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<br />FERMITTEE NAME/ADDRESS Ned. FMI"yNw/faanm //018innp
<br />NAME (.Y,, -•+~r Yt"o5 :; 41.L_Y _~?L ~Ji?.
<br />ADDRESS ~i '!'~ 1•~°{ "rU mnF ;:^1..4y ~Y
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<br />FACILITY
<br />LOCATION
<br />NATDNAL POLLUTµT DISCHMOE ELIMINATION SYSTEM /NPDESI
<br />DISCHARGE MONITORING REPORT (DMRI
<br />lT-161 I7-I91
<br />PERMIT NUMBER DISCHMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM .. 1 TO +" +~+
<br />176111 l22-231 !24261 !16271 l18-291 !343/1
<br />Form Approved.
<br />.. r ., ~ ~ ~ - - .F ~OMBINo~2040-0004 ~.
<br />-r~nv T~J) Approve~e~p~rec 0531-98
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<br />'~ NOTE: Reed inetrualorr belors complstinp this form.
<br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING !4 Grd OnlYl QUANTITY OR CONCENTRATION NQ FREQUENCY SAMPLE
<br /> 1~6-631 1545/1 138-<5 46631 (54671
<br />EX OF
<br />TV PE
<br />l37-371 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS l67-6J1 MALYSIS
<br />!64681 159-701
<br />;;•Y7U!)C _:: /I''T SAMPLE 4-`-.~;c .=.` , ;: rah;:.- . -:r-r: E ' ].)
<br /> MEASUREMENT
<br />UDU~?!3 ? 0 .~ PERMIT #:'Y#'k## 7r..;!t.. ~ ,~,.: tAa;~~„% q.^r1 u"' -^'^T^..'L ._./ ' ~t ~tLY ;u E'-•
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<br />tFFLUIiv REQUIREMENT .frc••t Tp
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<br />Pr. SAMPLE AYt-": ,^-:t .': ±: r,. -...... i :?)
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<br /> MEASUREMENT
<br />UU4U'7 1 ^ U PERMIT ###x#4 "K'•"•, :. ~,S xr""``-t'~ ".'` -E:L~ 41t'
<br />EFFL'JE ':'~i5 ya. L'J" REQUIREMENT ~{; rj ~!TMr)`• ,r';v in••tr, -
<br />SOLCUSr 'T AL SAMPLE :rc ~RF-:= k~A~}+t!• ;:;:-. .. ~ .~)
<br />i :7 .i F 6 d D; o MEASUREMENT
<br />?9i3U ) 0 ~ PERMIT ::X': .:'"- ,-.. nc ~. t,!:Yp;:r- a.. .-...r .. -'n(IOm I IV('r~ 'ooh
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<br />SJL SE Y7'"!.L SAMPLE .. .~.. -. ~+k r°'"<'"=:; ( 11)
<br />5L':;PEtID'.`; MEASUREMENT
<br />J53D 1 :' ~ PERMIT ~;x.t?n ««~";:;;. ?::Rr-,... 34 ~!; 'y.^.r/ ~R~G
<br />F:FFLU£IIT ;R"':; Y4L7 REQUIREMENT #:;:,`-'s Zn',Z T7f •'~Tl.v !Y •,.^/L F1If:PN
<br />SOLI US, vEC"1,~ 4~+I, =' SAMPLE ;<'k«7+^ RSc#" ..'~:'~ ( .')
<br /> MEASUREMENT
<br />JU~IfS 0 U U PERMIT' +'=«««« f%Rrf«0is 4.r k~l•":~.^# a+:"+74T !~~~ 4tf:F/ :?~~
<br />iEF: ~OM'1~NTS REL~4 REQUIREMENT mXc`+k Trlnt pr,•!; f)'L-T.a
<br />SOL.D:ir 3E TLE!1BLF. SAMPLE #0r:kkt ##:kr<vv ir+1Sc:~^i• ( Tr.)
<br /> MEASUREMENT
<br />JD'r45 1 ~ ~ PERMIT K#«S#~R ~ ##r-««T:t " #'+Yk «Ya>syl## v^rna„ ?:trt'„- + ,(t~;/ ~ptn
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF LAW TNAT I HAVE PERSONALLY E%AMIMED MD TELEPHONE DATE
<br /> AM FAMILIM WITH THE INFORMATION SUBMITTED HEREIN; MD BASED ON
<br /> MY INQUIRY OF TNOSE INDINDUALS IMMEDIATELY RESPONSIBLE FOR ~
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<br />hard Mf((5
<br />Ri OBTNNING THE INFORMATION, I eFLIEVE THE SUBMITTED INFORMATION IS
<br />TRUE
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<br />SIGNIgCMT PENALTIES FOR SUBMITTING FALSE INFORMATION
<br />Environmental Manager .
<br />THE POSSIBILITY OF RNE MDIMPRISONMENT
<br />SEE IB U
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<br />. SIGNATURE OF PRINCIPAL EXECUTNE
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<br />TYPED OR PRINTED Wwmuirru++MPr/swrlrrro/Mnrwremmtna nW6Wral. OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV
<br />COMMENTS AND tlcrLgnA I IUn UP ANT vwLA I wrvs lKererencs ui artscnmenrs oars!
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<br />PA Form 3320.1 108-951 Previous editions may be used. ~ IREFLACE$ EPA FORM T40 WHICH MAY NOT BE USED.1 f? r ~ t ^ r ^ , „ . ~ ~ - 1 PAGE I OF
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