PERMIT-TEE NAME/ADDRES$pwdd~FrmryNe.riLreua. UDrpoap
<br />NAME (-YNxhS LM}'!kt ~URPUkATIUN
<br />ADDRESS F' l1 JUX iSc
<br />~~al~ cu b16z>;
<br />FACIUT' LYPRU5 ~E1SPlRE ~GURPURATiON
<br />LOCA710NCKAIL ~ ~ [li i3101j
<br />ATTM MII:kAEL VI. LUUi_Dw. VENEkhI tlG:i
<br />.,
<br />Form Approved.
<br />.tat ~;, ~~,--ILH r~°Me",g,a~oa~q-pooa-
<br />SUfV~ '+„ Approval explteF 0531-98
<br />F - FINAL ILL y
<br />M 1 NQii
<br />;: ,
<br />UISCNAx.,t. xis:'
<br />a- sad iristruetiale bei a co Ietlnp this corm.
<br />PARAMETER 13 CirAOnty) OUANTIYY a~,.., l1 GTd Onlyl QUANTITY OR ION
<br />' tJO- FREQUENCY SAMPLE~i
<br />l31-37f - ~ - 106 3/ ~ ! 611 138-151 !4653 151-e1/ EX DF TYPE
<br />
<br />' ~
<br />'AVERAJ3F ,'•<3MAXIMUM
<br />.
<br />.
<br />l-S
<br />MINIMU,M AVERAGE
<br />MAXIMUM UNITS .
<br />lsasm ANµY515
<br />!GO.88/
<br />lls37ol
<br />LL Ahti IaREASE. '~SAMPLE_ ~
<br />$#+Farrk# ~~ qy ~~*6ii M#rk ti~~. v {'!<?4tr#
<br />V 1 UuAL MEASUREMENT'
<br />..
<br />
<br />~:'.' ::
<br />.. ..:.
<br />..
<br />..
<br />.:W...' .~
<br />,'
<br />~
<br />
<br />~ 1
<br />::~:.: ~I ~if .~~::"
<br />~I
<br />~ : T.T.*~ I~ V:'. ~y
<br />~T.~:f'
<br />7
<br />j:
<br />~ ~ r} .
<br />
<br />btLEt '
<br />
<br />: f SUAk
<br />
<br />PrMutivl ;,RQS~ YALUE REnUIgEMEnlti
<br />'.•.,..:. .
<br />..
<br />,
<br />::;
<br />. n,..;...;,-p~j
<br />,. se.+~r•:,It.;`.,.,.:
<br />
<br />
<br />..,
<br />, . -.
<br />.
<br />.
<br />,.,,
<br /> . SA1lr1PLE ~ - ~s „ r
<br /> MEA$UAfiMENT '-~
<br />. T~,~ ~ ~ '
<br /> ~
<br /> ::
<br />i~
<br />~
<br />~
<br /> 5RE¢1111MENT'.
<br />.....
<br />, -': ?: 4_?-
<br />
<br />,
<br />
<br />
<br />'
<br />,.~ :....... ....
<br />:. ,.
<br />
<br />
<br /><
<br />.. ;.
<br />.:. :i'
<br />
<br />.
<br />
<br />.:.
<br />
<br />
<br />
<br />, .
<br />
<br />
<br />.
<br /> SAMPLE
<br /> MEASUREMENT '
<br />~.
<br />
<br /> 'REaUIRENIENI`% : •:. r;+y
<br />~
<br />
<br />..:.
<br />. ,... .. ,. I
<br /> SAMPLE.
<br />
<br />. MEASUREMENT '
<br />~~
<br />~...
<br />::nu.~
<br />°
<br />
<br />, gnu.
<br />NLEN7:'
<br />..'. I.
<br />P
<br />. '_
<br />:..:.
<br />'
<br />
<br />
<br />.
<br />
<br />,
<br />~
<br />.:,
<br />, ,
<br />.
<br />: >s .;..... ...
<br /> SAMPLE?
<br /> MEASUREMENT I
<br />-
<br />:.:r':.
<br />
<br />,. -.1,
<br />
<br />
<br />.
<br />
<br />,,
<br /> SA PLE
<br /> ME'A5UREMENT
<br /> ..*,PE ,MIT:, Y.,
<br />,~~~.~.~M .~y ..:T:.. •:., ~.
<br />
<br />;.:..
<br />... :~~~
<br /> .: .-,:.
<br />...
<br /> SA PLE.- .
<br /> MEiLSUAE.iYtENT
<br /> :. .,,
<br />p ,
<br />I
<br /> >~.a~
<br />
<br />~
<br /><:
<br />Me ~" ..
<br />
<br />~ ~:
<br />s
<br />_
<br />
<br />,:: ,
<br />,:
<br />
<br />- ~
<br /> ,. ......
<br />.
<br />.
<br />::.
<br />.
<br />:~..
<br />NAME/TITLE PRINCIPAL EXECUTIVE FICE}t. / GERYIFY UNOER PEyFU.r o
<br />~N{~fAA11LIM wnTN'TME ~IN ~ AT kttAVE P[RSO
<br />QN 9UEMITTfD H NALLr EXAMIN
<br />EREIN
<br />AND OA ED AND
<br />9ED ON ~ TELEPHONE DATE
<br /> FW INOURI' OF
<br />TH09E I W NAL9 9MII~~FDIATEL ;
<br />Y RE9PONSB LE FOR -
<br />
<br />Ri
<br />h
<br />d r
<br />ti lis .
<br />OpTA1NING'iNE INFDRN(ATE
<br />T
<br />E
<br />7E ' 1 BELIEVE 7HE 9UBMn
<br />'
<br />Y TED INFORMA TION 19
<br />,~
<br />c
<br />ar
<br />u RU
<br />,.. ACCDM
<br />ANp.
<br />SIGNIFIGWT'PENA~TiF$'FG E. I ~RO..11 AWAR
<br />RLE
<br />Up~11jTINQ' F/~SE INFO E. THAI THE
<br />RMATION
<br />IN RE AAE
<br />CLUDING
<br />
<br />t
<br />Envi
<br />tal
<br />i
<br />a P
<br />f
<br />THE 00591B
<br />TY OkF1NE%I ,
<br />1
<br />1
<br />EE 1
<br />R /
<br />97 ~a~0-Z7~
<br />4
<br />z7
<br />~~i
<br />I
<br />r
<br />ronmen
<br />an
<br />. ILI
<br />Npi
<br />' N
<br />190NMENT, 9
<br />9 U,S.C.f 100
<br />AND 73
<br />P 810NA1Y/11E OF PRINCMAL EXEC1fT1VE l
<br /> u.9.C. 3 t3fe. I
<br />• Mdu s.a. .tiNbs my A+cA.w ~ • ep m t rooev AREA
<br />TYPED OR PRINTED rW rdW rerNnr«n snmM.W 6Yeenl OFFlOER OR AUTHORIZED AOEHT CODE NUMBER YEAR MO DAV
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IReJ)ibhce, M/ettschments heFS)
<br />ociTL.tAoLc SUL1u5 LL'~IT .iVAIVtO'fOR lUYKFt4tIrL P12cCIP EV'c'VT-~c~ leA.~r Pv 1Vr rUl~ Ki=QI~IKEMENTS. 1.1L -
<br />i,nt;+~E „I:Aii SAMPLL AhaLYSlS Rf4UIRE0 iF ViS1dLE SHCEN IS l,aSticVED. dxTRL'( ~aMPLING ir~SiRUCTIw~r[.._.o.
<br />EP Form 3320-T 108-95) Previous editions meV bb used. (REPLACES EPA FORM T-AO 1°~ICH MAV NOT t3E USED.) uuao4/ 961-001" 131 L PAGE 1 OF
<br />
|