|
F[RMITT[E NAM [IADO R[e! ~/nFIYdC
<br />Faeirity NamelLOnlbn fJdiJJaenr/
<br />NAME_ MT~nrr ~ilr
<br />z-,.-:~. r ----------
<br />A DO R Ef E-N{r~•1-E~ -miu-~~-~S~~C-F-_°~-F:--.MZT-I~~~
<br />---~f-~-z.-TT~-E`.=.°r-I-S--R-!-Sa-A-A{f,-P~n-F° !I---
<br />n.COnune O)L9)
<br />~~~T-1TS!TS - ~----~.~v1v>T.-
<br />-weruTV_
<br />----------------
<br />LOCATION
<br />ATTL~ .17y cTnVrR
<br />N ATIONrLL FO LLUTq NT OISCN AgOF CLIMINATION SYSTEM /NPDESI
<br />DISCHARGE MONITORING REPORT /DMRI
<br />z./IS n./9 HINUF. Form Approved.
<br />r`n -. ~ nn~ (BUSH NC)~MBF~:?01,40-0004.
<br />•ERMIT NVMe[R Br.Cr.ARGF NUM.Fq F - F1 NgLApproval expires 630-91.
<br />/ MONITORING PERIOD DUST-CINIhG F:IJ40FF SEDI POYU
<br />YEAR MO DAY YEAR MO DAY
<br />FROM y~y
<br />9 1L O1 TO 9d 1.: 31 '''a;° t+G u15CNAkHGF: 1 I ax"x
<br />11 O l21~131 /2115) lI6~27/ /ZB~291 IiO~J// NOTE: Read instruction before c'bmpleting this (orm.
<br /> (3 Cord Only) GUANTITY OR L G (l Card Only) QUALITY OR CONCENTRATION rq EOU ENCr SAMPLE
<br />PARAMETER (lb-Si) (Jlfi/) (iB~J) (Ib-JJ) (Ji6/) NO
<br />E% of
<br />TYPE
<br />(31-37) ANwLV515
<br /> AVERAGE MA%IMUM IT6 MINIMUM AVERAGE MA%IMUM UNIT6
<br />blfi3)
<br />(blfiBl
<br />(69-70)
<br />~H ~~"~ar1 Lr"//~%fyy} aaaaRt+ ( ~2~
<br /> MEA UREMENT
<br />00400 I O 0 ,Po~2aPER`MlT'~i4
<br />~ :~,n~-1I?7A~a°. .~a~?~'
<br />~aik'„ ti:>rG
<br />°__
<br />!° ~ ~,'~+~~pR`'
<br />~~
<br />#
<br />°
<br />p. •~
<br />° ~'F
<br />'="%~~ `°`°' Cr~6!"., ~,J~~°a.
<br /> RERUIREN ENTF .
<br />f.x "°
<br />~
<br />"
<br />~
<br />~ _a r
<br />,
<br />g H2 eh~°~ ,v.,
<br />C •rks" ,:k?i°r9 • .T/~~YY3 O % '" .i.'.4.. xizS
<br />a 's
<br />
<br />SOLIDS, SETTLEABLE
<br />6AMPLE
<br />aaaa##
<br />aaaaaa
<br />(:~) _
<br /> MEASUREMENT
<br />
<br />60545 1 O O
<br />° ~PERM~IT$ .
<br />I
<br />G
<br />.
<br />.. ~T^'* ~~~VM
<br />.
<br />.g"~s, Aa°~:
<br /><p
<br />>~~~t.^
<br />*'
<br />
<br />aa#
<br />d
<br />.~
<br />Sw w~
<br />' a.¢,j
<br /><w P¢ &:'T a"~; ~y.
<br />,.0.,.,. .
<br />.1F, .
<br />$ge ~~
<br />
<br />p
<br />yy!~~ a~~~
<br />~°~
<br />.'
<br />~~
<br />I° *~&
<br />~r~~~^
<br />e
<br /> IE
<br />UIREAt~BNT;
<br />' <
<br />nA`4.
<br />LS° .`
<br />d m
<br />{~
<br />,
<br />~e5
<br />. ~
<br />'
<br />t
<br />F +
<br />Us ~ ~
<br />a
<br />z
<br />'&'1v.bg'iF r$y
<br />S~ ~ ~ .
<br />.
<br />7"
<br />~ sa ~' ~
<br />~
<br />r P l` C 11 ..~ .
<br />. S Rx
<br />O
<br />J
<br />~
<br />° ..
<br />r p
<br />OIL AND GREASE 9AMPLE G#aasx=>, aawaaa _-ot+P#aa ax<a#aa - (-.~) ~~ rr.
<br />
<br />Y L7E
<br />E
<br />N EXTA-
<br />R
<br />F MEA6UREMENT
<br />A
<br />O
<br />G
<br />T
<br />A
<br />°.
<br />..
<br />°
<br />° ... _
<br />' a, ° •_
<br />60556 1 0 0 `•P,ERMfT„~°m
<br />' rr~.°,S+e~p`~O~
<br />x: °s~s6~°~' ,r•I};: a
<br />.xf„~s~e
<br />~'
<br />~t ~`4~.ar~
<br />^
<br />` fis~g +.,~;;
<br />'
<br />~ ~ ~ .
<br />~ ~'
<br /> REOUIREM Et(T "
<br />lYJafr °"rs" .
<br />•Irrv•F"~ =
<br />a~ yzs
<br />aP,.*
<br />L• .x° <~ e s
<br />FLOk, IN CONDUIT OR 6AMPLE r L3) ###c+a# sataaa #aclaaa
<br /> MEASUREMENT r
<br />-~
<br />T
<br />L
<br />NRU TREATMENT P
<br />AN
<br />~
<br />~
<br />R
<br />..
<br />..
<br />„
<br />"
<br />` °
<br />"
<br />';
<br />'g"
<br />° ° ,,,
<br />
<br />OOSO I O
<br />O .y •'.iPERM~i.T ^ n .
<br />aRt UI
<br />REN ENT ..
<br />°,
<br />~ OR.
<br />'~.' "
<br />°~I!dn ra• ,~ ,
<br />gy.
<br />x°,~ ^,.°
<br />~,Lf''
<br />'
<br />C.~.^- r~ e: °
<br />ia
<br />l
<br />+
<br />~ ~,a m
<br />~~ ~
<br />c ~ &
<br />y `
<br />.
<br />~
<br />a "" <''w a
<br />'° ,
<br />c
<br />E I M _n / !b p
<br />Em .. p m w
<br />SOLIDS, TOTAL 6AMPLE aca:~l~;l aa.>:-#a s71YAS$a## ( 19) .
<br />
<br />liISSOLYED M EABU REM ENT
<br />
<br />
<br />7J295 1 0 0 .~.. ..
<br />°f '~,
<br />~ PEgj1IZ
<br />:
<br />¢ '
<br />~ `°O~~+h.~R+4~:
<br />s; ~ a
<br />~ ~'~
<br />°
<br />L~
<br />.
<br />~
<br />
<br />aa:~
<br />'; S x`
<br />~1..=~~~+a?ia~. n,^
<br />8 '8°tt
<br />~ ~.
<br />~ `~ Y'sg a
<br />e"41°"~ 8°n
<br />JQ~~f~ y ,~
<br />~
<br />~~
<br />Y~
<br />~.°~ y
<br />S'z
<br />Q. gb"r
<br />~+S? ~
<br />
<br />~^'
<br /> -R80U1REN 6NX.
<br />Ys
<br />~ .
<br />;g. ,"$:
<br />°zs
<br />~i. ~ ,
<br />^s
<br />4
<br />m"
<br />g
<br />l "• •a
<br />sp g
<br />a
<br />s'
<br />"
<br />g
<br />x ¢
<br />8 4~
<br />'
<br />1 R
<br />~n+4 ?~.
<br />a a* e
<br />s
<br />~ '~`1F
<br />a
<br />b
<br />~ +~
<br />.~!
<br />a "&°~
<br />%v
<br />
<br />L'C r . .
<br />..
<br />d ~~. ,
<br />~ a
<br />x
<br />a
<br /><.
<br />1.M a
<br />n
<br />.
<br /><
<br />F~
<br />4
<br />'
<br />~ ~
<br />Na. +
<br />.e
<br />. ..
<br />-. - ,F
<br />~~ ~ r ..
<br />UIL AND GREASE 6AMPLE e°laaaa ( y4) aa*.c:,: aa#aaa ;~aaa>c:a
<br />VISUAL MEA6UREMENT
<br />
<br />64066 I O O
<br />t.'F~PERM.`I T.°'~° .N y.
<br />~n~T
<br />~p9
<br />8& z8S~8.y..
<br />y~
<br />EC=1
<br />ny'
<br />$,rG.01
<br />~M'xx
<br />x<d
<br />*
<br />~}.p ~A~
<br />id g
<br />'WlaF~n~
<br />q°
<br />i.8 n°w.@Ta•
<br />B+~g
<br />~R
<br />~
<br />
<br />h'•a¢ r
<br />
<br />~
<br />(y&
<br />p~
<br />eQ° ay,a
<br />.s,itj r
<br />S'
<br />~
<br />~
<br />~.3`
<br /> 'REQUIR6MtNT
<br />'
<br />"' .
<br />r. ~ 1¢ J .
<br />.
<br />.
<br />°
<br />~9
<br />'
<br />` e
<br />a
<br />~
<br />4
<br />~~ e
<br />r- y. n..a„a
<br />eC
<br />s
<br />'
<br />"
<br />° }
<br />%
<br />j
<br />S~ ° xl`"1°P y
<br />Xr
<br />'
<br />~W'~T'r°T
<br />PCT ? !` CC o-e
<br />s~
<br />'$ U. . by
<br />'¢P r
<br />x
<br />a haxJe9 :~s
<br />,
<br />k °
<br />s
<br />. x
<br />ttAdg~^i w. sa w
<br /> 6AMPLE ~ ~ ~
<br /> MEASUREMENT
<br />
<br />o~ ~
<br />" PER M
<br />S ^3
<br />~fT
<br />L
<br />y. ~p 4 iy
<br />ay O'P [1yP 4-8n°•
<br />•,
<br />
<br /><
<br />'
<br />r
<br />E F sYyR g
<br />°x~ ~k ap°b
<br />)' o/w aq°o~x
<br />3y 6~ffi:^5°-g`S°w' e.e
<br />F sy, ~
<br />
<br />~
<br />$y
<br />
<br />g.g ~
<br />~
<br />~ 4p #!/tr ~
<br />
<br />'f°'~°~a
<br />~
<br />g~
<br />~
<br /> -REGUfRE M ENI ? e ffi
<br />~`
<br />$
<br />~ -n~m ^
<br />r
<br />xp c
<br />°i°
<br />'
<br />y' ' °
<br />e
<br />°
<br />'~
<br />f~ a '
<br />~s
<br />%
<br />s
<br />¢ #
<br />~~
<br />Y
<br />i
<br />~
<br />d
<br />~' "4+Y '
<br />~v M
<br />IS
<br />~
<br />'
<br />°s
<br />°
<br />p
<br /> . ~,..~ t
<br />n <r s8 cl
<br />. °
<br />a
<br />v?F z
<br />x
<br />r a ,~c
<br />aw
<br />y
<br />t3 .
<br />.~tt
<br />s
<br />>
<br />;
<br />s'xa ~ ia ~
<br />n
<br />4
<br />a
<br />~
<br />.
<br />s
<br />NAME/TITLE PRINCIPAL EX[CUTIVE OFFICER r CERTIFT unDFR PEnALTr of l+w THAT r NAPE RERSONAUr F%AMBIED
<br />I1M FAMrLIAR WrTN TNF IHFORMATrOM SUBMITTED NERErM ANO BASED
<br />•M TELEPHONE OAT E
<br />G `r //
<br />~E/C•~~
<br />J O
<br />ON MY mOUIRY OF THOSE MOVIDUALS IMMEgATCLY RESIONSIBLC FOB
<br />OBTAMING TNC MFOIIMAnO`I I BELIEVE THE SUBMITTCD INFORMATON
<br />• 4~ ~ Y
<br />LL-- I$ TRUE ACCURATE AND CLM.RLETC I AM AWARE THAT THERE /rRC SIG
<br />NIFICANi MNALTrES FOR SVBMrTTIHG FALSC INFORMITION INCLVONG
<br />-1
<br />Jr~s /Q EN ~ TN[ R05516RRV OF FME ANO IMHi150NMEHT 5[F ra USC f 1001 ANO
<br />]3USC 4 rJr9 rP
<br />l nvr mrldr /m
<br />Mrr rArv rlvlulr
<br />r
<br />rlU rMn
<br />lb S NATURE OF PRINCIPAL E%ECUTIVE Z4S-
<br /> r. u
<br />r
<br />^
<br />rna
<br />rn uY
<br />A
<br />b
<br />lA
<br />d i AREA
<br />TYPED OR PRINTED .m..n
<br />mrin
<br />..n
<br />.wr.r
<br />a•d..~na.rnrwr rmP.u.rrlm.unr/ OFFICER OR wUTMORI2ED AGENT NUMBER YEAR MO OAY
<br />COMMENT AND EXPLANATION OF ANT VIOLATIONS IRrlornar all wlurhmrnli hrre)
<br />SETTLEABLE SOLIDS LIhIT WILL BE dAIVEC FOfi >i/r Yk, 24-Hk FHECIP EVENT-SEE I.A.2, PG IV, FOR RFQUIHEfeEtilS.
<br />(,dTHLY SAL`1PLING IASTHUCI'IONS-I.C.9, PG IX. 3G UAY AYG ZS HIGHEST MONTHLY AVG CURING PEF;IOC REPORTEf..
<br />EPA FOFm 332IYt (ReV. iN88) Pr~v1oU9 e(JIrIOR9 may bB USad. (REPLACES FFA FORM T-e0 WNICN NAY NOT e[ USED.) FAG[ OF
<br />_ OOGh7/940412-1B3B 1
<br />
|