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PERMITTEE NAME/ADDRESS pneY4iaeu~ryNa~/lamron UnrdDnwp <br />NAME L;Y,~nuS ;;f'P1r;L l,uhY'UriATLU,y <br />ADDRESS ,P~~qrU ALA bC <br />' ORAL„ GU 616Lb <br />`~± . <br />FACILITr CYPRUS IcMPIKE CUhYUKhT1Uty <br />LocnnoNCKAlU Ci; crlo25 FR( <br />ATT+'. MLChAEL ~r;. LUDLL:AIF L,a=NEriAL r+~k <br />Form Approved. <br />3 1,I .. n ~ 'i O fr - i l n T JOI~~P(o ; ~04~1,-0004 <br />Approve expir a (~~=31-98 <br />Sudn NN ! j$~ <br />I- - F1.v4L <br />MIi~cK <br />~+ ~^F NL U L ~i;nAKL,E u## <br />NOTE: Read Irutruetforr before eomplatlnp thb form. <br />PARAMETER l3 Gre Onlyl QUANTITY oR LOADING !~ nryl QUANTITY OR CONCENTRATION ND, FREQUENCY SAMPLE <br />BI-371 !46631 5ba/ -15 1663 5i6/ EX OF <br />TYPE <br /> AVERAGE MAXIMUM UNIT5~. ~ ~ IrlIMUM AVERAGE MAXIMUM UNITS !a7•e~l 'WALYSIS <br />1a1-6Bl /6¢701 <br />SLLIlljf TLTAL SAMPLE i•>;.{. {.~.i. .;.};.i.,~:. ####;* <br />j 0 19 <br />0 <br />, <br />1 ~ ~ VL Vt Ll MEASUREMENT • ~Q 9 lCJ~ 13 <br />7;;c`17 1 J 0 PERMIT. #$~+l~# ##!!knlrtF 4#•:. ~ <br />M`1R: <br />x' :{{PQL~ <br />:~" <br />: lii'FYirFiAj,.. i :~'~~~:: ai'1.?~~Tr':: <br />tF-rLut~~I GkU~S VALi! . REQUIREMENT, #4M# . <br />..... <br />. <br />x::52;_.: ,}~i1.: . <br />::i <br />: <br />, .F2 . <br />"'it kA M . <br /> SAMPLE ~ cr . <br /> MEASUREMENT <br />:'' <br /> c <br /> ~. PERMIT ~~ ~ ~ ~ ~ <br />. <br />. .. .. <br />s.:. <br />... ~~ ~ ~ ~ .::.... .. <br /> <br />~ ~~' <br />~~ <br />:::pie.:. <br /> .REQUIREMENT . <br />;;.. ... <br /> <br />+:<;' .: <br />' <br />~ <br /> <br /> <br /> <br />... <br />:...::. <br /> <br /> <br /> <br /> <br />... <br /> SAMPLE <br /> MEASUREMENT <br /> ~.':~.~PEAMIT. . ,. .. <br /> REQUIREMENT.: - <br /> SAMPLE <br /> MEASUREMENT <br /> ;::PERMIT" ~: ~ .:.~ .:.... .. :a+~:~:. .:;. ;;. ;:. <br /> REQUIREMENT ~ ~ ~ ~ ~ ~~ <br />~ <br />.~ : ... <br />::....:.. <br />... <br /> SAMPLE ~ <br /> MEASUREMENT <br /> ....5'..RERMITr::~~ . ~. <br />..:'r: <br />. . <br />::: <br />: ~:: <br />:~ <br /> ~~REQUIRENI,ENT ~ ~ , <br />. <br />. <br />. <br />~ ~~:~~ ~:~ ~:~~ <br />,. ,. ;. .. <br /> SAMPLE <br /> MEASUREMENT <br /> ~~:~ PERMIT~'~. ~.. : ~ ~ : <br />~ <br />~ :. <br />~ ~ .. .. ... ~ .. <br /> REQl11REMEN'I` ~ <br />~ ~ <br />~ ~ ~ ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> .~:. ~~~PERNIIT .: ~::. .. ~;~ , . ~.. ~.. <br />~ <br />~ ~ ~ ~ ~ <br />~ <br /> .REQUIREMENT: ' ~ .. ~ .. .. .. . . <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTI <br />AM FA FY UNDER PENALTY OF LAW THAT I NAVE PERSONALLY E%AMIN <br />MILIM WITH THE INFORMATION SUBMITTFD HEREIN; ANO BA ED ANO <br />RED ON TELEPHONE DATE <br /> <br /> <br />P,ICililrC? i.~lii5 <br />MY INQUIRY OF THOSE INDINDUALS IMMEDIATELY RESPONSB <br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMA <br />LE FOR <br />TON IS _ <br />' <br />~ <br />/~ <br />~'+ <br />En <br />i <br />t <br />l BIONIFICANT PENALTIIEB FOq 6 6MITTINO FALSE NFORMATI~ON <br />T N Cp W MO <br />~ <br />'~ <br />, <br />v <br />ro-l;~er>. <br />r, <br />L.nager , <br />T <br />P <br />N <br />O <br />T - 970 870-9712 4 27 9a <br /> HE <br />OSSIBILITY OF FlNE AND IMP <br />S <br />NMEN <br />. SEE to U.S.G. 1 1001 AND ]3 <br />iIONATURE OF E'111NCMAL EXECl7TNE <br /> u.s.c. 1 t eta. /nn.re.. ,.,sr dn. mnm• m.r NrAdF A`rF w m rroaso <br />TYPED OR PRINTED .redwmvA+run Mp/smwrt a/Mtw.xramarMawaW.'a/ OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lFa/erencs ell sftschments hers! <br />-I~1ILtA;;L.t ,~L1„~ LL'-:/! nA1Vt1J r-max 1JY~aL41f-~ i'ttL:IP LVt.JI-~LL i.A.j, PL, (V. FLn ntJLlnt~!i=nT~. L,lt. <br />~h~H.;t urt:.~ ~AMrLE An„~Yi1S rctwLilREJ [F VIS1~Lc SHtcN I., Li~cnVLi). iJ~TI<LY SAMPLL~i, It.STnuL f IUf~~-L.i-.~tE <br />VI. .. <br />EPA' Form 3320.7 108-961 Previous editions mey bs used. (REPLACES EPA FORM T30 WHICH MAV NOT BE USED.1 ~ ~ Z 32/ 961 ~ L)1-131 1 PACE i OF <br />