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PERMITTEE NAME/ADDRESS (rM.i Frdlry N~/L«auen UDrQ...np
<br />NAME ^`('~.~~: TS `CA V!iLL~:Y 'BFI. ~Ji'^~
<br />ADDREB$l~ ~"::•. Ir ):~ 1 °:,^•ijT ~~ c F'~gvA`I ir;
<br />FACILITY
<br />LOCATION
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<br />NATIONAL POLLUTMT DIBCHMOE ELIMINATON SY9TEM (NPOE$I
<br />DISCHARGE MONITORING REPORT IOMRI
<br />lI-t6I 17-191
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<br />PERMIT NUMBER DI9CHMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM .) . TO `? ~. -` -
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<br />Form Approved.
<br />M- •• .~• + ~ r. •. ~ " •r ~.OMB.No~2040-0004.
<br />I r „ _, ~ ~ ,! } APProveiex{}i}es 05-31.98
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<br />NOTE: Reed Inetructiom beforo olnpletlnp this lorm.
<br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING !4 Grd Onlyl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE
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<br />I31-371 MALr919 TY
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<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS lsas~l !5q-Bg) 169-701
<br />.: :]:: P.u~rl ~-I PY SAMPLE {:?-"•::r{a i:'-F:=:: -~'.: ( '1)
<br /> MEASUREMENT
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<br />~L`L D5, SETTLEABLE SAMPLE #xCOf-4 pQl#-":~•`• ###",`--~ 1 ^-~1
<br /> MEASUREMENT
<br />70545 L U ~ PERMIT 'tS+RR~O Lt94$p•',: ..~ ¢xif~## a^-tc.. ~..,yr.•a .12EI?/ :R0.
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AMINED MD TELEPHONE DATE
<br /> AM FAMILIM WITH THE INFO RMATION SUBMITTED HEREIN; AND BARED ON
<br /> MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RE9PON91BLE FOR
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<br />G OBTAINING THE INFORMATON, I BELIEVE THE SUBMITTED INFORMATION IB
<br />TRUE. ACCUMTE MD COMPLETE. I AM AWME THAT THERE ME
<br />INCLUDING
<br />SIGNIFICMT PENALTIES FOR SUBMITTING FALSE INFORMATION
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IRelerence ell efrecAmenfs lrerel
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<br />EPA Form 3320-1 108.951 Previous editions may be ueed. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.1 ^ ^ T _ - 7,. i ~ ^ r ~ PAGE I OF I
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