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PERMITTEE NAME/ADDRESS pnehde Facility Nmne/%carion iJDigerenq <br />NAME :-q ~~..~~ ,,~,. .. __ ..- no p~ <br />ADDRESS.![ 1•' ~ [~ rr t .. .-~ .^ 2 V 7: <br />.. 910, fir.' -- _";'r. <br />PACIUTY <br />LOCATION <br />^' <br />.. . ~ ~ ~ sIr _ .( 7L 11TNV <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR~ <br />rz fe) m- el <br />...~~.777",,1 ~~S n <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM +.r Irk .1 t TO ~ •~ti a . <br />(7471) (27-731 (24251 (78-71) (1829/ (3431) <br />Form Approved. <br />..~„ OMB No. 2040-0004 <br />Approval expires OS37-98 <br />f^-~" „01 Tt <br />.r. ~, ,,,..., Tn ~nT .~f. ~ ~ 'T <br />1 ,j <br />NOTE: Read Instructions before completing this form. <br /> (3 Card Ony) QUANTITY OR LOADING (9 Cerc Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-61 3845) 46-53) (59.61) EX OF TYPE <br />(32J7) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS (~~) ~~ Gels 6&70 <br />I SAMPLE <br />MEASUREMENT ~^.s~~ x:SRG," ~I I~ •. .. .... Q 11~ <br />o ` ( „~ / ~ 1~ <br />nDv~U .. J ~ PERMIT <br />- ra- ~ ~I:41'# +R` 9*-. '~ ~~LS~~: ~*~k,~~ <br />:. U ' .:'. .1, ~ :.. V * -. I!' . <br />: <br />REQUIREMENT <br /> <br />. -- xY ML!!Q!1 ` ' 1#kR Ii'!8 #! S'i ' <br /> <br />t <br />s -` <br />•_I~i.! .):s, SAMPLE `r :s 4x'3G= f <br />Or GG G wG~s~r. / t q) <br /> <br />`i I)`~'~~~~=~~~ <br />MEASUREMENT <br />~ t ~ <br />N~ <br />~~ ' 1n <br />N/T <br />tirl <br />I)95?7 U ~ o <br />PERMIT <br />~ ~#raa~~-~ ~::-~ +~#~#+sa ~ , ~ ,~ <br />~ <br />~ <br />~~ ~~ <br />~ r~ ~ ,~_ .fin <br />~{~r'~ <br />"/g` <br />~ ~ i <br />A'~'• ' <br /> <br />=. f' CU"!' iti1° i - . 7'. <br />, _ <br />.REQUIREMENT _ <br />~~'- <br />" <br />- - <br />~. _ <br />. . <br />, r <br />~ <br />.,'. ,, »~ lU SAMPLE r.-;: <br />-:G 7~-`r C.`. #x'k,v,.« ( '0) ` <br /> <br />~!' ~ i' 5 Y D P, ? <br />MEASUREMENT <br />~~ ~~pp <br />~,~ T; <br />C 1S7n 1 U 7 y~ ~ , fi~~~~ -~ . a ~ .~~ s. T~ R~ kR41~';: <br />LUE!7T GflO;:: 'J*i )F ~ <br />,)iER" NT '`~. `~ ~{ 3~DA k*'~ 9ATLT ~X 'I:/'. fl '('. <br />~1: .1 U'r~ UGf'[L`.r"C ~ SAMPLE G'`CSx: G3?ISa" ,~t•`--^!` ( ~~T <br /> MEASUREMENT /U ~~ <br />„DtinS ? U 0' <br />PERMIT aaaaas :Ga aAtAltlgraS ~ <br />= '1.5 <br />==~~ -a~: <br />CI~~I`-`1 ~ ,: <br />+ k~" ~- <br />~ <br />1d <br />'. '; (-OMMRNT4 p~' REQUIREMENT i'kp <br />"" " ~~`~= ` <br />~ <br />~~~ lII <br />n~T <br />~~ "i <br />~i ~ <br />~"~.?.. <br />!~~ -~ a;; <br />. <br />. ,_., * <br />. . <br />,,. . <br />_,; :, uS, S 't SAMPLE c;rx:a: x:x :G ~G G=.G-: r-r ( ~5j <br />l <br /> MEASUREMENT ~ I /3 ^~ <br />'')Sa5 1 ^ D PERMIT i #?t00#~ ;'#G ,C#41~t# RbP 'E' ~" ""t~!~*71k;"!'It'_., 41 '. <br />.c"i.:i F. r1T vN iS" 7pr:/! REQUIREMENT {: r~`z': 3U0k li9a~' :21 I4LLT M /T <br />'T §!"Q <br />1k` ';'~~`' <br /> ;. <br />, <br />m" . <br />. . <br />: <br />'. 1+. r, I~Yr:!'ir SAMPLE •^-~;•G3G t't G3 ~G t;;tG^:; ..~r+tr« ( '~) <br /> MEASUREMENT N ~- ~ (~ <br />': U S ` 6 1 J ~ <br />PERMIT I Caafs, ., .+ '!C;N!CrR##' #'#1~ t i? ~ I " <br />= <br />~ <br />©IF4 ~`!K, <br />~, ~~-.~,} <br />~LneN'r ..,~~-- .-!„I1c <br />J "REQUIREMENT ~::x LMSZ' MkX ^~T, G$fl .$++; <br />:t't. ~ V'." <br />. SAMPLE .:`h `, •: .~.zry~ •..kxA..~ / ~. q) <br />(a', .° r~.) MEASUREMENT ~ ~' <br />')i'iUS C Il .1 PERMIT C4rRO }`'.=~ .a az#oa 't ~'Pi1k? Rp~+OR* .. _ TAC!?,l ,''" ^~?''° <br />'~r'Y. CO!1:' .." ; .. .• "1:, REQUIREMENT y,,.,.F 7fYD1' t!^, @11£1.7' MX' <br />' ~•'-/,. hO~'7'A <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMILIAR WRH THE INFORM LAW THAT I HAVE PERSO <br />ATION SUBMITTED HERE NALLY EXAMINED AND <br />IN <br />AND BASED ON MV <br />/"1 TELEPHONE DATE <br /> INQUIRY OF THOSE INDIVIDUAL ; <br />S IMMEDIATELY RESPONSIBLE FOR OBTAINING / <br />/ <br />l <br />I <br /> <br />Rl <br />h <br />) <br />THE INFORMATION, I BELIEV <br />E THE SUBMITTED INFORMATION IS TRUE, <br />T <br />T T <br />ER <br />ARE <br />NIFI <br />ANT <br />/ <br />/ <br />%'/ <br />~ <br />~~~~~ <br />" <br />~ <br /> <br />r_ <br />ard I},I r <br />5 <br />ACCURATE AND COMPLETE. <br />E <br />TIES F <br />R SUBMRTIN <br />I AM AWARE <br />HA <br />H <br />SIG <br />E <br />C <br />G FALSE INFORMATION <br />INCLUDING THE '' <br />( <br />(/ <br />C <br />.~ <br />~!/~ <br />i <br />C:TVlrnnr-,eil ta) rila ne ger NAL <br />P <br />O <br />POSSIBIUTV OF FINE AND IMPR <br />' , <br />ISONMENT. SEE IB U.S.C.§7001 AND 33 U.S C. SIGNATURE OF PRINCIPAL EXECUTIVE 970 87C-272 E 7.4 99 <br /> <br />TYPED OR PRINTED g 1319. (PSnoln <br />es under 91ese ambles mey Inclutle /loss up ro 510,000 erM a <br />maximum rmpnsonmer9 ol6sl.een6nron0rs entl5yasrs.) OFFICER OR AUTHORIZED AGENT <br />p <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIULAI AFNJ (nererence an arracnmenrs nereJ <br />r'~":: P,RP.T' ~ +Trc -.n.r a_s I-(nM r r^,°Tf.o4 oTr <br />", ,,^LAIf!r;n~ Ccr 7.7, ?= 1. Y, F'Ta )9R+1cy ~!' CILTii ~' (T.9~ s.+c7 ~-.?(,Y n>rTv <br />n~'Tn^ ov~.T~crvy.. ~ "Tt, c r~ C. "1_V r <br />r,o F..-.•_coc• ~ 7n-t{n Do^^T' <br />rnnw~T+Tr c./ ~ , <br />s <br />:na~V cs+.P ~ vonnM1.~r•' T•1^+~ ~~u.-_o.~ w F <br />EPA Form 332x7 (OB-95) Previous editions may not be used. (REPLACES EPA FORM T-00 WHICH MAY NOT BE USED.) O D T T T ~„ D n tt I ~ _' S ~ rl PAGE + OF I <br />