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PERMIT7EE NAME/ADDRESS (ln Yb F.cYlry Ns../toemlan UDl~.mp NAME TBAri'EI . .s i .", „_. ADDRESS T 4 A i YES. ` i 4 v Y.O. E', t 11~ 7 C?AIG CO JL126 FACILITY LOCATION ;1TTN: w. GOaDO!I Pi';ES'S, !'kE5/GF.ti rGiZ NATIONAL POLLUTMT gSCNMOEEtOlMn~ ~~h,,TKfyyS'SiEM /NPDEJ/ DISCHARGE MONITORIRq~ftEPOlti IOMRI rT-rsl n-rsr 00032115 C11 A PERMIT NUMBER DISCNMGE NUMSEII MONITORING PERIOD YEAR MO DAY YEAR MO DAY FROM TO ' 12671) !TT-I31 111-761 lT6-771 ITB-791 /36311 .. .. ,nve~]6 I' 1). a+Yf' DONC ~: To ~e~Sr pN~1(+P•1Q04N~ (S U fi A A W) APProvelle%P~9Aj0 3 9S F MEAL. nx 0#a yr; CISC>:Ai'CE ~ 'k'"? NOTE: Reed Imtruetiane before co~lRpNtinp thle form. PARAMETER !3 brd Onlvl QUANTRY OR LOADING !1 brd OnNI QUANTITY OR CONCENTRATION NO FREQUENCY SAMPLE /16-531 154611 138-(5 /16-531 151-61 EX DF TYPE /3T-371 ANALYSIS AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UN1T5 t'a.s]1 !s•-sa) /6s7o1 SAMPLE ##P#G# ###Q## fiCaa#A ~~ 12) MEASUREMENT - J U 4 U 0 1 0 0 ~ :2°;rs::p .RMIT. ~-... .. . . . ., #~OI(r. ## ~ ~~ fi•; ~ :. ~ . ~~Dg101'Ll # ar 6.'S :. '. L±sacea>.R 5F4`.'::':.`: : . ~~I~I. Tp5IT'. 6FE'LUENT GR09S [ALU . ..... .. .....: ~Q.'R.., ENi :. =.. ::.,.;~,:.:...::. . :`< .. .....:... .. #+t## ?I:I;:J-:I1Ft)E.' <`:. ... : `.k1YX ES A.: U .. .,. 5, AL • ' PpE as as#.. .- sac#a# eseeeo 19) ` C S r E N D E G IDEA ~IEMENT :. ,~ V ±FFLUEtl'f G80SS. YALU AEOL~IfiEM~N~'f i .. D3 ~, d;' ~ ##~ll QAy~~~.C ~}It :' t 'Att !!G L "IIACT -.A • AF! SAMPLE 'kCGi: rF'f #'i~ .##Aa00 ( zg) . MEASUREMENT /) ~j ~N~,~ ~ j- U0S4S 1 Q 0 PERMIT. L... r,. :.: ~?'~ CcYICkJ1L PEfORT. NC E,/ .(fA6 tFFLUENT (i~t1SS YALI!. REQUIREMENT. ~ 4v;'# 3QCA AVG .C AI £Y T1A !!L/L 1`SOtiT; .N F SAMPLE ~-;°# 1# ##'~### afiaOfit ( 29) (AS 1'E) MEASUREMENT U104ti 1 0 0 PERMIT. 44####::?. .,,:+-c :x##? #.# #>afiaalo .3.0 S.C," vcE~ .RAIi cFFLUr:NT 1,8.035 YALO~ REOVIREMENT ~ -` ... `i:::~:~.i .~ .~ ~~ ~~ #aa# .. 3OCA' 6.YG :.CAL~1~Y 1'1V MG/L 'ft~3b1'~'! - r .FN SAMPLE C##Ot ~ ~:`-3{rO## _ #1p##!a rS#O,:>5 ( 19) MEASUREMENT U3Sul 1 0 U PERMIT.:- +'.. .. a.. . ac>dE #7S: KY" ,.C91D :.. fae.ti. aA..` .'2:C .[: ,?. '.1YT.jH k;cR 'F'ELUENT G8055 YALU :REQUIREMENT '.( ~: #aae iN8'1 flRX :I:;/L : :;i4'j' ~ .. . ~ . ~ . r ~U•, ^ t SAMPLE ~ ~ 03) aoaaaa naaeaa Y.:;f=#;•r,. ': ni: ii TREATMENT PLA F' MEASUREMENT - a ~ r .. ~. ,)~~.1 1 0 (1 PERMIT :-: R ORT ~~~; ~.. R :~~R.F .: afioo*J# ~ A9 .?01.:. .. ts; ><>ti~7# ~ •>r~x r,: ~~ E$'j,Y IN~Tht r FLU E;NT GROti-`, YALU REQUIREMENT. ,jODJ1 .AVG 1fAILl' 19X RGD b#'~# ~ • SAMPLE , a##t' : A fi n ( 7.9) ~I~:iULYEU MEASUREMENT 1U29S 1 0 :r PERMIT .. #3# a. "G ICltAL liE. OTL2 TRLT RAB :.FFLUBNT GRL..`;5 'lALU RE(1bIREN1ENT #o## ~6.?~,"1k.VC. `.` QAii,T .!!X f".G/L NAMERITLE PRINCIPAL EXECUTIVE OFFICER !~ FTAMIU wDwlilEiNr~ile FO RMATIONTSIIeMITTED EREINrMD eI/NiSED ow TELEPHONE DATE {~. Gordon Peters MY INQUIRY OF THOSE IN OeTNNIXO THE INFORMATION DIVIDUALS IMMEDIATELY RESPONSIBLE FOR , 1 BELIEVE THE SUBMITTED INFORMATION IS /~ ~ President 6 General Mana er TRUE. ACCURATE MD COM SIGNIFICANT PENALTIES FOR PLETE. 1 AM AWME THAI TNEAE ARE SueMITTINO FALSE INFORMATON INCLUDING L'^ )Il n as 7O 824-44D1 9 I e 5 g , ' THE POSSIeNTY OF pNE AND I MFMSONMENT. SEE f! U.S.C. f 1001 MD ]] 610NATIINE Of PRINCNAL EXECUTIVE U.S.C. E 131 e. (MWM, uMr 1M•r .bpnFa nMY L'IrAM• Frwa W N P I0,00p TYPED OR PRINTED rNwmart.wn~.w~vwlr~rwbewF.nsman~. rgsF.wF./ OFFICER OR AIJEHORIZED AGENT COD NUMDER YEAR MO DAV COMMENTS AND EXPLANATION OF ANY VIOLATIONS /R~lir~nn Nl tmchmsnts A~ro/ - ;~5 6 'TOTAL IROE: LIMI"'S WILL SE: WAIVED, AtiD SETTLE A9 LE S7LIC` L7EI19 AFFLTED FCfi <=lOYR,'4RR PEECID P'YE:N"- ;1:: bURUEN OF PROOF AE~lUIHE11ENT5 U:IDF,H I. A. 3. TDS MONITOkING - I.E.?. CIL f GFEASE - '>F.P. I.F.I. (U) . 1n 1.. r. .vu o~.rc Tr u. ruc em Nr.u~nurr .uno.rv r...,r Nr w.o•nn ~.r w~..e. EPA Form 3320-1 108-e51 Previous editions may be used. (REPLACES EPA FORM 740 WHICH MAY NOT BE USED.( Q C 1 U i / ~ ~ I ~ 11-1 6 4 F. PAGE IOF