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rCRMITTEE NAME/ADDRESS pu(rl.frmryNayto~m..IJD,Q'wwp <br />NAME TttdpPE; MILIt:S, IrvC. <br />ADDRESS T KA P P ti.4 B I ti E <br />F.U. liUX 1H7 <br />C H .~ i'.; <br />^(. 5162G <br />FACILITY <br />LOCATION <br />ai_\: il. GOF:DOrt pPTi F°„ Pnt S/•3Eti ^, .;d <br />NATIONAL POllt7TANT DI9CMMOE ELMIINATIGN SY97EM pVPDfSI <br />DISCHARGE MONITORING REPORT lDMRI <br />1-161 17-191 <br />C09U32?15 C?7 A <br />PERMIT NUMBER DISCNMOE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO ~ = <br />1161/1 112-131 (14151 (16171 /IB-191 !30.31) <br />Forrn ADProved. <br />FL%CFf/MThr YTit ;Rl'I~R#DQ414.4a}I <br />(5 U P F !i w ~ ApProval.e>Sp3Fags0$-31-98 <br />F - FIIIAL <br />MICA <br />~r:;: vc ~1:scHaPCe ~'~ vz:n <br />NOTE: Rs~d ImtrucllaFr 1»1«~ eompMtinp this f«m. <br />PARAMETER I3 Ard onlrl QUANTITY OR LOADING (1 Grd on/TI QUANTITY OR CONCENTRATION ND FREOVENCY SAMPLE <br /> 116531 (51-fi/1 138-r5) /1653 161-5/ OF <br />(31-371 EX 'W'LLYMg TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS lsa~s]I /56.581 189-701 <br />~, .. N i,n !i SAMPLE =:I;r0 r1:: ( Q4) '~Ott'fLt :{{hyYl {:{i'ICO <br />V j :i U A L MEASUREMENT P O ~ `il~NL <br />duJoG 1 0 U PF,RMIT ": <br />" ra acrx 13EPOAT E5=1 n~olea.# OA~7gd.a #C>v>a~~l. .IOQr,. B~'t{L. VTSUA <br />c FFLUE4T GROSS YALU "FjEntiIREMENT~" ~" - ~ "INS.S. L~~A.Y. NC=O ~ ~ 4a~# <br /> SAMPLE <br /> MEASUREMENT <br /> "~ :PERMIT " <br />-. <br /> ~;REQUIREtii1EN7 ~ ,, <br />"~ "` ~~" <br />-" SAMPLE " <br /> MEASUREMENT <br /> PERMIT-..:',;,~ " <br /> [tEQUIREMENT <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 PRINCIPAL E7EECUTNE OFFICER I CERTIFY UNDER PENALTY OF L AW THAT I HAVE PERSONALLY E%AMINED AND TELEPHONE DATE <br /> AM FAMILIM W1TN THE INFO RMATON gUBMITTED HEREIN; AND BASED ON <br /> MY INQUIRY OF THOSE IN DINDUALS IMMEDIATELY RESPON98LE FOR ~ <br />/ <br />~~ <br /> <br />W• Gordon Patera <br />TRUE,NACCl1MTE FOµ ACOM <br />gIGNIFICANT PENALTIES FOR <br />~~FLEVE TXIME S WMMI EEDHAT THE FO ME <br />SUBMITTING FALSE INFOflMAT10N <br />INCLUDING / <br />.. ~~~~i-- <br />~ <br />~ <br />/ ~ ~"" <br />970-824-4401 <br />98 <br />~ <br />'2~ <br />Prea?dent/8aneral Mana eY THE F'OSSIBIUTV OF FINE AND I , <br />MPRIgONMENT. gEE 10 U.S.C~ f 1001 AND ]g dIONATUIIE OF MIINCNAL EXECUTIVE <br /> U.S.C. f 1110, nWrNY. M10w IMw mom. nwY McAd. IM. y ro 510,000 <br />TYPED OR PRINTED Ygrmvir..n Me+lonwrrwanr..,emana.w6r.w1 OFflCER OR AUTHOR12E0 AGENT CODE HUMBER YEAR MO DAV <br />~~I <br />t ' <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS !RS/ersncs sl/ sttsehmsnES hers/ <br />~;.; b IU'(i.L IiiJt+ LjttlT.; ajLL :f F. IIAIYY'D, ASC SEPTLEAHLE SOLICS LILT? AFFL:F^ FC5 <=1VYI!,244F Pk P.^7i ~'VBI:T- <br />~Ef. iiURU~N OF pIIUGP F£;,.UIrtt.7::NT5 U4DF;i I.A.3. TDS tiUNICOF It. r, - I.F..3. CIL E GFF.ASE - SF.E I.°.1. (~) . <br />s;l ':AY AY~RAC.t Is ,IIr.MF,^ ~.>>:TR1Y avFUn,.a ;IIInIHr. TI:I;=n~ arcrl;7~_ <br />EPA F«m 3320.7 108.951 Previous editions mey bs used. (REPLACES EPA FORM [-40 WHICH MAY HOT BE USED.F Q D ? ~ 2 / 9 ~ ? : 11 ~ 15++ h PAGE .)OF ~ <br />