|
ENAME/ADDRESS (1raiY4 fs11~yNrw/a.rlm ljDyFw)
<br />CYr•'rtuS ~rTN[Kt ~UkPUF(AilUh
<br />s P ~ yt/x eEs
<br />,.~LAti; LU d161b
<br />CYPKI,S EMP1FiE %UkPURATIUN
<br />JN[K/ilV [(r tTlbZ~
<br />+ M1CnAEL w. WUILIt, I,tNEkAL M6R
<br />NATIONµ POLLUTMT DISCNMOE ELIMINATOM 4Y8TEM (NPDESI
<br />DISCHARGE MONITORNVO REPORT /OMRI
<br />I-161 17-/91
<br />' •S"r ,
<br />PERMIT NUMBER DI9CHMDE NUMBFA
<br />MONITORING IOD
<br />YEAR 0 DAV Y R MO DAV
<br />FROM : . TO ]
<br />l1 tL rJ1J91 04151 @61]1 118-091 /30311
<br />F~oMrm Approved.
<br />N w t~. c v 7: •~ N l n T J fr l8 I~lo ~C~0-0004 F
<br />pprove ex vee 0631-98
<br />SUak iln L~4':
<br />F ~ FlNAL
<br />~*~• NU G15CHA~Gt/~ u+f*
<br />NOTE: Reed Imtruetlorr be a completlnp this form.
<br />~ PARAMETER 13 Grd Onlrl QUANTITY OR EO !4 Grd Onlrl QUANTITY OR CONCENTRATION NO. FREQUENCY SAMPLE
<br />I l3I-371 (16531 (54-61 ~ = (38-15 !46-53 51-5/1 EX TYPE
<br /> AVERAGE MAXIMUM ~ NITS MIip11MUM AVERAGE MAXIMUM UNITS IeJ-6al MALYSIS
<br />(64.661 /6&701
<br /> SAMPLE ~".iti$+1'44 #4+h~I*d -. ti•ti~#tilPt• j,'
<br /> MEASUREMENT
<br />~'
<br />L1L9U~ 1 U G ~.,~~BERMIL ~ ..$##PiAt .~. •ak'KS•i.?O1R ~
<br />
<br />~ ##t< ..
<br />0.~
<br />:<~`:. ',
<br />:: .a~s~Ell#~y . .,,
<br />4.~ .
<br />iNCIn./'
<br />>stRti
<br />
<br />~FrLU+=NT GkOSS YALUE REQUIREMENT.
<br />.... .. ~ ~ ~
<br />`.
<br />**a~x _
<br />.....~:.....'~
<br />ri...M .. .
<br />..: .....=::-.
<br />a
<br />H
<br />ALL IL]r StTTLEAbLE SAMPLE M4~>,•#{• v44$*.;• ,t#~>MraM ~
<br /> MEASUREMENT
<br />
<br />L `J4~: a 0 0
<br />.;: PERMIT.: ~ ~
<br />~
<br />~N'#i•d13 •k
<br />~ ,.
<br />>%ia+f1.1-+0#
<br />i•4t•
<br />..?i~#.~:.. ~~ ~ t.;::
<br />::-
<br />':: ~
<br />3t
<br />~~.
<br />.. ~
<br />~~.{;~ ~
<br />~
<br />~~
<br />~~
<br />~
<br />~i~k~~.
<br />
<br />LFFwc;t f ~kq:;5 VALUE
<br />RT'QUIREMENT
<br />.~.:: .::.
<br />~
<br />~
<br />41:•4
<br />.....~. .::: ...
<br />;...,`.•;~,rTs;
<br />,-
<br />~?, :Q
<br />M'
<br />M /L .
<br />,.....
<br />.
<br />1L Afr .i IsREA$E SAMPLE {..y44ti•>• S Qfi•?~ti• 4tk#11MIF i####•I• j`r
<br />rrtt•~t~ cxTK-GKA'J MtT MEASUREMENT _
<br />~
<br />J1.77o 1 0 U ~~PERMIT~ ~:
<br />
<br />•
<br />0+~$OrM+k . ~~ :.~
<br />$~•f~d+k
<br />~N:• ~
<br />;
<br />;: iM'
<br />:; -
<br />', .~#>lr.+F?I!b~:. ~
<br />..
<br />:1:~, ..,:; ~~
<br />t3T';jN
<br />~+~
<br />~#.a
<br />
<br />FFLUEirT GkU55 YALU[
<br />:REOUIREb1ENT:.
<br />
<br />
<br />.
<br />~. ~.{<1. .
<br />, :.:.
<br />°'.'Y~;~;;:?:.
<br />.... ... .. ...r
<br />
<br />_,
<br />~~~.. :~.:. .
<br />IT~{S ::'HAX
<br />YU/L
<br />u >Ci T` .
<br />
<br />
<br />:.
<br />Lu•tt IN UNUUIi I'iK SAMPLE ,;~ t"I##'1't!# +Y44#pti• •%}4vf•k
<br />1 hnU TlttAihENi PL ANT MEASUREMENT
<br />J I,JhU 1 ,0 U ~.:, .. PERMIT.'..:. :kE Pt3.i~1T1 ~. ~ .:. .:R E~~LTk~T ~,.....#i?1!iFti+~}°<;:: (.:;~ll!i/NM+R!~?(i~~:: ..:.:.'};~:~?frM'4# ~.~~ yr~"y :: T~~~./:I'::- ,~.E~PS .
<br />i
<br />-FrLUENI GkUSS VALUE /iEQUIREMENT .30JA:AYG :.:pA3i:T:: 1KX ,b~ , , `".. .. t•+~v><• ; ~
<br />E:H
<br />: '
<br /> SAMPLE
<br /> MEASUREMENT
<br /> :;f:::c:PERMIT ~:.~,~. :. :~ ~ ... ~~. ..
<br />~
<br />'
<br />'
<br /> 'REQU EMENT-
<br />
<br />.... ...,
<br />!lf
<br />~.~~.:.. ..
<br />~ ~ ~... ..... ..::. . ~ : ~
<br />~ .. :
<br />;
<br />:
<br />,
<br /> SAMPLE
<br /> MEASUREMENT
<br /> ::,':: PERMIT.::'., :. ~:.. ., . ...........
<br />. .......::::.: ..::~•. ::.:~.: ~
<br />:1::::..: . ~ ~.
<br />
<br />,:
<br /> ;pEpUIFEMEN7. ... ....:...
<br />...... .. ::......
<br />....:a ... ~~~
<br /> SAMPLE
<br /> MEASUREMENT
<br />:
<br />
<br />.'.~.: PER
<br />MIT:"~ :
<br />~
<br />: .
<br />
<br />,..
<br />.
<br />~
<br />.:~:~_; ..
<br />i
<br />~
<br />:;
<br />~ . .
<br />
<br />~REQUI
<br />R .
<br />.
<br />.
<br />EMENT ..:
<br />.
<br />...
<br />.~. :.:.....~,.::~.
<br />:; .
<br />:
<br />.
<br />.r.:.::. :~.~
<br /> . .:
<br />::.
<br />,...... x.::' F::o:... .., .:.. .:..: .:.
<br />
<br />.
<br />: ...
<br />:.. .::.:: ...
<br />
<br />:.:..'r .. ..
<br />
<br />.... ...
<br />
<br />... ..
<br />::...:. .
<br />
<br />.
<br />NAMElTITLE PRINCIPAL EXECUTNE OFFICER I CEeTIFY UNDER PENµTY OF UW TNAT 1 NAVE PERSO
<br />AM fAMIUM WITN TNE~INFORMATIOX SUBMITTED H NALLY EXAMINED ANO
<br />ETEIN
<br />AND BASED ON TELEPHONE DATE
<br />
<br />MY INOUIM Of TH09E JNDMDUµ9 IMMEDIATEL ;
<br />Y RESPONSIBLE FOR _
<br />
<br />
<br />Richard Mills
<br />OBTAINING THE INFORMATIDy, I BELIEVE THE SUBMIT
<br />TED INFORMATION 19 -~
<br /> TRUf, ACCURATE AND COMPLETE. I AM AWM
<br />SIONIRCANi PENµ71E4 fOR SUBMITTING Fµ9E INFO E THAT THERE ME
<br />RMATION
<br />INCLUDING
<br />
<br />27
<br />2
<br />Environmental +~{af7lE)Cf THE POSSIBILITY OFFlNEMDIMMBSONMENT. SEE I3 ,
<br />U.S.C.11001MD77 BIONATUREOfPRINCRALEXE
<br />UTI 970 7
<br />870-
<br />
<br />TYPED OR PRINTED us.c. E t ate. rF.rMlw. r.w d....uAm. nMr hcprd~ Rn.. w ro J ro,oaD
<br />.nawr.v..arwn.nPnomrNwMw«nemwdr..r•Fer..r.l C
<br />VE
<br />OFFlCER OR AUTNORRED AGENT
<br />CDDE
<br />NUMBER
<br />YEAR
<br />MO
<br />DAY
<br />•,~mmo• i o nnv cnrcnnn • •vn yr nn • vrvcn ~ ivn~ Inn wrncr sn suecnmsnrs nqe/
<br />~L I JLtA:,L`. SuLiL,S L I~yI f nAIVcu FUr, 1~Yr. f24H-: P/a.i.lt' L-~tr~T- aL~ 1.:;.3, Pv (Yr FUri KEJUIKEMctvT~. L1L c:
<br />vkL'a~~ i•.<Ah ~A`iF/Lt A1v4LY~lS i(tVUlttCii lr VISIULr= SHtcN I5 I,,jjLKVL'J• y~7;:LY '~ANP`LING ifv5lkUCT1L~H]-1.•..::F
<br />~,.
<br />EPA Form 3320.1 108-96) Prsvlous edltlane mey be used. (REPLACES EPA FORM T~0 WHICN MAY NOT BE U6ED.1 JU 1 y G / 5 G 10 u 1 ~ 1 ] 11 PAGE OF
<br />
|