Laserfiche WebLink
PERMITTEE NAMEJADDRESS (Include Facility Nanr/Loco(ion ijDl$errnQ <br />NAME ';Y~ .: ~.n: •~ ~~' .. -~. '~ <br />~ ..^,. <br />FACILI'LY <br />LOCATION <br /> <br /> (3 Card Ony) OUANTI <br />PARAMETER (4653 54-61 38-45 4653 54-61 EX OF TYPE <br />(~37J AVERAGE MAXIMUM UNRS MINIMUM AVERAGE MAXIMUM UNRS 'Waf-Y513 <br />6&70 <br /> f5tL0) (64-68 <br />CU'-'I [: :'[7 y SAMPLE '`'?naa ;:'x r-ra-: ~•4-_..o <br />1.) <br />L ; <br /> <br />" MEASUREMENT <br />('L" <br />~v i (' ;r PE MIT, r.; !aV4P 4 1`4a p9N01?i+'# R$~(7p~' ¢~TItMA~ .~ w..n~ ~ ~~:: <br />' ..Uh"- "'l]' J~Grl4 : U ENIENT ,k1 E~ °>are^ ._ff Tfi~R-~X~ <br />~~. 11~' M~~i r-° ;i'°% '+"t. ~~v <br />~~ SAMPLE aaa-rv ahv`^ah O;t ~prn~~ ( 1~) <br /> MEASUREMENT <br /> <br />GC4ftn L ^ '' ~ PERMI ...:~ :' R#YS h67t -; .)'.n rrS' "~,' v <br />j' ~'~' ,~~~n'76~ <br />~ 3-=~ f~`[X <br />f'L.'L*';* :.0 :1 r~$ V?. L, fie REQUIREME[T "'f*~ ~ :',~- " <br />~,~. 'r~ ~` t' '' <br />~ .. t <br />; <br />~ ~ [ +i <br /> w!e . ~~ l <br />SUL,....a ,l:':•!l SAMPLE )rr,xa^ ,.':~:=a- t^. / to) <br />? U: D? q D L i' MEASUREMENT <br />~053U ') p D PERMIT O+Ca'30Li ~. oAr#hR4 -••"•. ~ROO#4h R°PT1R~ ?~°:P!TP'!' `: O MCFIC 1 :1- ,~" <br />~'i' CU"(?'O~.°i RF(.~'_ REQUIREMENT <br />' ~;.`-•"• ~Rt74 AYE Q•4T LI". Rr~ ""/!. MC}N'I'N' "•~~` <br />.i7LID5~ mt ^'SL SAMPLE ''01`''•`'ht[ <br />'P ~~:: rtr. .. r... t.... - ( . n~ <br />S J'; }' ~.; N U E": MEASUREMENT <br />J J'.. tU 1 C 7 .pERM1T PPODrF h37 Q#~~#A ~$ ~ -.~ ~ - <br />• ~~. I~C~~".; :; gilt <br />_F°I.:R4:T U^7' <br />YA!'rT REQUIREMENT Ps. #teh;t ~ 3^~kA Air'' ' •'^ <br />• ' ) <br />~ <br />. ~T. <br />! 1x / fl( <br />J~B a~-f; <br />; <br />_;;i 1.1 l)S~ ..."r°L.f+A(,r SAMPLE R': fr^~.n aa'?r, Z.. .-a.r,[,.. ( )~) <br /> MEASUREMENT <br />C 7:)45 T) C ~ PERMIT ..~4CYr hLr Or AIAk-416i .....,: (t -, .~ , ?.~:; ~ <br />~ C.1-~, T F' ! ~~' REQUIREMENT <br />..: <br />~ '`C'n ~}~~, RYA' .trA Y~'Q~' tlif~~ "!./L "~ <br />U[.i LSr i":TTL"s`iL- SAMPLE ,.:aa h4h <br />a !:X (....a n..;t ( JS~ <br /> M(ASUREMENT <br />I~J~i ~15 ~ O ~ <br />PERMfi C'r Tf'#171Cr _ ~~~~--0I ww.. ~ag~. <br />#'!bOi11-= <br />~'A'~'lti7~ <br />iF .'j` <br />` <br />' ~# <br />~~` <br />. <br />„°f L"~' ';R7S'" :'9T n' REQUIREMENT _- '- ••r.*~ - <br />)OD l!3~ <br />b#~ 'T NfF _ ., <br />r /T <br />y . ~."~ <br />14 <br />~,;r. <br />: ` - <br />'T!, r;qy yc[ SAMPLE ~: X~''.Xaa C:r ^:h r.y h.....r .. {- ,:: Y...; .r,Y.. / <br />~0, <br /> MLASUREMENT <br /> <br />~~~ : (' I ^ ^ <br />PERMIT <br />a##vbR <br />#ara4fO tl7r 9 <br />--'`•~`-C <br />O~L!~iriEtOrh. <br />~ #7pIAeQr#KS <br />7 <br />'. C <br />%T~~~t t,~ <br />' i <br /> <br />:,llF.~' Gr'•'; ~ „'. ,•' <br />REQUIREMENT <br />t,.Arn <br />Tp9T !~ E <br />"/r. <br />~ i <br />t. <br />"af~j <br />NAME/TITLE PRINCIPAL E%ECUTNE OFFICER I CERTI <br />AM FAM FY UNDER PENALTY OF <br />ILIAR WITH THE INFORM LAW THAT I HAVE PERSONALLY EXAMINED AND <br />ATION SUBMfrrEO HEREIN; AND BASED ON MY <br />/ TELEPHONE DATE <br /> <br />r3lchard ~YiIIIS INQUIRY OF THOSE INDNIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br />THE INFORMATION, I BELIEVE THE SUBMRTED INFORMATION IS TRUE, ~~~ <br />. i/ <br />C! <br />i/ <br />/ <br />j <br /> ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT /~~ <br />/ <br />; <br />(~ <br />r <br />~ r <br />=n4rironmentai ![4anager PENALTIES FOR SUBMITTING FALBE INFORMATION, INCLUDING THE // g7Q-B7O-2712 7 Z8 99 <br /> POSSIBILITY OF FINE AND IMPRISONMENT. SEE 16 U.S.C. ¢ 1001 AND 33 U.S.C. SIGNATURE OF PRINCIPAL E%ECUTNE <br /> 4 1319. (Percales urMer these smtutes may Include Mnea up b E10,ppD rvM a OFFICER OR <br />TH <br /> <br />TYPED OR PRINTED <br />mexlmum lmpdsonmerx of belwsen6morx/u end 5yeera.) AU <br />ORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />GOMMtN I p ANU tJ[YLAN/111VN Ur• AI`IT VIVLA I IUNJ (HBIBrBOCB 91l a[raCRRIB06 DBIBJ <br />:, i.":R4AT'.: LrMIT ["~P ..'i, T~:n•1 r. ,,^rr.?a^i.° ;7L?DS (L7' err) rn^~v 1+;rv rr i- rr_r..a 1t1-P^ pocnT•. „)r.r <br />CTIM4'O" +°° L. 4. ~~ F: IYr rO? rl p',n [•'j ~C n~7~F uTr~llT Orv or,-• ~ ..Tr r r..n'r -r rl• [.nlT.^Nnn. .. n^ ~. <br />. r o ~ a an• r. r e. r. n.. ^..v ^/a <br />Epp Form 3320.7 (OB-95) Previous editions may not be used^ l ^(REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.) n ^ 1 r n / n ~ n rl 1 .r_) r , t1 PAGE ~ OF <br />NATIONAL POLLIfTANT DISCHARGE ELIMINATION SYSTEM MPDES) Form Approved. <br />DISCHARGE MONITORING REPORT (OMR; OMB ND. 2040-0004 <br />^ ] ^ ~ ^'71 r It ^ n ~ ' / ^ . ...,1 Approval expires 05-31-98 <br />PERMIT NUMBER DISCHARGE NUMBER n _ :• S •• ~ ~J LL T'• <br />MONITORING PERIOD ~• ~ T r ~ " ^ '" °I ~ T n ~ r ^ o P q r• <br />YEAR MO DAY YEAR MO DAY _ <br />FROM 't l TO -t'1 '1 it .. .:: ~ n-.-rn+7-~• ' ':::. r. <br />tzaxp tZa-ss) lzass) !se-a~) (ze~aal !soap `NOTE: Read Instructions be w plating this lorm. „j~ <br />TY OR LOADING (4 Cam Ony) QUANTITY OR CONCENTRATION NO. FREOUEN SAMPLE 'S~ <br />