Laserfiche WebLink
PERMITIEE NAMEIADDRESS RedrL irdry NaWfec,rlen yDbnartl <br />NAME ~Yrn(,~ ~11r'i~~" L,.: _...T i.,:I <br />ADDRESS P L L: L;A Ct3 <br />(ixAlU Lu ti1G_. <br />FACILITY•~TY n1,S EHPiRE CURPUI~.AT iI.N <br />LOCATIONLnAlV r.. (, L, c,1V lrJ FR( <br />a I il. F~It;rTAE~. ~+. LUDi,~, GENEKAt MGR <br />FQQo~~nn NAppqproved. <br />IJ SU Dl:Gfl„cJ-'rlw iv A'pproveC e~xp~765=~~r9b <br />F - FINAL 11 <br />i'7 1.r:,ik <br />~+~~~ NU uliCHArlGE ~ ~xft <br />NOTE: Reed Inewetlone before oomplNlnq thle form. <br />PARAMETER -- l3 6rd ~~ryl OUANTI7Y OR LOADING ~ <br />' ~~ Dory/ OUANTITV OR CONCENTRATION NO. FREauENCr SAMPLE <br />l32-371 ~ <br />~ 116531 l51-5I ~; , F ~ y38-I51 4653 5F5/ EX OF TYPE <br /> <br />'AVERAGE MAXIMUM UN <br />yIMUNI AVERAGE MAXIMUM UNITS <br />m7.6,T1 MALY519 <br />/µ5g1 <br />159-701 <br />~(.Lllijr fUTAL SAMPLE '" 4444#%< 48#4#~, ~i~~li 19 <br />1 ~~ V 1. Y ~ V MEASUREMENT ~' <br />l(..:y~ 1 L "• Pf~RNIIT ;R~.~ <br />._. ~41F+rl~l~.#::... #ir ~t~8##. a, '~':.I~~t~'Q~T~:: :[i~~~i.~AI,: ~`~(:1r'i 'Kl~t3 .: <br />i_FYLUcNI ~hCl~`., YAL_U' 'R QUIREMENT. n a #~4 . . <br /> SAMPLE <br /> MEASUREMENT ',~ <br /> :ir :I?E~ip11T. ~. <br />, ., r..,. <br /> <br />>. . <br /> <br />: - <br />..... : i.: <br /> SAYGIPLE :.~~I,, <br /> MEASUAEMENT ~•~;'f <br /> PERMIT . `:. ^?":::::::: <br />•: ".:~" .:... 7..r.:n: <br /> <br />..: ., ~:: :... <br />. <br /> . ,;.,. <br />::. <br />, <br /> <br />s <br /> ,... <br /> SAMPLE i <br />' MEASUREMENT <br /> ~:~ PERMIT ,,; .:: ;..; <br />::.::.. <br />. .,.:•: .. <br />. <br /> <br />REnuiRl;nnENT . <br />. <br /> <br />,:.> <br /> <br />. <br />'::~>' <br />~. . <br />•. .. <br /> <br /> <br /> <br />;:: <br /> <br /> <br /> <br />»:. <br />... <br /> SAMPLE ~ - <br />t. <br /> MEASUAEMENT t <br /> .. ;'PE MIT.: .~ ~ .... ~ .. <br />.... . .. <br /> <br />.RE~OUIREMENj: ,...,. •. <br />~ <br />~~': <br /> <br /> <br />,. _ <br />.„ <br />,. ,. ry, <br /> <br />.:. <br /> SAMPLE <br /> MEASUREMENT <br /> .::.: PERMIT. :~:. .. . ...... ... ~ ... <br /> :REOUIREMENP ..:..x. `i; ;:.:: <br />. SAMPLE <br />;. <br />1 MEASUREMENT <br /> PERMIT. Vic`% <br />~ +.'; ":.. . <br /> H~QUIREMENT~ ~ ~ <br />~ ~"~ ~ <br />. .::: ~+::: ~~ <br />::P;..7;~. <br /> <br />~ <br />NAMElfITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENKTY OF L <br />AM FAMILIM WITH THE INFOR AW yIAT 1HAVEPERSONALLY E%M/IN <br />MATION SUBMITTED HEREI <br />MD B ED MD <br />D ~` TELEPHONE DATE <br /> <br /> <br />P.ichard P,1111s <br />MY INQUIRY OF THOSE IND <br />OBTAINING THE INFORMATION, A <br />N: <br />IVIDUALS IMMEDIATELY RESPONSIB <br />I eEUEVE THE SUBMITTED INFORMA RE <br />ON <br />LE FOR <br />TION le ~ <br /> <br />n <br /> TRUE, ACCUMTE AND COM PLETE. I AM AWME THAT THE RE ME /' <br />Environmental ~Ylanacder SIONIFCMT PENALTIES FOR e UBMITTINO FALSE INFORMATION <br />INC LUDING I97~~87 ~-Z7~ !{ 27 ~n <br /> THE POSSIBILITY OF RNE MD I , <br />MPRISONMENT. SEE 18 U.S.C. 11001 MD 93 EIONATT <br />R <br /> <br />r/~IeI, unlr IMM NNM1I mIr hcAd, nrM, IO ro ! 10,000 <br />S ) <br />E OF pRINCIPAL.E <br />X~S;UTTVE <br />TYPED OR PRINTED VN p Ayf <br />rnun <br />wlw~+,mrn or A,twwnemonm„rMSrr,.l OFFlCER OR A1TT1ioR12EDA0ENT CODE NUMBER YEAR MO DAV <br />..vmmcn I a nnv ur~nnn r ran yr nn r Yw~n I was Ir*ererence sn srmcnmenra nere/ <br />,cIILtA~Lt SLL1.;5 LLf4Ii n.iIYED FJR 1~YKT~4H•< PriEClp tVLi~i-~tL 1,A.}r Pv 1V, Fhn :tc+.lUIRCMErvTS. tJIL ~ <br />to :~L .~-~c i, ItA~ SA.:d~lt AhALY~1S kLvJlhaJ IF V[SIBLE ~nEur 11 Uo ~t r'Ye(;. ~11: T~tL 1' SAMPLI NU INS TRUG (IU+a;-l.l..~~r <br />I. . _ <br />EPA Form 3320-i 108.95) Previaue editions mey be uesd. (REPLACES EPA FORM T-40 WNICN MAY NOT BE USED.) JO 1 bb/Ybl (]G 1 ~ 1311 PAGE 1 OF <br />