PERMITTEE NAME/ADDRESS pnd+6 F¢14ry Naw/(acenm gDjQG.a+q
<br />NA!'~ i;Yr~t,`., cr,rllit tiilkPURAT:IGty
<br />ADDRESSP Q vLX 6$
<br />:~^ l,h•AIt; ~G islb2,y yr
<br />FAauTVCYPRUS EMPIRE CfUk•a'uf`wT1f3N;
<br />Locnnor~fiA I V ~ • ' 1CG 41625
<br />ATTN MICHAEL 'ir. 1 1101 frl.l: r_J-titta&i urn
<br />Formgg NNApprovgqeood.
<br />>. A T t .~ i^ [ I. L ~ T is A~4obgRi 2>°pf r~s 5 31`-sa
<br />~l.ni NW 1:}4
<br />r -FINAL
<br />H I irI3R
<br />.~.~Yiead Inetru«iora 6e1«e comDletina thb form.
<br />PARAMETER ~ 13'Grd On/p O q
<br />~ ~
<br />'
<br />.~ N Ord onlyl QUANTITY OR T , TION ~ NO• FRECUENCr SAMPLE
<br />13I-3)P /dG51. ~
<br />( ~
<br />, ` 138-d51 /d5-53 15d-611 . EX TYPE
<br /> - ! AVERAGE
<br />.. -
<br />~_MA Ml~1y1~ 1T5. .
<br />MINIMUM AVERAGE MAXIMUM UNITS lemeal MALYSIS
<br />l64-681 159-701
<br />~H ~. SAMPLE ~
<br />MEASUREMEP}7 •###1t##
<br />i #~P-###
<br />~
<br />' ?•r,<ti<k?<4
<br />8+ rf ~p
<br />I 1
<br />O
<br />i `
<br />~-jr2AB
<br />
<br />G400 1 0 U
<br />
<br />- _.....
<br />r,:etrR;M3":;.'°:
<br />4 tit
<br />R~QUIiiEMEfCL;
<br />;..,.. ; ::.:<-.::..',:::
<br />3Rf~~MM+k#
<br />;+:::. :...~
<br />## ~#' YF
<br />'~
<br />.
<br />,p
<br />## ..:
<br /><<..: ,
<br />;,, /,., _
<br />~ •
<br />
<br />
<br />Jl~f#4#•.
<br />
<br />
<br />7
<br />
<br />
<br />:
<br />
<br />
<br />~KLY:
<br />_
<br />
<br />etAa .
<br />Iv
<br />LLIUS, TGiAI
<br />- SAMPLE _
<br />MEASIREMENT ####aa #$#*## #it+Nt#N
<br />!J
<br />/' 19
<br />y
<br />I,ONclvOtu ~ ~
<br />
<br />~ -
<br />• "
<br />~
<br />' /
<br />f
<br />~7 7" (J ~~
<br />• V>jU 1 0 D ;i~'t~~P.~R1NF;:::;::;. .> ~ ...
<br />~
<br />~F?F##kl.# . ...
<br />~..:
<br />.: 4. FA #9??7~?k. #
<br />
<br />4t+.• ...
<br />:.:
<br />:.
<br />~":r:
<br />~#~ ,.
<br />
<br />'..:
<br />s..:,..
<br />
<br />ra; ..
<br />
<br />r±1C~~ ...
<br />
<br />;~~r~
<br />-,
<br />-
<br />LiEQISIHEAAENj..
<br />..T.::
<br />.. ,
<br />
<br />
<br />~,
<br />:...
<br />,:
<br />.
<br />,.
<br />
<br />..
<br />/IL AivU (F K'EA SE SAMPLE
<br />MEASUREMENT ?. µr<ty {.;: {<q>}v. t~l ;t y##yjl~ i.a ###IF##
<br />~
<br />3 19
<br />
<br />KL.,;V LXTrt-6KAY METH
<br />
<br />~ _
<br />~
<br />~
<br />'n
<br />.
<br />~<•3'
<br />~
<br />9p ~A,¢
<br />lJ
<br />
<br />`:
<br />~L.1~io 1 0 v
<br />,..
<br />- :F+: ~:~p
<br />~ :~
<br />...
<br />t
<br />.RE04fIfiEMEN ~~'~41t1~k #+!#~~
<br />
<br />
<br />; .:.~~?F~R iF*~1'.# # ~k!• i.##~~f+l!#1r`~~ ~##>Yir(Dk:'~,.: ~. ~~~:r::..;~~~-::: r1:~~~`:'. ~ :~: ?133 ~~I+1~~ :12]~~~. .,
<br />F N Y , :. #4K ';. :. „~:
<br />Kuly ~ SAMPLE #h<i•v?.V t<9Px#?< .?v:r#+k ~t 1'1
<br />I+TAL RCCLIYEcliABLE ~ MEASUREMENT ~/SS r gZ d d
<br />(,yoU 1 0 i.' (} := . ...MFG;,:...
<br />1BEMEN~' :. ~.###~>{F .
<br />• ::
<br />: •; ,,:>61##if## # >i# il$44#v I.G Is'>=P(73#T- : t~El;•:` :TEltii ..
<br /> : I. ~a
<br />' iP.L-
<br />` 's '. Lq
<br />MEASVREM~NT {.,yM##4v #V#u#•~ i<1Elk4k>kd
<br />'
<br />19
<br />3
<br />L i AL Itt~i}Yl3RAbLE~- O O Z O O
<br />L d ~~~
<br />: ..,.'.
<br />.~....
<br />~
<br />
<br />###
<br />
<br />i23
<br />
<br />.
<br />:46
<br />:;.
<br />
<br />11i~~! i
<br />
<br />1i A$5
<br />_ r r L- u c lv i ~ Y A U EN1Er}5<:
<br />: ~? fll : :.' _
<br />..
<br />.
<br />`
<br />•LLlW, !Iv (,UNVU'ii UR
<br />HrtU T~tcaTMENi r'LAN1 S PLE
<br />MEASUREMENT
<br />O~/~`1f5~
<br />p,~~35 uJ e.i<#•Yi<# a##+f~F#
<br />~ #:,•~•
<br />h?,i<
<br />2G
<br />INSYAN
<br />c,~ ~~ I o . o
<br />- - r P . MlT .•¢,
<br />REllU1RQF.AEN~V'. ,~,~j~.-s•.::,..::'°:-
<br />,.- :.::l2i_RLliiti.. +,
<br />'~' `
<br />EK .
<br />
<br />~ ~:.. M. ,
<br /> SAMPL
<br />~ -
<br /> MEASUREM~NT
<br /> / ..
<br /> AiaU EM~~~ w~' ....::
<br /> •...:.
<br />NAME/TETLE PRINCIPAL'EXECUTNE. OFFICER ILERiI
<br />AM FA FY UgDER PENALTY OF UW TNATI HI1vEPERSO
<br />MILIAR VJITN THE INF011MAYION sUBM1TfE0 H NALLY EICAMm
<br />EREUI: AND BA Ed AND,
<br />SED ON . TELEPHONE DATE
<br />_
<br />Flchard A1iil5 ! • MY 1NONRy OF THOSE 7NDLVIDUAL$S,,. IMMEDI1ATEL
<br />OBTNNING•THE IppFO ATIDN, 1 eEL1EVE'THE SUBMIT Y RESPONSIBLE. fOR
<br />TED INFORMATION IS
<br />
<br />Environmental Manag9r TRU , ACCUMYE• I.YIO COMPLETE. J AM AWM
<br />9DNIRCANrPENALTIESFORSUBMITTNO'FALSEINFO E ~TTNAT THER[[ ME
<br />RM71nON,INCL4YDING
<br />~
<br />97O)H7O-2772
<br />1•
<br />77
<br />9R
<br />' EPOSSIBILITY OF NE MO IMPNSONMENT. SEE to U.S.C. ! 1001 AND 7] $IO
<br />URE
<br />R
<br />
<br />U.s.C. ! i 11,. / • udr Ul,r .anms nrr 1r+rA.W F,wa ye ro ! 1D•000 NAT
<br />O
<br />PAINdPAL EXEdTTNE
<br />TYPED OR PRINTED rgar.ra:+.,.l inp+aa,+wrf orbmwxl6monoYa r+d6 rrr:l OFFICfiR OR AUTHORIZED AOENi CODE NUMBER YEAR MO DAY
<br />i~ ..vn~~.~~n rv nnv r.nr~nnnrrvn yr nn. rwcnlwna rnnrrrence sn srmcnmsnrs ne/e/ , .
<br />I L„+i LIhIII :?h'L1~5 -1Li L;JrldLrvLL FL(.+v F'KUN JU3, 022 6 G[4. UfL is v1EAaL ;;RATS ;Ahlr'Lt dr.ALY5I5 Rt=wUI.<E:t lr
<br />+i~l ULt= ~NL-GAJ !S Ud StKYEO• t?RTiiLY AMPLIMta iN 57i:U%7IU"N 5-I.(.. Ei, PG X.
<br />EPA F«m 3320-1 (08.95) Previous edition, mey be used. IREPIACES EPA ORM T40 WH16H MAY NOT BE USED.1 PAGE OF
<br />UUoUd/9olUU1-Lill I
<br />
|