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PERMITTEE NAME/ADDRESS pwdrLFrWryNar/lacmlm IJDI~i.mQ <br />NAME C~PnUS L'ri(-'IiCC CuKPCr+dATiuN <br />ADDRESSP ~ ii LIA 6U , <br />~~Ltcal~ CG iti6Lb <br />FACaITVCYPiiuS EMPIKE CURPuItATiON <br />LocAnoA~ K A i ii GU b3 6 2~ <br />ATTN MiLhAE~ .M. L17 f1LLi«. :.r iJt RAt_ MCk ' <br />Form Approved. <br />0 0 040,0004 <br />yt~sr 3U bN-91k TL ~~~ ~ ^e4 b5-fit-se <br />SiiBK NN APPro~§I~~hy <br />F - FINAL 1 <br />Mlhuk <br />##~ biJ L)ISCrfARGE #++' <br />NOTE: Rud inetruetioru bslor omp in0 this form. <br /> <br />PARAMETER ~ ' !3 GYd Onlvl . OUANTBY' L <br /> <br />' <br />: rd Only QUANTITY OR CONCENTRATION Np- FReDDENCr SAMPLE <br /> f46.53I rsa•s <br />n !39-451 14653 ~ . l54-911 <br />E~ OF <br />TYPE <br />137-371 AVERAGE - .MAXIMUM MINIMUM AVERAGE ~ MAXIMUM UNITS ~ ls6-ss! ANALYSIS <br />15`991 /99-701 <br />,h ###**+ ~ fi#+++# v+.r+++fi 1 Z <br /> M~ASUREMEN7 ° <br /> <br /> <br />iiyOU 1 0 0 <br /> <br />:s?EFiMk:.; ~<: <br />' <br />' .:.: ....... <br /> <br />:.~Y6~''<; <br />~ <br />~ <br />" .:, r r:.,.:. <br /> <br />h.::?il#tF~*W" <br />~ ~.: <br /> <br />M <br />_... <br /> <br /> <br />. .. <br />~l;~tc:K' <br /> <br />iY+~*#~F~s: <br /> <br />r~. <br /> <br />NCE/ <br /> <br />i~AG <br />- - ~ - 2R~QUI <br />EMENI <br />q, {.:.:. ....:..'::.' <br />: <br />: <br />: . <br />~.:~.', ~:..:~:.:: ~ .... <br />- . . <br />I:LIiJSr ~ETTLEAdLE +#+d?M+ ~++*d#+ - .. ,• ~t- ~`> <br /> MEASUAEMENT ,~ <br /> <br />)c7a~ 1 ~ v .:~..; BE tT:~ .~ <br />.:,.:..:g*~....... <br /> <br />E <br />1' .. <br />. ~+r#ts~,:.: <br />..,...~1.4~~t~~r. ~: <br />+a <br />,;~:... <br />..4 • S <br />- <br />,,,;,,.. y/'~fp~~::: <br />~' .~ .X <br />::: <br />•:~ ::..:::.:::...:.. <br />;£.~l , <br />.~aa <br />v I . K V REQ}Jyg <br />MEN <br /> <br />: ### <br />i <br />', ~,„ . <br /> <br />~ <br />1L ANL GKEASE .saMPLE .+4Y++a .;..x+r+:~ +i4#,~#i ';`~~~*### ~ 19 <br />kti;~v cA Tri-taKAV Mk7ti MEASUREMENT <br /> <br /> <br />(,»0 1 G 0 ,.. ,. <br /> <br />i::::';PE......IT.:.' <br /> <br />kPi+A+>k . <br />' <br />~ <br />- <br />...~#d~d* *. <br /> <br />+•~ <br /> <br />+~#~r+~' <br />;, .. <br />~'~~~': <br />~ <br />~ <br />~ <br /> <br />flt: .::~: <br /> <br />^NT1Nf <br /> <br />RA8 <br />- ~ !J1 lr .ty nC719ENIEN'Fo .. ..~. ~~. <br />~~ <br />::~: .. ~. $fi^ ~~ <br />~ <br />- <br />-L:inr Iti 1.QNa(jiT IjIZ ..SAMPLE. Jj ti~+;~fia+ #i#++# ##~V#+ <br />h~cl; TkLATMEN? PLATAT M€dsuREMIN <br />CvSG 1 0 ''0' ~' `:,"a> Eif+!IT' : <br />k1.Pt7i2T 4~rPtial2T ~~i#++~ d+#A#+it .. .. f(~#... <br />' +# CE! '1~T117d <br /> <br />-F1=LUC~I tiR• VA ~ E `gEdVlRpr~AEr~lt~: <br />°<..,.:..::..,..:::...•.::. . <br />•.: <br />. .. .,: <br />Y X <br />- . <br />r.,.. :*r-:. <br />;; .. <br /> <br />+## <br />- SAMPLE <br /> MEASUREMENT <br /> ~~ <br /> SAMPLE <br /> MLASUREMEN? ~~ <br /> <br />IT.A~ <br />r <br /> <br /> <br /> ,'sA PLE. <br /> MEASUREMENT <br /> <br /> .:~.: . <br />. <br />.~..: <br />:. <br />.:. <br />~ <br />. <br /> ':kon.:::~ : . <br />.. .... : <br />. <br />. <br />NAME/TTTLE PRINCIPAL EXECUTNE OFF. CER. ~ I aERn <br />' Fr DER.PEH/t[iY Qp~FEE <br />T <br />T <br />NF AAyl ~TEH1AT I HAVE'PERSONALLY EXAMINED AND <br />AND BASED ON <br />MA <br />10N SUBMITTED H <br />REIN TELEPHONE DATE <br />' FAMIDAApp VA <br />N . <br />tlE I <br />G <br />AM <br />MT~ iHGUIRIL OF YYryryOSE 11N ; <br />R <br />j <br />E <br />DINDUALS IMMEDIATELY RESPONSIBLE. FOR <br /> <br />rZIChBrd MIIIs O&7AINING CHE INfOBMATION <br />TRUE, ACCrIMTE AND COM <br />Ni <br />PENALTIES iOR' <br />R , I BELIEVE THE SUBMITTED INFORMATfDN IS <br />PLETE. I AM AWME THAT THERE ME <br />SUBMITTING FALSE INFORMATON <br />INCLUDING <br /> <br />Environment I IYSaT18TE'(' • <br />SIGNIl <br />CA <br />TMEPOSSIBIUTYOFRNEANOI , <br />MPRISONMENT.SEEteU.S.C.11001AND]] // <br />\97~ <br />87Q-27~Z <br />4 <br />27 <br />~l$ <br /> <br />TYPED OR PRINTED U.S.C. ! taae. lFMrab u,l.. IMr.mnmr m.v c.cA.dr IG.r ,o ro !,0,000 <br />rqw M..Lrwni,prlevnuNWArtwwn smmNS rM6yra1 SIONA E OF PIIINCIPAL EXECUTNE <br />OFFICER OR AUTHORIZED AOENi AREA <br />CODE <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IHeier~nce sn sttecnments neiel <br />;_IILLarzLt 5UL[L5 LINIi irAiVtU FL,k 1JYRr~4TIR Pi2cC1F'tVtNT-~EE ir.1~3r PU IVr FL,t ~.L~~iIitEMENT$• LIL <br />~nEAS~ GhAb ~At;NLY ANALYSIS Ktuuini=U li= "V1SIbLL SFEtN IS Us~~hVCJ. ~.F.T~LY ~:.HF`L1t.G ['dSTRUCT[GN5-[.(..o. <br />0 3320-1 106.951 Previous editions mey be used. (REPLACES EPA FORM T~0 "N'rI1CN MAY NOT BE USED.1 PAGE OF <br />0v49h19G1v01-1311 a <br />