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PERMITTEE NAME/AODRESB l1.d,JrFrulry NwWTaalrw t/Diefrrmq NAME (~.i i' J ~ v 1 n F 4 r .. ~. r -.....1 ~ ADDRES51~,yrl ': ~.'i _~ 1 -J .. ~ -" 1.1 :~ G:1~~Cr li7 .. ~, »t.~l FACILITY LOCATION . i°V7 ^!.7r sir r. „'C ~C9. :FF•4 r7I. "GY NATIONAL POLLUTANT DISCHARGE ELIMINATION SYStEM (NPDf$l DISCHARGE MONITORING REPORT lOMRI I-I8I I7-I91 :70127171 nnc .~ PERMIT NUMBER DISCHMGE NUMBER MONITORING PERIOD YEAR MO DAY YEAR MO DAY FROM ~" l! TO !+ 1_ !]6]II U]-]31 114751 /]6171 !]8-791 130-371 Form Approved. ~*._.. , ^^Gn T•~TOMBINo~2040-0004~~, (- r• , p ~, ~ ~ APProvel exPUes 05-31-98 F I °~4l. 7 ~ l ~ ~~ NOTE: Read Inetructiors before completing this form. PARAMETER 13 Grd Onlyl QUANTITY OR LOADING /1 Grd On/Yl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE !46531 !54671 138-I51 !46531 !54811 EX T E /37-371 µgLY9S YP AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !s]-s71 !84881 18&)Ol n :,rN SAMPLE -;`4 k::5.;~ 44:`.5x,. .;5#..; ;Y 66 0 2 ~ ~ ( 1'1) ~? CI~B YJfAL 7C_7~"Z'"I '.r MEASUREMENT . , p JI "?9~?Q 1. ~ 'I PERMIT 55!ASsS.- r4'~~#fi 4'=k t4='k<`5# 1.Q ?rp•~;.r !TRi.F/ :PIA FFFLUP.:VT. ,'^,~'. cAt,tll. REOUIREMENT ~-f,;k? 3Q Fyn ?'IeTTY 'RY ~C/T. An u iILVER~ :'G'.' vTTFLLT • SAMPLE MEASUREMENT ~^•X555 4;:5##5 '••#%'''~? O,OOD3 O.OoOso ( 1?) ~ 2 / r1 CI~ ~ DIS50Ly' U I3U4 I G i PERMIT O.'t.30hOR ##RS4# #:. k##O%S# O.OD3 Q.'~4n '!{FZ,fE/ .RA? cFFLUEVT ~H;1, VALU_ REQUIREMENT r;Ykk ;ODA AV DgTTY a MG/L KA H :UPP!:il• PJTP.NTTgLLT SAMPLE ~•:`-5RC4 6°-il:r## vCrk+`nR 0.p01 O.rOI V ( 10~ O Z /3 `-ntg CIIV~ Ii,SOLVgp MEASUREMENT 1 713 LT:i I 0 ~ PERMIT At"5R'F# 5#:tSP'# 5...~ t..#;rl..,~ Q.n-' ~ /•:.l i H?Vp~:f' IR1P. =F'LUBNT GROS$ ~AL7~- "REQUIREMENT ;;}t Y 3e)nj 7Vr n.TTia "% M'/L Ii0!'T!1' ~' .\ I~Ad65'r 70TXL ' SAMPLE MEASUREMENT ..•;::55.'`5 5::44#: ., ~:`~` O IOJL J 2 ~ ~•O { 1Q) O ~ /3 ^~,~ l~ '.: O V E R A' I L °' . , I I:C123 i 0 0 PERMIT li!;>?i#':.^•.^- 44C#RR 5;`-l±c•~(: ?^F:.1n+• 7..G{Ir:T 1 cPrLT ;~AP UENT ;8735 yALtl~ -:'! REQUIREMENT rr5 q 74F 317~ ?AT LT MY ` ,-.J ~ ~ ' . ~ . . ~ ~ f. l:-~ :N C7NDUIT ('~' SAMPLE n /1/1L~7F - ~Zi F O ( )3j '~^~r.;:,: ,r< ~•-•^+•-h;- ~... -•.•-`-; -~•• v. © tI ' / tt-~~ ~ fi~ ~•; Ali Pa "A T'TEMT Df.Ryr MEASUREMENT C. O 0 7,0 j . . SI P~ 100SU 1 U J PERMIT aEP?7T F.E PD R'!' k4##r~: ,::'; "•a"'."; ':r.+~•,.~ 4nt £?~Lv "t~Ta ~I EFFLUi;t1T ;R7SS Y7LUi'. REQUIREMENT ~nnq .Ayr, DAILY !2 .', hr,7 454~t. 7I aN/ ;RF.AS~' SAMPLE :: ;: 4;=~;: ~q ( 74i tr'=~°.`•~ '~"„`-~'^.~ '.`#4<-r-:;: 2 / ISlIAL MEASUREMENT ~J O 31 vlsup~ iu066 l Q '1 PERMIT. .n r4}5# . j. Y ES.1 :>kC:':t:5 ..-,~~N4 :Xt-~#..« .-, J y ;,..vLY 'IS'!El. :FFLUEIVT ~{:7 ~ ± VALUP. REQUIREMENT jNSS IqA% 10-~ a ,;: ~: SAMPLE MEASUREMENT PERMIT REQUIREMENT NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENUTY OF uW THAT I NAVE PEgSONALIY EXAMINED AND TELEPHONE DATE AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND BASED ON MY INQUIRY OF THOSE INDINDUALS IMMEDIATELY RESPON9BLE FOR Richard ~i+l ii.^.I OBTNMINO THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS _ n ~ TRUE, ACCUMTE AND COMPLETE. I AM AWARE THAT THERE ARE 9GNIFCANT PENALTIES FOR SUBMITTING FALSE INFORMATION INCLUDING 9~Q B]Q-] l12 ~ ?G gn i'llii pr nvironrnentai i J' , , THE POSSIBILITY Of RNE AND IMPflI50NMENT. SEE 18 U.S.C. 1 1001 AND 37 SIGNATURE OF PRINCIPAL EXECUTIVE u.s.c. f 1716. lANWtlr. ursr erw mvhs .I.r r+dul~ r • w ro t rD,aso APEA TYPED OR PRINTED rldwmunnnrirorlalnw,+r atbn.wn smmna.nds ywn.l OFFICER OR AUiNOR12E0 A0ENT CODE NUMBER YEAR MO DAV COmmr:rv 18 AND EXPLANATIUN Ur nrvT vwLI1R I lurva Irrsrerence an errernmenrs oars! ..~HpAT i'~*~_ ~n~ .3` ?".`TT.'9-'L°. .7LIJ3 (?'7C F7t) .4?`TV ('u~Y T° (0 1^-•(n ~/!_I~tt • ..r-Tr vl ram r, :L.4Ii7$fl• ~~.. T.'•?~ ^" i.t FQR .•."!7=Y 7F P!V77~. ag!11I4o ..-yT-. l`T. r1 rt7°6qP--`c°F °r', 7T ~;') °/F ~": 2. EPA Form 3320.1 108-951 Previous editions may be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.) .~ n ~ t J / q ^ f~ 4 ^ 7 - t n 7 P PAGE ~ OF