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PERMITTEE NAME/ADDRESS (Iryir4FrWryNwWlamm pDl~...nq <br />NAME ~F'KL:S tMF'IRE CUKPURATIiJN <br />ADDRESS.F ii DLX 6b . <br />t. C1tA14 G17 Y11626 <br />i :. <br />FAaLtrvCYP12u5 EMPIRE Gylt~ilKATLQN <br />LOCATIOft LZA 11~ ~i] 0162 ~. . <br />ATTN MICkAEL '. LULL GtNE A G <br />Form Approved. <br />O o 2040 004, <br />~tSN ~U ~N"iIn ili 4"~A'r` Lc]~+b <br />jUCK Nd App ov~l ~xpue_ 5=31-98 <br />4~, <br />F .~ F.INAL <br />M1WQR <br />##~ Nl. JISCHAKGt ~"~"p <br />NOTE: Reed lnetruetiom bef eo letinp thin form. <br />PARAMETER !3 Geld OnlYl QUANTITY OR LOAD( G;I'. bOnlyl t3UANTITY OR CONCENTRATION <br />~ NO, FREDUENCY SAMPLE <br /> <br />-3 `~ 146-531 15b611 ''-~-- ~ , 138-d51 !46-53 15L611 <br />EX GF <br />Narss <br />TYPE <br />l31 <br />71 'AVERAGE MAXIMUM MINIMUM AVERAGE' MAXIMUM UNITS (eZ-en A <br />16a-681 I6g701 <br />ll ANU GrtE ATE sAMPiE ##*;+P# ! ". ~:. 94 at•!•:.{+v •tG•r %A •:a #:+V \~Y4k <br />I S t <br />A L MEASUREMENT <br />. <br />. 41.,...1.:; <br />r <br />4U06 1 U 0~ <br />`YP <br />w <br />„~~•~;~_':>~ <br />, <br />`,;~.,~,6....;`:: <br />..c;.c:~= <br />, <br />~:.r:~~~w+i. ~ <br />~~ ~~ <br />c s <br />`S 1 <br />#:aF?F#M. <br />~. <br />aukN!%:~ ~ <br />#14N19r##:~.~ <br />, <br />y,.,~ <br />GEI <br />IS.U.aL <br />f L N R~4UlKbMEN , <br />~ ; . a ¢ <br /> . SAMPLf <br />- <br /> MEASUREMENT <br /> <br /> <br /> <br /> MEASUREMENT ~ ~ <br /> ~.~,''pE.~iMIT~~. .' <br />:~RfC~11REIv1ElJ~7?; . .:~.,~ ~ <br />: '.-. .. . .,. ~ <br />: ::, ..k ;' <br />s/j:•a: .. ... <br />,~... <br />~: `~', .. <br /> <br />~~ . ,. <br /> '..SAMPLE <br />'„. MEASUREMENT ' <br /> <br /> ~~EQt71.F.1,~. Ef3T' <br />W <br />_.. ,. ~ . <br /> <br /> MEASS~EMENT <br /> <br /> "Il. N~M~~s . <br />:. .. <br /> SAMPLE <br /> MEASUREMENT <br />- ~ <br />' <br />MIT;;:::^.: <br />"'~~wAE : <br />: <br />~::: <br />.~ <br />~ <br />~~~~~~~ <br />~ <br />~ :;; <br />~~ ~ <br />:: .. ~ . <br />, . <br />. <br /><. <br />R~TYiiL ~EAA~, . <br />:.::• rc . <br />. <br />. <br />. <br />, <br />.. <br />, <br />. <br />;. <br />:. ? :.::...:...: <br />.. .. :.....: . <br />. <br />., <br />:.. <br />:.. <br /> SA LE< <br /> MEASUREMENT <br /> <br /> .... :. .' .. ''~ ..T.. '.. :. . .. ...: ti.:.:: .. .. ... ..: ... ~. ... - <br />NAME/TITLE PRINCIPAL EXECUTIVE 6F ICEft: I.CFR~ <br />T Fv uaDER PENµTY 4FS <br />H Ay ~,IAT I.kAYE P~RSG <br />T <br />A NALtr ExAMI <br />RDM AND <br />B Nfo ANO <br />ABED GN ~ TELEPHONE DATE <br />~~ : <br />/fit <br />A ON BUlMI <br />T D NE <br />AMILfM +Mi <br />TkE M R <br />UIRY AF THOSE INDINDUACB 'IMMEDIATELY P~SPONSIBLE FOR <br />MY'IH <br />i~ <br />T:IChH rd dAIiLS •"' p <br />OBTNNING THE IN RMA71[1M 1 BELIEVE THE SUBMITTED INFORMATION IS <br />I 'AWARE THAT THERE ARF <br />AOC6RATE; D C:D ,Y <br />T <br />TE , <br /> <br />r <br />anayer <br />':ITVironmentRl F~ RUf... <br />. <br />E <br />SIGNIFICANT. PENAITIBFOR SUBMITTING FALSE INFORMATION,INCLUDING /~ \ ~r <br />~J7O 18 /O-27i2 <br />4 <br />Z7 <br />9Q <br />. THE BBlpl[/TY OF FINE AND IMPNSONMENT. BEE 1B 0.5.G,1001 AND ]] <br />E O <br />UTIVE <br />N <br />T <br />I <br />E <br /> U.B.C. f t]ta. IMWdrF vW.r rhra mans /tiY icA,d~ rwa Iq b S IO,ODO BIO <br />A <br />U <br />I <br />F PRINCIPAL E% <br />C <br />TYPED OR PRINTED .•Mwm.+:+wnM.r+wrwnrMaw..nemonna.nderrr+/ OFFlCER OR AUTHORIZED AGENT CODE NUMBER ~ YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS. (Reference ell ettechments here! <br />,~iIL~A.:~:. SULKS LlrTii FFgIVEtJ Fi1K 1JYKt~4i-iK 1''tCCIP EyEvT-.iLt= I.A.3, F%Lr lUa r~~s hL~UIi~tMENTS. L:[L t. <br />~n~ASt :r:~Atl SAMPLY ANALYSIS RcWUlhtti [F Y1SIdLE SHfEN IS I;dSLdVcO. JkiKLY SAMPLINI; INSiRULTIL+:~-l.C..t., <br />,~ ' <br />frA Form 3320.7 108.951 Previous editiana may a used. (REPLACES EPq FORM T-AO !+'-11CH MAY NOT BE USED.1 PAGE OF <br />UU4yl/yD1Uv1-1311 i <br />