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PfRMITTEE NAME/ADDRESS p,.i,l. FmwryNa./Locwm UDID6,wJ
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<br />ADDRESS P U 17 L11( Ou
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<br />FACILITY CY~r.c,S tMP1Kt CURNOKATIGN.
<br />LOCATIONL~A1,~ CJ b1625
<br />ATiti M1CriAf`L N. LUi)LGn, GENExAI MLR
<br />NATIONAL POLLIlfMT DISCNMOE ELIMINATION SYSTEM /NPDESI
<br />DISCH=R6E MONRORING REPORT OM91
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<br />PERM UMBER DISCHMOE NUMBER
<br />MON TORT G PERIOD
<br />.Yb R MO DAY ~ YEAR MO DAY
<br />FROM ' U TO y.,; ~3 s1
<br />l7 777731 111-761 !76771 178-791 1363/l~
<br />Form Approved.
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<br />PARAMETER 13 Ard Only) QUANTITY 6R A 11 Q,rd Onlyl QUANTTY OR CO NTRATION ~ NO, FREQUENCY SAMPLE
<br />137.371 ~ 1653 ~ 61.5/ ~ 35-16 11663 !6451 (:X TYPE
<br /> 'AVERAGE ~~~'. MAXIMUM UNITS ~MINIMUIYI AVERAGE MAXIMUM UNITS 117-em MAtY819
<br />151.551 l58-701
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<br />NAME/TITLE PRINCIRAL EXECUTNE OFFICER I CERTI
<br />AM FA FY UNDER PENALTY OF LAW THAT I HAVE PERSO
<br />MIUM WITN THE INFORMATION SUBMITTED H NALLY E%AMIN
<br />EREIN
<br />MD BA ED MD
<br />SED ON TELEPHONE GATE
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<br />MY INOURY Of TNOSE INDIVIDUALS IMMEDIATELY RESPONSIB LE FOR
<br />
<br />Richard A7(Ils OBTAINING iME INFORMATION,.1 BELIEVE THE SUBMITTED INFORMA
<br />TRUE, ACCUMTE MO COMPLETE. I AM AWME TNAT THE
<br />SIONIFICMT PENALTIES FOR SUBMITTING FALSE INFORMATION
<br />INC TON 19
<br />RE ME
<br />LUDING ~ i
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<br />Environmental kiana P.r ,
<br />THE P0981BILITY OF FINE MDIMPRISONMENT. BEE IB U.S.C.11001 MD77 BIONATUIIE OF %IINCRAL EXECUTIVE I Tn - ~ •77 n^
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<br />CODE NUMBER YEAR MO DAY
<br />COMMENTS AND E](PLANATION OF ANY VIOLATIONS IRetrrsnce s// ef/schments hers)
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<br />GIi~A ~t unA6 yAr,r Lt Ah.4LYSIS KC:IUI RcU !r V[yluLL Slit.tr IS C3St KV, D. uK i,tLY ~dMPLING INSTRUCT lLN,-[.'..r„
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<br />EPA Form 3320.7 108.961 Previous editions mey be used. IREPLACEB EPA FORM T-40 WHICH MAY NOT BE USED.1 J V I b 1 / 1161 OU 1' 1 j 1 ~ PAGE j OF
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