HYDRO28277 - Laserfiche WebLink

Home Browse Search

PERMf[TEE NAME/ADDRESS pnclude Facihry Name/Locatian ifOi$nenq NAME ^vI- :1- .'. - ~... _ • ADDRE.SSrMi'..S Le.'.'? q~,'1"^e ._ _ - ^~f FAClury LOCATION NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOESf DISCHARGE MONITORING REPORT (DMR~ R-181 (1 ]- 9) ^,~»~t5n ~~n PERMIT NUMBER DISCHARGE NUMBER MONITORING PERIOD YEAR MO DAY YEAR MO DAY FROM ' I ° {I ~ I TO `.' `.'' T R6P1) R~-231 R4t5) R5-2]1 R&PB) (3W1) Form Approved. OMB No. 2040-0004 ~~ ~ ~ ` Approval expires 0531-96 ': NOTE: Read Instructions befor~mpletlng this form. (3 Cerd Ony) QUANTITY OR LOADING (4 CeN Ony) QUANTITY OR CONCENTRATION NO. FflEOUENC SAMPLE PARAMETER (46.53) (54-61) (3Bd5) (4G53) (54.61) ETC OF TYPE (32 97) AVERAGE MAXIMUM UNffS MINIMUM AVERAGE MAXIMUM UNITS (ezm) aNALVSis (84-88 69-70 .. SAMPLE .t':7 t: ~.: #;:a:rX :,- .. ( T ~I MEASUREMENT U •:': U 1 ~~ ? PERMfi - - Y"~ ` ~w - ~'~ . t} - - ~ _ S Z'RX G'K 4~f~n*~ -'1,U"r1" •./'~ i 'VA r, •_ c REQUIREMENT ~ 4Cr"' ~ ~g'! ![A1(~wf[1.~ ri.r _ .:a ~C`1.1U5, ('OT 1T, SAMPLE `•G4T3: 34##2# C'k d'Y'=^ ( 7. q) 7 U ~ U ~ N f' %' .{ MEASUREMENT '.1'r .10 3. " 'l PERMIT - O - ~ C iR'R#>R-':.. #'i . .C Aa>ylk'~ . ` . 5tt .."' ~ ,~ ~. " x *~ -,. ~ *: ' "~-~' N.'f4~ :°t'LII `.ST u'"'"S YALI''' REQUIREMENi;~ ~ ~ '~•"_ `t` '~1~jy~: A~+ ` ,• ~~~. YC/[ ~ 1113.-; „i t';T .v SAMPLE "r'c`:: {: t- .. ~a4Z AQQt. {r ': ( ! ~~ f: T t. L F F.:.? D; R{' L ~ MEASUREMENT L1 O 1'r'0 1 ~~ ~ PERMIT ;< -' Tv~FC'X #~I#~,` ~ , ... #31At#'-'kE>' • f ~~ R7 P"~t?T '` sl' 1[R~'~tE. ~~',~~,.,. "F:'i.0`~N'" ;R')Sr+ ie. Lit? 'REQUIREMENT ~... t'{: ~'~ iF1DR illy n>1f Lf 1!i" ~"/(. NON*q .. :.v t'de °J RN i .L'! SAMPLE .^-'r C.. .. „-.. ,.. r...; :. ". [ 1 q~ .: I t. ~'! L V .i J MEASUREMENT hiiUl! ~ o o ~ ~° suaap aQaa¢R. ~;x aaaltsmLp APPORf .t1T4 ? NRBF/t t;~<; ElA °:' .. C h :' .' u ~ c n n 1 r ! '.~E T~EMENT t' .~ yQ. a ~~A~ k9, ~ rIALLX „~ _ ~ , 7. M'1T N ~ .. , ::U:}'EHe i''~T`NfiM1LLT SAMPLE ..#Rn a~;:aF,'; 'k"~'.:br. [ ''jl ?ri= ~?L V r. ~~ MEASUREMENT J~3']F, 7. ~ ~ PERMIT [irf#rl~#Ar 914?fP9t#~ #~~Slp#' .~')'~ f r~i~~ ~` ~ <rRlw~~t RK~1.''. ")SS YA Lt1 ' °"L'J2`f'' '~ REQUIREMENT - `.';' .t~:;~ 'I (1 ~ '~~ ~ DRL~ T }SZ '~^/L *~ :. MlOK4T[ - , . . ...; _ . u . : ..i NU `:ems, SAMPLE 3.'--:: •:;= ~##`4r 5{*Q'Y!r f! r-•-~r ";!t.y ( LO1 MEASUREMENT :31:'12 7 '] :1 PERMIT 9LPOr#Ra Ct~# Itf r~ r -.; :CTEH§eylltJMl #'!t'¢>dlfr.@ ~ ([) .:.:~" MTr!/r Rll-' .=i..!i y:NT L'475.i "'. T. ':' REQUIREMENT ~ ^^! I'MS 1' 11a* ^/T, F)§ - .,AN Y.:>. i:~ T7^ ~ SAMPLE ~ ~: h^-;: r. r. ., ^-r,: ( 1qT ~ V F M A H L F MEASUREMENT it77j 1 D ': PERMIT s%R#R -tiOQ130Cr tr ,.•.:: t9r4!¢•S9t R~"n'{!R? 4oP1)RT_ ..? .. ARP, F./ RA#~;...: ; "'IIPfiT ;: H')~~ 'e T.. .~ REQUIREMENT ~TDK AT; DA*LT !!X "'/T r. !t :3NFH . NAME/TITLE PRINCIPAL EXECl1TNE OFFICER I CERTIFY UNDER PENALTY OF F M RH THE INFORM LAW THAT I HAVE PERSO ATION SUBMITTED HER NALLY EXAMINED AND TELEPHONE EIN AND BASED ON MY DATE ; A ILIAR W AM INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING ' :LICNIa CO (.'III~s THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE, ' ~ yr ?VII'n!1!!lr?.^.tG~ ~!~^narer ACCURATE AND COMPLETE. 1 AM AWARE THAT THERE ARE SIGNIFICAM PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE ~'~ ~ •7U B7O-77)Z Cl ~~ 9~ POSSIBILffY OF FINE AND IMPRISONMENT. SEE 18 U.S.C. § 1001 AND 33 U.S.C. SIGNATURE OF PRINCIPAL EXECUTIVE TYPED OR PRINTED ~18.~Pone/des untlw Vase sfefufes mey Inclutl~rsllnee up ro f10,000 erM w pM1SOnmenl of beMeen B monHU ends ) OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference ell ettecnments Here) -._ f. .,R=.C -.. - .^r s(`.~^~~!"' R/e . acTY 17 7 ""TI]; rTMT^ - 'c^ r-)••r~1~~. /~ n„r... ... T. s. T.° lT'-.S".~ 'T ," ~L:, FD7T't lr: ../~ s•:1 x. 7'iT^7:+T'7T - :*!E .'7~q~M°' T': ^T rrl'. 's~ '{^ oil +'T )+teT •'~ n• t• Epp Form 3320.7 (0&95) Previous editions may not be used. (REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.) n ~ T 5 T / a ~ O N T ~_ 1 ~ ~ 1) PAGE T OF