F[wMIrT[e NAMelwoow[sa (Include
<br />FaLility NalnrlLocalbn IfdifJennt/
<br />NAM[-_~-_---
<br />ADOREtt~~~__~---_
<br />-wcr urr_-_ _--'
<br />LOCATION _~-_-
<br />u _
<br />Nwn oNwL rouurw Rr oocNAw DE EurwwwnoM arsTEM (NPDES!
<br />DISCHARGE MONITORING REPORT /DMRI
<br />_~____ 1-/b 17-19
<br />______---_ •ERMIT NUM B[R oracN.wcr N~raaw
<br />--------- MONITORING PERIOD
<br />-------- YEAR MO DAY YEAR MO DAY
<br />_~__-_--- FROM Tp
<br />(101!l /1LZ3/ /Zl.IJI 116.17/ (ZB~1fll /363!/
<br />~'? ~-~ .
<br />C b' ~ /J
<br />Form Approved F` e
<br />OMB No. 2040.0004 `~ ,n
<br />E:plres x9.30.91 ~ ' 94
<br />~..,~,/
<br />~r~ 4 L~ ,
<br />~. L.~.9Y
<br />NOTE: Read inatruetiona bsfafs edmplstinp thin form.
<br /> (J Card Only) OU ANTITY OR LOADING (1 Card Only) OU ALITY OR CONCENTRATION FREOUENCr
<br />9AMPLE
<br />PARAMlTER (I6-J3) (Ji6f) (38aJ) (16.73) (J16)) HO.
<br />E% of TYPE
<br />(31-37) AN wLrsrs
<br /> AV ERAOE MA%IM UM UNITE MINIMUM AVERAGE MA%IMUM UNIT9 616!) (61661 (69-7lI)
<br /> BAMPLE : 1::.... -. ` ) .. -. r .
<br /> MEABUREMENT
<br />
<br />., .L ~ _ ~
<br />a~PERM ITeaxe
<br />~ s
<br />>.'rM~1l ~+1?raff>>,
<br />`
<br />~:syY~ A~:~$I:
<br />.
<br />~
<br />.:.~
<br />x,l g.ga eza°ae
<br />8
<br />°
<br />~~s
<br />c s9~et.4 ~ %.
<br />a
<br />4'~
<br />e
<br />~%a' x8~ :
<br />s
<br />~~%rd `<
<br />° .
<br />°9 g '
<br />£,
<br />, s ,t'A
<br />~4<K
<br />s°s.:
<br />L~az3e gy`
<br />
<br />-
<br />- REQUIRCN CNT ar a.f
<br />,Y€
<br />¢ xsx
<br />qj~
<br />xg s ge
<br />a x
<br />8
<br />e L 8 s
<br />ss
<br />s S 3 g
<br />$
<br />'
<br />6
<br />g g
<br />.
<br />®
<br />1 0 Y e s
<br />~
<br />b 8 y
<br />~ x S 3 $' 6 j.
<br />(r• ,&, ss sYx . 4:.. ag < ,; i.
<br />8.
<br />3
<br />a 8
<br />a r
<br />F
<br />8 a e
<br />Y .
<br /> :.. ~. :::: :.:::-:::.: : ..:
<br />F Y .. ~.- r. MEABUREMENT
<br />~~V .. , xlx~:ERM1T`8x" ` NYL~fitf.A6P•e•
<br />Ts
<br />'
<br />x
<br />e
<br />~ 1~
<br />aeg$ip ?~'~in,`~f6
<br />s
<br />:.: `X='d' S ¢
<br />;. sA~(T~.b?~
<br />se.
<br />~5 q~s kxerta.k$x,le
<br />36x
<br />II
<br />k as g83x e8°
<br />°e
<br />x
<br />~
<br />x ~~x
<br />. ,~+
<br />~
<br />',~c s ^. ,} e°s
<br />~
<br />i+~"~
<br />
<br />' .. f
<br />'t
<br />~ xRffOUIRRM'EN'T i¢
<br />>~ <
<br />.
<br />e1
<br />x
<br />e s. ,
<br />s°°
<br />F
<br />Y
<br />8
<br />¢
<br />1
<br />8 ~g
<br />.
<br />eY
<br />8 .
<br />¢1
<br />t
<br />$.
<br />a s
<br />xl
<br />fs
<br />8`x F
<br />~s8 ¢ m
<br />g1:
<br /><
<br />l{
<br />../
<br />.. ~ r 0e.li
<br />.° " 8g
<br />e
<br />a
<br />s, a x
<br />r
<br />.
<br />X
<br />1 naa
<br />e
<br />1
<br />$g
<br />r 5 Y
<br />g.a a .a 8w
<br />k •
<br />.
<br />F &
<br />Y p 8
<br />>L~ .. .. n.. E.tl.:. BAMPLE .:;i:,::,.:" .; ~L,::,:.j.~ )
<br />a ~ ...
<br />_
<br />~ MEABUREMENT
<br />.J 7. . (/ ,.R I YPffRAI"(T' < °e}a1>;:
<br />ffi4}~ik 441.!, °s<s i0'ifQ,l~i }~
<br />Xk
<br />s~
<br />':l.
<br />:
<br />i
<br />L('}f ~kS!Fa'k~xe`«
<br />s
<br />_.S .C
<br />e sfe ~--'S `°i~!f
<br />$
<br />a`p sa e e sa Y=
<br />6RS
<br />ex' ~s
<br />(g
<br />181 xi
<br />~ ~ si iy
<br />a %
<br />~
<br /> AEQUI'RCy ENTm e
<br />sx,s
<br />x
<br />sYgs
<br />S
<br />' ,
<br />r
<br />8
<br />~`
<br />`
<br />'g"
<br />k ,
<br />1
<br />>
<br />a .
<br />a
<br />sy
<br />a
<br />@
<br />~
<br />x` 1
<br />.
<br />1 `gx x t
<br />r
<br />;
<br />g
<br />.
<br />g 3R
<br />a
<br />p
<br />
<br />~~.. _
<br />i.i YA
<br />., s
<br />. .. 5
<br />Y
<br />S
<br />s<1
<br />., <. ~.. k
<br />e
<br />3t
<br />e
<br /><. <
<br />e ._'.r. ;1 rs ¢
<br />s
<br />Ya
<br />a x
<br />1
<br />a:
<br />"¢
<br />e ° s.T, .
<br />x
<br />~ k
<br />s
<br />xaa
<br />_
<br />
<br />_
<br />~I:urT 1" .. ~~ 1T ~k BAMPLE
<br />>
<br />r
<br />r~
<br />..
<br />.. ~.:'..
<br />.. ...
<br />.. .v.
<br />... .. ...
<br />.... ..
<br />:. .. ~
<br />
<br />_.r~ ._. .. ~~LnN MEABUREMENT ~.
<br />
<br />v . ~ . .L _
<br />o- " •f?ERM.i7<« x y
<br />s.i.fBx~1~°°:
<br />` x~~".~frf tA~a& °
<br />'
<br />«: aFrs~v $'i~8'-'6 s 1
<br />g¢ s7~1~iI~~'~ ' u.t
<br />s c a'^"y eft 3`Ba °
<br />~
<br />s x'm
<br />,,a d, ez
<br />1'
<br />~~~
<br />0, °>~
<br />I'
<br />~ti
<br />_ RE4UIR EM ffN.7° y g ,e g. 8.
<br />n d z .g
<br />f A' r...<
<br />w an
<br />°+ sxe °
<br />a9 ~ a. ®s aW g
<br />; Po 1 x s Ya
<br />r
<br />J ._:JJ • _ . 1 A L BAMPLE u':.,: e,.:..:.: . . ~ ) . . . . .
<br />) ~ J Jr MEABUREMENT
<br />1 ) 1 _ x`PERMIT,<,8g flFi £= 'vl:fE~:,
<br />II
<br />,se
<br />~ X!T?~b1y "v
<br />"<~~LLr'
<br />Z
<br />$ . y,
<br />'~'A4v'tl
<br />s 8
<br />~gz °
<br />R [9 R~1~,a, ytyy <
<br />1F
<br />a
<br />'
<br />aiw'Y ii~ s Ml!,, ~~si x~Yrr
<br />t,y~'st
<br />i+
<br />i ~4~
<br />5
<br />s9~ y~ •n.
<br />~$
<br />°s'Si aepp .
<br />^
<br />~PoO "
<br /> REAUtREM ENT> 1
<br />k
<br />a$
<br />g °
<br />R
<br />'
<br />n n ,
<br />.
<br />gxa, g
<br />g
<br />e
<br />f
<br />} K
<br />•
<br />8 ~
<br />~P r
<br />11a
<br />'• Ae
<br />'d pp.` St e
<br />E
<br />Ry
<br />`.J L T
<br />.a
<br />s. °
<br />1 I
<br />.
<br />i x
<br />. a k
<br />•
<br />8 a',x .
<br />
<br />° + w ~
<br />s
<br />k
<br />4i ' 9 z
<br />°;fi
<br />-..
<br />1 L A~fl .f '....
<br />BAMPLE ..
<br />....':: j q. .-
<br />y .~ ~
<br />:;'. .. x}...:i.:
<br />.: }:j :. I: L.
<br />~ .
<br /> MEABUREMENT
<br />.'J . '
<br />'•~PERM m.jF~s~„a °~.
<br />ea~np •a xg' -'c s9 ycLy ®'p^L~w$sp.M <r~'.'
<br />4 w;$e.gY}x~. 'k~~~
<br />~~~
<br />`y
<br />`e - tlS` y
<br />~
<br />w
<br /> S
<br />REQUIRE
<br />MENT s 1
<br />y !
<br />e
<br />l
<br />t <
<br />° .
<br />~EIv #g
<br />~.
<br />~
<br />_u ~ - °Y~ ea °1: ~
<br />Y, ~ s«
<br /> SAMPLE
<br /> MEABUREMENT
<br /> a.aPERM~iTr ~'a c,;q'
<br />~ . a °s a~ e
<br />e
<br />' ~1"x °.Y
<br />9
<br />z
<br />°<e
<br />9 ,, e
<br />x as Po
<br />°~`
<br />« ° °
<br />ce
<br />.
<br /> ~RtC~UIRE,M ENT' g eaa Y
<br />e
<br />s '
<br />a .; x
<br />e
<br />a
<br />a
<br />y a
<br />a~ma es
<br />; ~
<br />w (
<br />,
<br />,
<br />r~ ;
<br /> 9 K a Y g +e
<br />NAME/TITLE PRINCIPAL ElI[GUTIVE OFFICER I CEwTIFr
<br />unOER PENALrr OF LAw TNwT I
<br />NAVE PERSONALLY FaAMInCD
<br />•ND wM FFMILIAR WrTN THE rNFORMATION SUBMITTED NCRCIN wND B.LSED TELEPHONE D A T E
<br />I'l/~ f
<br />~r~ E`' wr(M1Q~ ON MY INOl11RY OF THOSE INdVIDUILLS rMMEOIhTELV RESPONSrBLE IOf1
<br />OBTAINING TNF INFGRMIIT10:1. r BELIEVC TN[ $UBMITT[D rNFORM/.TION )
<br />/
<br />
<br />7
<br />IS TRUE wCCURATE wND COMPLETE r AM 1W1gE THAT TNEq[ ARE SrG , (/N/
<br />T!I/..
<br /> NIi ICwNT PENALTrCS FOR SU9..rTTING FALSE rNFORMATION IryCLUDING
<br />
<br />I~
<br />•G
<br />'
<br />~
<br />THE POSSrBaRV OF FME ANO IMPRISONM[NT SEE r8 USC f rOOr AnD /
<br />C? _ _
<br />}
<br />/~
<br />~~
<br />mil/ /
<br />' I
<br />S
<br />/
<br />t ,
<br />Li l~
<br />I rA ~1~ (•~~ -/ ]3 vSC I IT9 .Prnalu.. urWr. rfirv Fmmr.. n ~NUdr /w u
<br />gar ~ •
<br />n, ll4rnr BIGNAT RE OF PRINCIPAL E%ECUTIVE C ~/
<br />'
<br />~
<br />~
<br />/ /
<br />1 (. i
<br />`
<br />TYPED OR PRINTED y
<br />u,d ••emu.~nruni rnrprr..,,I~~.nr,./Mru«nfim.,nrl+und i..ar.r OFFICER OR AUTNORIIED AGENT AREA NUMBER YEAq MO DAY
<br />COMMENT AND EIIPLANATION OF ANY VIOLATIONS IRr/errnrr ull uuuohmrnv here)
<br />__~ > ~:..•.~_~. ~~-. ~s~_..Jl .. ~/f .. ]'• .-_ .. .. ... .~ _... •- ._ ~ ~ III IIIIIIIIIIIII III
<br />999
<br />EPA Form 3320-7 (REV. 9-BB) PrBVloua editions maybe used. (REFLACes E.A .oRM r-.e wNICM MAY Nor BE uscD.l FADE pF
<br />.. r -_ .--
<br />
|