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PERMITTEE NAME/ADDRESS O.d~d. fwWyNwWL«sN,n IjD~..q <br />NA'~ BOYIE 3t:3~I1H~i:5, '.I•LTED <br />ADDRESS B D Y I E N 7, 1. '! I ti <br />P.O. BSA 4'+3 <br />PAi1NIA ~O 81129 <br />FAal.1rv BOYIR RES7J5~BS, i.I"ITED <br />LOCATION <br />ATT!!: kILLIA'f A. 9?AR_ V_P_i~upRArNs <br />NATIONAL POLLU7MT DISCNMOE ELIMINATION SYSTEM INPDESI <br />DISCH2 R6 E MONFTORINO REPORT ~OM9/ <br />a <br />.. PERMIT NUMBER DISLHMOE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAV <br />FROM y y Ol )1 TD 9 >f v <br />IT4TI/ !T?-T3/ !?~-T5/ !Tb?7/ !T&191 !34371 <br />POND D DSCft(: '[0 <br />(SURR YC) <br />F - FINAL <br />`!INOR <br />F~oM1rQm~ Aplproved.~ <br />P/lp~TdrJvel b~p'I~reA'O5~ X98 <br />17345 <br />-~NOTEN ~eed ImWCRtloru be~or~ EMR~btinp thb form. <br />PARAMETER !3 Grd OnlYl QUANTITY OR LOADING l1 Grd Onhl QUANTITY OR CONCENTRATION ND FREOVENCY SAMPLE <br /> 146-531 /5d-611 I3Bd51 146-53 151-611 EX DF <br />l3T-371 <br />MALrsls TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS laT~63! /µ6g1 169-)Ol <br />JIL AND GaEA5E SAMPLE 3ROOt4 ( 94) :,:4#p~ a°„~ ,~;; aausx« <br />Y I:iU A i. MEASUREMENT <br />H40fi6 1 0 D PERMIT x#Cg20 REPDaS Erl ip".r##C tAk"fFAY .# #?#~#-~ ~YA# $P.RLY ISDA <br />E F t' 6 U E N T 6 R O 5 U REQUIREMENT ,~ <br />x <br /> SAMPLE <br />MEASUREMENT - <br /> ,. <br />~ : <br /> ~Y;~EQUIRENIENT~ <br />.. '.~ ~.. <br />:.: ~.~.~ ~. .:. ~ ~:~ ~ ~ ~ ~ .. ~ ~ ~~ <br /> $.! MPLE , <br /> MEASU~iEMENT <br />~. .. PERk11T <br />`:REQUIR:~MENT <br />~(I, <r <br />- - <br /> SAMPLE <br />"~_ MEASUREMENT <br />- PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> ..PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT .. <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMERITLE PRWCIPA EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW TNAT I HAVE PERSONALLY EXAMINED MD <br />AM FAMIUM WITN THE INFORMATION SUBMITTED NEREIN; AND BASED ON TELEPHONE DATE <br />;~~/L C(f~(n ~/( ( <br />' MY INpUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOP <br />OBTNNINO THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS <br />J <br /> <br /> <br />/ <br />TRUE, ALCUMTE MD COMPLETE. I ANI AWME THAT THERE ME <br />SIGNIFICMT PENN <br />TIES FOR SUBMITTING FNSE INFORMATION <br />INLLWING ~~ <br />~~ H ~ <br />~V <br /> <br />°r~O~lJ ~ T , <br />. <br />THE POSSIBIDTY OF NNE MD IMPRISONMENT. SEE 1e LLS.C. E 1001 MD 3J <br />BIONATURE OF fMiINCMAL EXECUTIVE /J,L <br />`7 <br />~ ~7 <br />f 9 <br />U II <br />D " <br /> U.S.L. f 131 e. lMIMtl„ IOrtl,I eMw mNN, mFY IrCE,d1 lira w1 ro S 10,000 <br />TYPED OR PRINTED rd w~nuhe.ni.lvdomlrROfe,rwwn emaneu rp 6YwAl OFFlCER OA AUTffOR1ZE0 AGENT CODE NUMBER YEAR MO Dpy <br />COMMENTS AND EXPLANATION OF ANV VIOLATIONS /Re/erence ell effschments hers) <br />,.ETTLEAtlLE SOLIDS LI"1IT APPLIES ONLY IF := LD-!3, Z4-NR PP.d,;iP e:YEN'P IS CLAIMED. IF CLAP! IS APPROVED <br />nY Y1CD, T55 IR~g LI:1IT5 PILL NJf 3E APPLIED TO REP~H[?D 96kSGHEMl;eTS -SEE I.3.lA, P~ 5 AND I,B.1D, P,', <br />~ 'EP For^ 2 - 1 -95) Pre 'b edlti d ey d. 1 E LACES EPA FORM TAO WHICH MAY NOT BE USED.1 PAGE OF <br />',., 0574 /970H14-153 i 2 <br />