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PERMITTEE NAME/ADDRESS 8.ry1. F.aerryNaw/L«.nm rjDrp..mp <br />11AME l;Y1r~n~S tNrlK~ GuKrUKAT1UN <br />ADDRESS Y `7. tiUX f)8 <br />el~at,; co Bloab <br />~. <br />FACILITY CYPnUS EMPlkt Gi:KYl1K'ATICN <br />LOCATION`nAlla CIi b1625 <br />ATTN tM1ICHL~L W. LuGl fiw. Gc NFR~~ MGR <br />NATIONAL POLLUTANT DISCXMOE FiIMINATON SYSTEM /NPDESI <br />DISCHARGE MONITORING REPORT (OMR1 <br />n-rsl rnasl <br />• r <br />PERMIT NUMBER DI9CHMGE NUMBER <br />MONITORING PERIOD <br />..Y - R MO D Y YEAR MO DAV <br />FROM '" O~ TO y (~ :; 3 ~ 1 <br />'. ' 12 799.131 121- 51 f26-271 lYB-29l 13631/ <br />~[I~a Ja o+v-~ln <br />SOUK iVw <br />F - FIM1H~ <br />Forrn Approved. <br />.i OMB ~la. 20a4~-0004 ` <br />T' AppiovaY e~ptres 05-3~-98 <br />1~j47 <br />H1M1L:k <br />*•~<' ivu lriSGHAkLc ~~*E" <br />NOTE: Raed imtruetiom beto com etin0 this form. <br />PARAMETER" ' l3 Grd On/yl QUANTITY ORL ~,, .;. It Grd Onlyl QUANTITY OR CONCENTRATION NO. FREDUENCr SAMPLE <br />l32.3J1 ' 146-531 154-s11 138-151 Ms-53 I5~-61/ EX OF TYPE <br /> "AVERAGE MAXIMUM ITS MINIMUM AVERAGE MAXIMUM UNITS <br />161.691 ANALrzs <br />/51-58/ <br />1s9-701 <br />~l.L.luS! TOTAL `SAMPLE $***«;~ a**v** p**##i 19 <br />ISSULVtU MEASUREMEN <br /> <br />~ <br />~ <br />~ <br />' ~` ~!'~::~' <br />: +~,• *~!*'~: <br />%; :: : ;t~QtTR7'.:. (JPjlilPiAi T•,LY ;riau <br />.- EN1ENY" <br />~R1:QU19 : <br />..: .:: ,.:. ,. .: „ , <br />,. <br /> SAMPLE <br /> MEASUREMENT <br /> ~ :,,: <br />i <br />~~ <br /> 'REQUIRE.NIE.NTt .: .,;. <br />.. . <br />~ , <br />..:..t~:" ... <br /> SAMPLE <br /> MEASUREMENT <br /> . ...PERMIT <br />:: <br />~ ~~ ~ <br />, ~~~ <br />. .. . <br /> . .. . <br />. <br />!f1[.QUIREMENF <br />..:. : <br /> <br />~..• .. ~.. <br />.: <br />~ .~:.: <br />.,... <br />... . <br /> <br />. <br />., . <br />- SAMPLE <br /> MEASUREMENT <br /> : <br /> . <br />:AEnUIR,EMENT:. . <br />: <br />. ~ ~: <br />. <br />.::. <br />. <br />,. SAMPLE <br /> MEASUREMENT <br /> ,.. . <br />~ <br />~ ~ ~ <br /> Ol11REMENT~ <br />:~BE .: <br />~~ ~ ~ <br />: <br />~ <br />~ .": ~ ~ .. <br /> . : <br />.:. <br />;: <br />.. <br /> SAMPLE <br /> MEASUREMENT <br /> .`. ~. <br />PERMIT.; <br />:' <br />' ...; ~;........ :..> ... .. <br />~ <br /> . <br />. <br />: <br />EM~NT. <br />:RE~UI9 <br />~ ~ ~. ~: I <br />; <br /> . <br /> SAMPLE <br /> MEASUREMENT <br /> ~. . <br /> 'AEnI~IR~M.ENT.~~ ~.;.,.; .. ~ ~ . <br />NAMElTITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF I.AW TrAT 1 NAVE PERSONALLY EXAMIN <br />IAI FAMILIM WITN THE INFORMAl10N SUBMITTED NEREIN <br />AND BA ED AND <br />SED ON TELEPHONE DATE <br /> ; <br />MY 1NOUIRY OF THOSE INpVIDUALS IMMEDIATELY' RESPON58LE FOR <br />P.IcYlard ~1~lills OBTAINING THE INFORMATION, J BELIEVE THE SUBMITTED INFORMATION IS <br /> TRUE, AOCUMTE ANO COMPLETE. I AM AWARE THAT THERE ARE <br />91DNIFICANT PENALTIES FOq 9tMMITTING FALSE INFORMATON <br />INCLUDING <br />~ / <br />97(]~ 870-Z7~ <br />/{ <br />~7 <br />q~ <br />F FI VIr0ll Erl@h tell L1a Ra F'r <br />g , <br />T <br />E P \ <br /> H <br />OSSIBILITY OF FNE AND IMPNSONMENT. SEE 19 U.S.C. 1 1001 AND 33 SIGNATURE OF PRINCIPAL E%ECUTR/E <br /> U.S.C. ! t31e. /FbWe.A IwM~r N.~ mum.a mry MsA.dA r"ws w ro t/0,x00 AREA <br />TYPED OR PRINTED All er nvairrurr inivio.ttArr aiMrwAer6mmrh. rM6yArs/ OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference M/ sffechmenfs here) <br />~t:l(L`_:1._LC S~lLIuS L[.<-il tea!/cG FuK 1JYr,l~~ErtK f'.a.l~l}~ t4=~~rT-.,LU I.A.3! P., iv! 1=1~R .1teLiIKEMtNTS. :.1L <br />L. n;. ,BSc ~::di, ~Ar11'Lc Aiv,ALYSIS Kt41U1KtU Ir V1S1dLc ~NLuiv 1S uc Si;i/L,D. ,;k TRLY ~AI~1•LIhU [NSTitUCT[C ,-i.L-"sE <br />EP ~ Form 3320-1 108-951 Previous editions mey be used. (REPLACES EPA FORM T-a0'""!ICH MAV NOT BE USED.) PAGE OF <br />• UU~Lics/9b1UU1-1311 1 <br />