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PERMffTEE NAME/ADDRESS (Include FaciJiry Nmne/Locmion ifDigermq <br />NAME AONIc '•~ <br />ADDRESS {a~o(w~II <br />C • V • .. , i <br />FACILffY PA :i'J 14 <br />LOCATIONAO,f It. <br />nTTv; WiLLIr:.'. <br />• I,;F <br /> <br />co :11+29 <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHAR GE MONITORING REPORT (DIMH;B) <br />-~ ~ ,. <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM ^ I 07 0 TO ~ Oo i <br />(M21J (2223) (2x25) (26-22j 88-29) (J63f) <br />Form Approved. <br />v T •I () L, OMB NO. 204D-0004 <br />Approval expires 05•.31'-9B <br />t•-.r•,q ,~~ <br />~, <br />C ~ 4I FI t. *. DP.LTM <br />~ i r)^ c,n/.TyI AHtJG rr ~}'°1:' y#1~. <br />2 <br />NOTE:` Read Instructions beforr~ ct7m~leting this form. <br /> (3 Corti Ony) QUANTITY OR LOADING (4 Card Ony) QUANTITY OR CONCENTRATION NO. FREOUEN SAMPLE <br />PARAMETER (4653) 54-87 815 46-53 (5481 EX OF TYPE <br />(3PJn AVERAGE MAXIMUM UNffS MINIMUM AVERAGE MAXIMUM UNITS ~'a-YS/S <br /> (62aT/ Ba66 6370 <br />i r! SAMPLE ###;~••^.4 4?r'.r d'S ,k't i,; {:!~: •e ( 1 2j <br /> MEA <br />SURE <br />M <br />ENT <br />~1 /~ <br />UU+iUV I U D {{ <br />~~ <br />Jy <br />Yryr IA4~ C <br />l~ <br />Y <br />i <br />Y. <br />SIr4 <br />~' . . <br />M:'~ <br />x'~ <br />TAAIir ~}{ <br />~ <br /> <br />~ <br />[.PFLU ENT •, r <br />,.u05., YALU ~OUTA <br />" i <br />e , <br />~`;~.~,~~.=r~t~ ~ <br />A' •, '• <br />:t,.~,.t. arc# ~ ~ k. ~ 4(4 ~~, } <br />' ~ ~,~ _ "' <br />Yl~ <br />SOLIDS, T.JTAL SAMPLE aakCiRO# a7aaa# eca##a <br />( 14) <br />'.U`iPENDtU MEASUREMENT <br />CU53U I U 0 fiti~ " ~#a <br />~: <br />r:Pl'LUf,NT GNn~S YALU EM~NT <br />" ,; . ~ x <br />' 3 " ~_= #### ~ 4d *~ <br />'' <br />^ 1: <br />`}+.-- <br />`,i)LIUS, SETTL!:At1LE SAMPLE %''~#>t## *fi'Jr:#-3 ##fi44':^. ( <br />15) <br />" <br />~ MEASUREMENT <br />,;c~;us i <br />c:.ro <br />' <br />~ a n~ " ~~~ <br />' ~~iarr~s <br />`" , <br />fi #~a ~, r,.~ ~~~ ~.,~;~ <br />'~' <br />'r <br />YLUEXT 6ROf <br />AL:I ~~ :s - <br />i ~_ ~ aaaa '~_ <br />~ ~3,T ~ f <br />.. g} <br />i~Ut+, 70TAL ~~ SAMPLE ;-.}~X##« a3a### ##?:xfi=2 ~ ( 19) <br />(AS PE) MEASUREM i ~,.~. <br />~iJ4S L 0 0 '"'- a{tRFep" ~ "" <br />~. tr Mk .fir,.-'.< <br />x; <br />'r~1 <br />-~`~y <br />'~ <br />~ <br /> <br />_ <br />"'4r <br /> <br />... <br />=-i9LUt.:IT' GROSS YALU " 'r '=C,;~'," ;..'.,:' fi#[:+: ~'~,4 ~ ., v . ". hr <br />'.:LL AND ;kEAS£ SAMPLE 'x#aa0a #o;:##:r 4#?3b~ ~•;##,x# ( 19) <br /> MEASUREMENT <br />u3S&2 1 U n ~~ <br />MIT <br />~~. <br />. <br />'~« <br />a#r -" <br />,~ aF~J <br />~ <br />~~ ~ <br />~ <br />~':~ _~' . ~-; <br />L}'FLOEAT GPJ ~ V1lLU EMENT" ~ <br />, <br />~ ~.. <br />`'_="~ ; s ~ ofiaa r ; , <br />+t F^' <br />~ , <br />~ o' ~-`~, <br />" <br />FLON, It+ C:ri:r'?UIT Oq SAMPLE ( U3) #^;"r~k'k -~laaa~` ,^.###4# <br />T ff ({U T f; l' :'" ? N T r L.a ^I EASUREMENT <br />~OUSC 1 U U PEEiMIT;+ ~i "~~RPdk$~ <br />~ sue"" IM <br />~~~~ ~ ~ <br />' <br />#~ *` <br />~ ' <br />~'!L <br />EFPL"~r.'J: LNnSS vALU REQUTAI:M DD ~ '' ~ ~+~ hGD '`` `.,tr~ as +~ , ~ <br />~OLIU~, fJTAL SAMPLE #CfiG## >F'R#C#;: +sw#.~:.'- <br />( ~~~ <br />l~i~'iOLY"zJ <br />MEASUREMENT <br />I U ~ y S 1 G 0 `PERM ~~ '. Cry ~' r-a# <br />~ '' ~y~ °'` <br />e <br />,~774 <br />~ <br />1FF'~"~~~ <br />J~~; - <br />' <br />L~" <br />P r <br />. F'LJENT G8:1S3 YAL[. 'AEQUlREMENT x e ~ fi^>`# +. .. ~~` <br />~ v <br />. <br />; <br />':a , <br />a <br />~ <br />~ 2 <br />,i <br />* v <br /> <br />, , <br /> <br />" <br />NAMFJTRLE PRINCIPAL IXECU7IVE OFFICER I CERTI <br />AM FAM FY UNDEfl PENALTY OF <br />ILIAR WITH THE INFORM LAW THAT I HAVE PERSO <br />ATION SUBMITTED HERE NALLY E%AMINED ANO <br />IN <br />AND BASED ON MY TELEPHONE DATE <br /> INQUIRY OF THOSE INDIVIDUAL S IMMEDIATELY RESPON ; <br />SIBLE FOR OBTAINING ) ~ _ <br /> THE INFORMATION, I BFJJEV E THE BDBMnTED IN FORMATION IS TRUE, <br />~ <br />' <br />~ <br />~ ACCURATE AND COMPLETE. <br />PENALTIES FOR SUBMITTING I AM AWAKE THAT TH <br />FALSE INFORMATIO ERE ARE SIGNIFICANT <br />N <br />INCLUDING THE ~ <br />`, -- ~ <br />7iI •/ ~ ~ <br />/ ~ // J ~ 1 r L ~~ POSSIBILITY OF FINE AND IMPRI , <br />SONMENT. SEE 16 U.S.C. 4 1001 AND 33 U.S.C. SIGNATURE OF PRINCIPAL EXECUTIVE ' 7 rU % ~ '~' T / / L' -l 1 <br />TYPED OR PRIMED mex/mumllmryASaurrerrt of balMee 8 monlb AnIC 5ude Ilrres up ro f10,000 arM or <br />rears.! OFFICER OR AUTNORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />comMtN I ~ ANU r~ePUWAI loN ur ANr vwu I luny (Nererence aJ) eurecnmenrs Here) <br />:i'iTL6AAL£ +7LIDS LI"7' APPLIiS ONLY IF C=10YR,24HR FRFCTP PYf'9? IS !;LA;'+'_'D. I° ''I,AT'1 AD950Y£D ['Y N^C p, <br />I'.~5 f. I80N LIMITS NIIi YOT S1 f. APVLI?D T^ aF.POkTF.C ":FASU~7,`!cWTS_cr: i•71.2, fir, 5 eOn yUgpup 7P pgO~P <br />PX "dorm Previous a itlori's ay no'be use .•' • ", (I~EP ES EPA FOR T-4 I Y NO 'BE E .) ~ " ` • '~ • ~• r • PAGE OF <br />Qr.~61/°gQ3!2-122' T <br />