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FERMITTEE NAME/ADDREBS R++y Fr•Wry Ns/Locnrw dDlfi.mU <br />NAME K2RR ~)AL .J.TPANC <br />ADDgESS Iy A i! R M I V F <br />7. U. H)Y 71}47 <br />Sic.naa)4T "RI~t~S CJ <br />FACILITY <br />LOCATION 7 A L ri Y A <br />•: i" .. :,J tG F. <br />NATIbNK POLLUTANT OISCHMOE ELIMINATION SYSTEM /NPDES/ ~ ~ FOml ApprOVed, <br />DISCNARGEMONlTORING REPORT IDMRI <br />r1-/61 /7-r9i ?ORD F/?RZR ?O LA9~~°A$Daq-PR~P <br />~)~95UD37 GDTi (SURE 6W) APProvelerx{~i~e0 31-98 <br />PERMIT NUMBER DISCNARGE NurABER F - FINAL 1 <br />30J17 MONITORING PERIOD tlINOk <br />YEAR MO DAV YEAR MO DAY <br />CD 8J4}) FROM 'J V' TO U 'JU 3 +'~' NJ UI5C9AkC. F, ~~_~ #~~~~ <br />V . ~ f i ?' t: 'i . J :1 , '1 I ~ ~' ': .; R . /1611/ l11-13/ l1~75/ !1617/ 119-191 /36311 ,NOTE: Reed Instrueliaru before complstinp this form. <br />PARAMETER 13 G.d on/vl QUANTITY OR LOADING !a a.d onrv! QUANTITY OR CONCENTRATION ND, FREQUENCY SAMPLE <br /> - 46531 /5661 !3B-s51 146-531 1566/1 EX OF <br />r31-37/ ANALYBIB TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS rs1-s.Tl !66681 16&701 <br /> SAMPLE '.`-.~;fG3=k :t#3:s .;; :~ ~F~ti: #:= ( I2) <br /> MEASUREMENT <br />./u:i/:) 1 J J PERMIT a'!4:¢3;kb~ <br />~ ttS.¢i;f.iL' 0 #;--':, ,j.~ ~ .riff,''...- .vk ~rD Er,MLf ;NSITU <br />r FLU t;~f .,x)55 Y0.L IE; REQUIREMENT . ~ #~tR !!I!1 ~~K lF.'S~ !lAY IMUtl ~~~ <br />;Ji.lUS, ,:TLEA:tLE SAMPLE #Rx#RR OOxR## #RR##:7 Cr# ## ~ 2S) <br /> MEASUREMENT <br />J ;145 1 U U ~ PERMIT CCxiiR ~ .~:###$~4A: #Y' .###x"r4 Y~#~. ~: it D:S~: .. .. ~: ~NCr'/ :RA.'i <br />'.FPLUEaT ,; F,J3S YA LJ:; :REQUIREMENT -it~R kIL'i Y iiL O N <br />1IL AND vi(EA5? SAMPLE ~'~r<G'.`•~Y x#3?~¢-:: :F#~.'~-':I S: .~~# ¢O ~ 19~ <br /> MEASUREMENT <br />~}So2 1 D 7 PERMIT rTARRC: #u#R## 0 #?:: Ralf#ts# #;fr# # IQ ( O^1TI^4 .R#~ <br />'f'PLJENT 68755 VAL'J:i REDUIREMENT •'°,:~:.s DaIL7r MX nc/L GBN2 <br />.Y, N ONDULf Url SAMPLE ( U]) r.-.:=#~ .~'X . #+::.t :=.~. <br />:. ::U THP-2nENT PLA"+f MEASUREMENT <br />,UJSJ 1 D J PERMIT PTI)VR-L ~epoar a;xusxa ~f;f;tu ~ r;.#>r~# ( #.a :c N~E/ psrAv <br />;Fi'LU'dNT GRJSS VAL'J: REQUIREMENT $~DA AV^a GAILY NY. MGD #### <br />~~~ <br />N'~IiTY <br />~1L dhU udEASIi SAMPLE :G3:~3^ <br />• ~ ~ ,; ,~ j, MEASUREMENT <br />,~t J'rD 1 ~0 U PERMIT r#a;zar- ~ REP~EZ Y ES=I :#OF~~>b #:, Ct,T~ ;. .~.#ttY#lf:: #:~# t NSF./ '257AL <br />-rrLUEN'f GE7S5 VA.LJF .REQUIREMENT . Z9$T ~IAX b0=) rfi:~: ?IUpTK <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> ~REQUIRENIENT~ <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I cERn FY uNDeR PENALrr of uw THAT I HAVE PERSOF1uLV EAAMINEO AND TELEPHONE DATE <br /> AM FA MILIM VNTH THE INFORMATION SUBMITTED HEREIN; AND BASED ON <br />'- <br /> MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RFSPON518LE FOR . ) <br />/] <br />o~ `-_ <br />toCt18L'd A.• MUIIESOn OBTAINING THE INFORMATON, I BELIEVE THE SUBMITTED INFORMATON IS` ~~ <br />/ <br />1 <br />YSCE pl'981flIan TRUE, ACCUMTE AND COMRETE. I AM AWARE TNAT THERE ME <br />SIGNIRCANT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING '~ <br />^ <br />') <br />f <br />' <br />ar <br />Y , <br />TH <br />IBIOTY <br />E AN <br />! 1 <br />1 <br />F R <br />PR <br />ON <br />SEE <br />S <br />C <br />D O 9~ 7 <br />~ <br />- <br />+72~ <br />r OD O <br />~ O <br />I <br /> E POSS <br />O <br />N <br />D IM <br />IS <br />MENT. <br />to U. <br />. <br />. <br />00 <br />AN <br />J BIONATURE OF PRINCL°AL EXECUTNE <br /> U.S.C. ! 1Ste. fgedba uM,r N,r +brvn++NY AICAd, 6rw+w ro 110,000 AREA <br />TYPED OR PRINTED ..e er nrr+nl+n iAalsml,nr el e,:w„n enianera aM6Y+e'+1 OFFICER OR AUTHOgIZED AGENT CODE NUMBER YEAR MO DAV <br />COMMENTS AND EXYLANATIUN OH AN7 VIOLAIIUNS fHl/elenCe !//etM1C/ImerlfS here/ <br />.,EI2Lt:AiiL~ S)LIDS LIiI^ dAIVED FOit 1J-YR, Z4-8R PFECIP d7ENi JJL.JE,:'L TO 9U4DLA pY PnpOF k^.UIHf,"2viS I~ <br />,FAitT I.r1.1.D, P. i. ;TJ"+..y~0.Ttit .'7AYAJtHiiti: ?LAM DUF. 1-1-)3, <br />A Form 3320-1 106-951 Previous editions may bs used. IREPLACEB EPA FORM T40 WHICH MAY NOT BE USEb.) U j } 7 / q) ~, g 14-12 , 4 PAGE I OF <br />i <br />i <br />