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PERMITTEE NAME/ADDRESS pnclude Faci6/v Nnmr/Lomrion if Di/ftrtnq <br />NAME <br />ADDRESSI I, R F P L F C I h E <br />i'.(:. bG% 1H1 <br />FACWTY C'r.n IG CO tllb[E <br />LOCATION <br />. ~rmu. a onr~ r~rt.cc r-c ca i.~~ ~ru <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved. <br />DISCHARGE MONITORING REPORT (OMR; OMB No. 2040-0004 <br />(z-rs) ("- el C I h C h Approval expires 0531-98 <br />PERMIT NUMBER DISCHARGE NUMBER ~~ U Y F E Y <br />F - FIAAC CCf;[ <br />MONITORING PERIOD FLKC 11C IC JCFE~CE CL1Ct <br />YEAR MO DAY YEAR MO DAY _ <br />FROM OC CS U] To GO C3 J1 ~#r ETC [1CCNAFGE ~ ~~ ### <br />lzo-zu (z2-z31 (z4-zsl (zs-zr) (za~29) psal) NOTE: Read Instructions before completing this form. <br /> (3 Cerd Only) QUANTITY OR LOADING (4 Cerd Ony) OUANTIIY OR CONCENTRATION N0. FREgUENC SAMPLE <br />PARAMETER (46-53) (54-67) (38-45) (46-53) /54-61) EX OF TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />(62-G7) ANALYSIS <br />(64-6a) <br />69-70. <br />IL ANL GEI~:A:;f SAMPLE Y_t~=}O~ ) y4) ~##-'.'=+. ,;#~#. ` r?##### ~ <br />. <br />7.i U A L MEASUREMENT D .m SM~u- <br />u0bb 1 U G ~z176~-~'F ^ . ~~L~-31N ~~~~1l~= F5=1 ~ ~4s4~s# ~. - tsA7w#101 ~, #+fr#~gda+~~lp ~## <br />~~~ ~ <br />~~ b ~'1 <br />F t F L U E 1+ T v it 0 5 5 V A L C f fl~QF11REMirF1T; hC.p :#: <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> „ ~ x: <br /> SAMPLE <br /> MEASUREMENT ' <br /> 14117,,' , . 'I. r ;..' <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> P~ ^ .. <br /> <br />~' ~~ - <br />L, <br /> HEOUf NT ;. , <br /> SAMf)!t <br /> MEASUREMENT <br /> -;- y , r .. ~ . <br />v -- 1 <br />b <br />' <br /> .-~ . <br />T, <br /> SAMPLE <br />MEASUb~MENT ~ :-}'r;~ <br />~ ~ ~r, ~~l~g(. tii iY.'! if^~ ~ <br />i,.rt.~• b ~~ - ~ ~~ <br />I <br /> .~ 'I' <br /> z <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> ..~e '~' .TKO` !yn 4~i <br />' <br />~ ~; ~; ?"~+. µlL _lx.'`~,- <br />F <br />-" y eJ1 r <br />'' <br />r ~-~ ;{,o- ?} ~ . <br /> N~" ktk S <br />- <br />.Jk"-:"k"~ ~ <br />, is <br />~ ! ..Y~ ~ . <br />r <br />~ <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERS <br />AM FAMILIAR WITH THE INFORMATON SUBMnTED HER ONALLY E%AMINED AND <br />EIN; ANO BASED ON MV TELEPHONE DATE <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING /~ <br />~1 <br />W. Gordon Peters ACCURATOERANDOCOMPLETE~I AM AWAREI HADT THERENA EOSIGNIFICANT <br />INCLUDING THE <br />F <br />RMAT <br />ON / <br />~ / <br />~"'^ `~• 97(J-824-4401 UU U4 2' <br />I <br />, <br />O <br />President/General Mana er PENALTIES FOR SUBMITTING FALSE IN <br />S POSSIBILfTY OF FINE AND IMPRISONMENT. SEE le U.S.C. § 1001 AND 33 U.S.C. <br />0 <br />00 <br />tl SIGNATURE OF PRINCIPAL E%ECUTIVE <br />or <br />,0 <br />an <br />4 1318. (Penalties under these srelNes may include lines up ro E1 <br />TYPED OR PRINTED maximum rmpnsonment of belween6monlhs entl 5years.) OFFICER OR AUTHORIZED AGENT <br />C O <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />'f_`:i E; TUT AL IhCF 1IC115 aI1L ~F nFlk';C, Ar,C SET'[LfAJLF. CCLIC:i LI"IT ~k4CI~C .~F <-7LtF,~oF:- rFf(IF tVEt:T- <br />5EE bL'HL'Eh OF FNCCF FE[UiNtMEhTS LNCta 1.A.3. FEFCITTr.E FLT" 'tAr.c ?LI :.cr,3Ct;,`t CER_lr;_ 'li FfCGCF <br />rm 0.1 ) r vious e i Ions a not a used. R PLACE F 440 WHICH MAY ~ l)S D.i ~ ' ~ ' ~ ' ' PAGE OF Z_ <br />l ~. ..~i/~. ... it i -J t a <br />