Laserfiche WebLink
PERMITTEE NAME/ADDRESS P•aW6 FxrnryNa./lxanon r1OrQ..r.p <br />NAME LYPrtLS tNP((Z_ (,Uh'LIr(Ai1L'iV <br />ADDRESS P u dUX Uo <br />,.c~-:alL, GU e161o <br />~ ~" <br />FAaLm L;YNnLS C1•!Pii!~ Lilkr'uKAi11~IV <br />LocArloNUKAII, (.U t31G25 FRI <br />eiTty Mil FeAFI 4_ 11111111..._ 1:1-A.f~G LI atf=J <br />Form Approved. <br />0 B o~y2040-0004 <br />~ uF ;;I~,~ i~ wl~Cppr~v Ls~pjrs~'0~31.98 <br />iU1fK ~w L~4~ <br />F - FiivaL <br />MINLIi. <br />~#t hu ulSCFIAK~F ~~+' <br />NOTE: Reed IneweUOne baton om trop tlb /orm. <br />PARAMETER I3 6rd On1Yl QUANTITY OR L /I Grd Onlyl QUANTITY OR CONCENTRATION 0. FREQUENCY SAMPLE <br /> /1663 16461 <br />~ 38-<6 !<663 6Ld1 <br />EX OF <br />TYPE <br />132371 AVERAGE MAXIMUM ~I~1INIUM AVERAGE MAXIMUM UNITS /ea•ea! MALrse <br />(64691 /68701 <br />u~l aNL vkt ASj- SAMPLE >k##*{<ti. ~,4 ##~i«#~ #+iaV+•~ti~ t'~#+t4#b <br />Y 1 SUAL MEASUREMENT ~ ~, ~, <br />:,ti.1aD 1 U U '::,:?ERMI7 ;; a#~~il.?k ' {~:::: :::;'..,.' t5 1 ?: ,: :.:~: <br />• _ ::. <br />#4~f#:!1# . ` <br />;:a~k~!.+~~:A..:• l~~f'•° '!Li<:k:/.. <br />+ ; rl. <br />~UAI. <br /> <br />cFf-LUENT bKUSS YALU REQUIREMENT.: <br />..::..:::>:<.:..... <br />`::tt",. :. <br />'~.:'?:~:: .. <br />... <br />. <br />::.;.:..:: ~:"::;.:. . <br />:: <br />M4M?a <br />Mif':Fi . <br />'::... . <br /> SAMPLE <br /> MEASUREMENT ' <br /> .:_.. PERMIT ~~~ ~ ~~ ~ .. ....,:. . <br />: <br />~;:~:'<::~" ...~:: ... <br />.. <br />. <br />'~', <br />` <br />~~~: <br /> ~R ~QU.IREMENf~ ~ .. .. ~ . <br />. <br />~ ~:...~ .:~.~ . <br />..:. ... <br />. <br />. <br />,. <br />: <br /> SAMPLE <br />• MEASUREMENT <br /> ::.'P . MIT: ~ -: <br /> <br />~ ~ : . . <br />~:: <br />~. ~ . , ..T.,,. .. . .. <br /> .. <br />:: <br />REQUlREMEN7 <br />~ ~~ <br />~ <br />~ <br />~ <br />~ ~~ <br />?.~~::? <br />'`;T" <br />~ <br />~~~~ <br />:~ <br />~f' <br />' <br />:3><~s-i <br />::~:"€~; ~:~~~ <br /> . <br />. <br />;. . <br />. ~ : <br />. <br />~ .. ~ <br />. ; <br />: <br />: <br />:: <br />.# <br />; . <br /> SAMPLE <br /> MEASUREMENT <br /> ~PERMIT:~ ~ ..... .. <br /> HEQUIREMENF ~ ~~ ~ ~ ~ ~~~ <br /> SAMPLE <br /> MEASUREMENT <br /> .. PEFIMIT: ~ .. <br />~ .. ~ ..:.:... <br />~ . <br /> REUUIRENIENT~ ... <br />~ ~ . <br /> SAMPLE <br /> MEASUREMENT <br /> ~~~ RE.RMIT~.:~: <br />~ <br />~ <br /> fIEUUIREMENT.. <br />:... ~ ~ <br />~ , . <br /> SAMPLE <br /> MEASUREMENT <br />. <br />~:: ~PERMIT:`~~ .:. ., .. <br />,. <br />REQOIRENIENI~: <br />,.:.... <br />~ <br />: ~ ~• <br />. <br />: . x• <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTI FY UNDER PENN.TY OF LAW THAT 1 NAVE PERSO <br />ED NALLY E%AMINED AND TELEPHONE <br />MD eA9ED ON <br />RE DATE <br /> HE <br />IN; <br />AM fAMILIM WITH THE INFORMATrION SUEMITT <br />MY INDUIRY OF TH09E INDINOUAL9 IMMEDIATELY RE9PON91eLE FOR <br />Kicltard 141i11s OeTNNINO THE INFpRMAT10N. I BELIEVE THE 9UBMITTED INFORMATION I9 <br /> TRUE. ACCUMTE MD COM0.ETE. 1 AM AWME THAT THERE ME <br />RMA <br />ON <br />INCLUpINO n <br />970) 87~-Z7i2 <br />4 <br />~7 <br />q;. <br />~ ~ <br />Fnvircmmental Lanager S <br />TI <br />910NIFICANT PENALTIE9 FOR SUlMITINO FAL9E INFO <br /> THE PO951pILITY OF FlNE MDIMPN90NMENT, 9EE to U.9.QE1001 Mp 33 <br />IN <br />OF <br />E <br />NE <br /> U.9.C. 1 late, /PwroY. rnNr IMr morn,. nrr YrchrO. rxwa w ro JI0,000 iIONATURE <br />PR <br />CMAL EX <br />CUT <br />TYPED OR PRINTED .nswerinun,HrM>o+mwtele.wwnemanlna rW eY••1•~1 OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPlANA710N OF ANY VIOLAI TUNS tRnersnee en smcnmenra noel <br />,itiiLLAuLc S:L1•!~ Llr,tl nr,IVtU FLw IUYk,<4~ili P..<cC1P EVci:i-ScL 1.A.9] P,; l'v, ru~< ~c._,;lrinLMENiS. loll , <br />L;n~.~~c i,rtArf SA;srLt A".ALY~iS RcuU[iir_U 1F Y1SItlLt ~IicE;a iS i,~StKVi:O. ~nirtLY SANPLI~~U (riSirtUCT[~rd~-:.~.=.. <br />A Form 3320-T 108-961 Previous editions may be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.1 UU 1 U 1 ~ 4 U L U v 1- 1 ~ 1 1 PAGE iOF <br />