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PERMDIEE NAME/ADDRESS pnclude Fadliry Nome/Lomrion IfDigerenq <br />NAME gOYLF: RcS'11+'TC::~ (I!ITr:I~ <br />ADDRESS RO M L c' NO e J F I .: t !\~~Q <br />P.G. PJ\ '~'t7 q"G~G~`i <br />FACILITY PAO'!.R r0 rTl r7rT ,~ t <br />LOCATION ~t_ <br />e~ L <br />bOwl~. !'n HIU< 4 FRI <br />Tt: MI Li,IAY ;y. ~' r F .i 2 :;TNC Nf,Hc~8~` <br />~i <br />ILLUTAM DISCHARGE ELIMINATION SYSTEM (NPOES) FGRTI AppfoVed. <br />(CHARGE MONITORING REPORT (OMR~ OMB No. 2040-0004 <br />!z-TSJ a~-9J wT NOF <br />Approval expires 0631-89 <br />AIT NUMBER DISCHARGE NUMBER ( • I R R ~ r) } <br />~ - °I~AL '[A <br />MONITORING PERIOD ~ "' H'7 O'' P R T' 1 D g c V ",`RAIL D~ ~ i~ i i. <br />MO DAY YEAR MO DAY _ -' ' ~-' ~ '• <br />10 0 TO aq ~ T . •:n .,~ ;.T FCN;(uC c 11~i~ #[' '~~ <br />(zz-z3) (14-Z5) Tz~zz) tzs-zvJ (3wf) NOTE: Read Instruc[lons befor~ Ltmldleting this form. <br /> (3 Cerd Ony) <br />ITY OR LOADING (4 Cvd Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER \ <br />(54-61 3845 46-53 54-67) EX OF TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 'w'V~~ <br />B& <br />0 <br /> IszaT) 6438 7 <br />.. 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