..
<br /> SAMPLE
<br />~
<br />IZ
<br />L°I'~
<br /> MEASUREMENT .~
<br />,
<br />
<br /> ..::::: •PE .MIT :..... ..... ..... . ..:..
<br />..::..z.:
<br />::'.aS:.:~
<br />~.:
<br />~. ..:
<br />.
<br />~..r ..
<br /> R~ME
<br />~.,~En
<br />.: ~~;...,~..
<br />,.
<br />::.:: ~a ...
<br />,,.:
<br />c .~~.
<br /> ..
<br />.. .
<br />.
<br />.. .
<br /> SAMP.I,E .
<br /> MEA54REME14T - ~ .
<br /> . .. .. .
<br /> ANT:.
<br />HE .. < . ,.,...,
<br />. .:
<br />... .
<br />
<br />;,
<br /> . ,
<br /> - SAMPLP,~ ~ .
<br /> MEAS~RENIENT
<br /> _.
<br />... .. ..
<br /> ~REQ
<br />ULREMEN'[.. ~~`: f
<br />~
<br />'-
<br />~-~~
<br />~:
<br />~ .
<br />.
<br />..
<br />... .
<br />~.:
<br />~ ,.. .' _,. ~ .:. .~.~. .. ~ ..
<br /> . ,
<br />..
<br />..
<br />.
<br />::
<br />. ,
<br />.
<br />,
<br />..
<br />n ... :Ij'.'.' '.. ..
<br />' ~ ' . r.... .. .
<br />~:~:-..PERM1AiT"~.. ~-~ . ..:..: .:....-.... .:.. ... ~.... .. ~. .~ ... ~.
<br />=.REQUIREMENT-: ,-: _;.;: _..;:: ~:...~: ,::~...;,-:,'.":•::~~ ~:: ~..... - ::. ~.:..
<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDFR PENALTY OF LAW THAT I NAVE PERSONALLY E%AMINED AND TELEPHONE DATE
<br />AM FAMILIAR W4TH'THE INFORMATION SUBMITTED NEREIN; AND BASED ON
<br />( ! MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
<br />-'~ ~ ~ `_ ~~~ /-~~E "~~~ TRUE.NACCTURATE FANDA COLI0.ETE,~1 TAM SAWARE EDTHAw THERE ARE -
<br />SIGNIFCANT PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUOINO ~' - ~' - tT ;'7 ,
<br />. ;~ } }4 ,-.wF ~~~ THE POSSIBILITY OF RNE AND IMP11190NMENi. SEE IS U.S.C. f 1001 ANO 9] SIGNATURE OF PRINCIPAL EXECUTIVE ~ ..I~~ ' ~ / l ~ '
<br />u.s.e. E r3rs. drA.ro.. urar vwAr mean, A,.r x,e4d. sA., uP ro tro,DaD YEAR MO DAY
<br />TYPED OR PRINTED AnenmuhAne hrcvivnr.nr a/MnY.m lmanplrAMSwA'A/ OFFICER OA AU7NOAIZED AOEN7 CODE NUMBER
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /RsfsrsncP sll ettschments here!
<br />T~:, L T,.T~L Ik;ih L1'4IT} HILL nc r,.LirE:]F Auu ScT11~q~L~ ~JLiL.; ~IttTT ari'~i_.. 'r,~r LV(;.~_Ir... r'. _L!'r' LVcI.T-
<br />ot~ cErn ~Ci, tr (• h'nl~lJf nt ulUlrtcY:LhIS irMuL~l l.A.1F %~. ~~• LiIL L oricA}L ~ .+LL 1. ., 1.,.• :U ,.'I ,: Y:. -.aye 1,
<br />1 T.11 V n r T:: ~ r 1 1
<br />EPA Form 3320.1 108-9 Previous editiom may bs use ~ - - IR CES E A FO M d RICH MAY NOT BE USED.) J U L ~ r. PAGE OF
<br />1~.~. f.
<br />
|