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PERMITTEE N •.ME/ADDRESS OmLL F,aISry Nw./laanm l/PIO..+,n) NAME ~ r ~~v~-, ;. ~'i i~ I+_ l.'..K .> ,..4 { Sl~i~ ADDRESS PF „ DLiX Gd ,~~+'. L Alt; CL tilyl. NATIONAL POLLUTANT DISCHMOE ELIMINATION SYSTEM //NPDES) DISCHARGE MONITORING REPORT DA1R) 1.761 I7-I9I PERMIT NUMBER DISCHMGE NUMBER .,gs ' .Yr-w r,,v;.L: v 7h-ylw T SliDk NN F - FINAL N f A :) - Form Approved. OM8 No552040-000,4 /Cpprovefeipir~e 05=3198 1~.i4~ FACILITY CYF'kL5 EMPIRE CQ~tPOkATIUN - MONI EAR .MO DA T IN PERIOD """"' ~ YEAR MO DAY J LOCATIONCRAIv ~ ~. CLi CS1b1J FROM ~ 3 O ~ 0} jl 44V NU Liljl',HAkLt 1'~"~ A1Tw HII.HAEL W. LUDIC 'AIEKA Hbd l1611d.l1=13111 !1617/!18-191136311 NOTE: Reed lrnwetlorr bs~ors eompAtinp thb lorm. PARAMETER ~ l3 Csrd Only, QUANTITY OR LOADING'. Card Onlyl QUANTITY OR CONCENTRATION NO, mEOUENCV SAMPLE 14653 15b6f1 38-15 !4653 5L5I1 OF TYPE !31.371 ' MALYSIB :gyERAGE MAXIMUM UNI MI,NIMU ~ AVERAGE MAXIMUM UNRS /ez 631 16'1-681 (59-701 :,LL1UjF iu7+1L SAMPLE ;:_ *##!## ##vi!#+): #~+FI~~i4 i 7 u1~jULV[L' MEASUREMENT 7trL`l ~ i U O ". PERMIT ir$4E+~1`i':: ~:.~?~! +~R~~~€"~ ##v ~~Y.+FIR ' y...,: ;,.: ~ : _~(~I~~ ~Ls:T'X>i~IY:A~ : : T?~lY:. i:f hil.. LFhLUtN( vl<LjS YALUt REQUIHEMENT .... .,~.. ~" . a.:..... •,w-:;.:....: ~....~ . ., .....:.......~. : . . , SAMPLE - ~ • MEASUREMENT - .: : .. ... . ~ ~ ~. : ~ _~ ...~. :R QUIREMENT: ~ ~ .... .. :. .;s:~.:~'~~~~ ~'~I~: ~ ~ . ~ r::,::~ ~ :~ ::::, ... .. , .i:.:, ~:..:. .. :~~~;'~ .::....::: :'%'"':~: : : .. . :..: . : ...:.. :i .. i. . . : , . .. .. ... S. PLE MEAS EMENT ~ ~: PERMIT ~ ,:.. ~ ~~ :.'~:j ~ ' ~ k.:.. ..:r, ~.; .^,:,...:.:: . . ~ ~ 4 ~`:...: .. :::>, ~. ,.~. :: ; ,. REQUIREMENT .:: F.::.:~:.r::.~ . ..,:.. .e::~...: : .. ,.:..< ~ . ..::«~ .. SAMPLE '.*~._~ MEASUREMENT ~ ',~'3RI~ ' .::"::::PERMIT::: ~ ~:, :. :... r.:. ~ ~ .. .: ::' - . Jii :: ...~... .. . . . . ::: .... .. .. SA'NIPLE MEASUREMENT ~~ PERMIT:'?~ :<..„. .:.~~. ~ ..: -! ~ : ~ ~ ~~ ~ ?REQUIREMENT. . . .:..: ~:. ~ .. ... ,~„ .. r .. .:. .. Y.::..:..ti :. ~: .. .. ? .: X: :!r.:. ~ :~.' SAMPLE MEASUREMENT - .. ...... . :~ ~ : .....~ .. ,.:...:. ~:.. ~~~. . T • ~ : ~ ~ :. : :' . .. . . . ~REOUIREMENT' .. '. b.;:t ~: .' .~.:: ::: , . .. '..:.. ~':::::':' ' ri:.: (,r..xF .::;':~..::; .:::~ .:, .~~`~. ~.. : is:::.:':;. SAMPLE '~ _~ MEASUREMENT . . :... .. ~~AEQUIREM.ENT;: ~ :. ..~..: .:. ... ..:..:.. ..... ... ... :....::...::..~ z::.:~~~: ..... ~~~ ~:.. .. NAME/TITLE PRINCIPAL EXECUTIVE. OFFICER I CERTIFY UNDER PENALTY OF L AW THAT9 HAVE PERSONALLY E%AMI TT MD B N S NED MD TELEPHONE SED ON DATE AM FAMILIM WITH THE INFO MY INQUIRY OF THOSE %:IN RMATIO ED HEREIN: UBMI DIVID.VAL~IMMEDIATELY RESPON4B ' A LE FOR ~ ~ ~ Richard I11111s OBTNNINO THE INFORMA ON .11 BEDEV TyE SUBMITTED INFORM ATION IS ~ ~ TRUE, ACCURATE MD COM R PLEFf. ~ AM AWME THAT TNE SE INFORMATION IN TT N RE ME CLUDING ~ ~ ~ L/~T/ Environmental IMana~er SIGNIFICMT PENALTIES FO , I G FAL SUBMI THE POSSIBILITY OF RNE MO I MPRISONMENT. SEE 18 U.S.C. L 1001 MD ~] -rn ~ -E1 ~ N S.C. L 1310. IP,nNM, nNr D e'wr mean, m.r 4shd, !w, ~ ro (10,000 BIOMATURE OF PNINCIPAL EXECUTIVE M TYPED OR PRINTED . ,n, ar,rr,hx,n inpdo,rNrrr,! 'brrw„n emmN,W 6 yu,l OFRCER OR AUTHORIZED AGENT coDE NUMBER YEAR O DAY COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Ra/rrsnci s//sttechments hare! jtTTLtADLE SLILIJS LIMIT WAIVED FUR' l0YR.24Hr{ P~tcLI~' EYEwI-;k:,_ i.d,3F v., IVFtL~ KEQJIFcHthT~. :;1L t. uriL:.St Ghdb jAMF'LC AtvdLYSIS K~aIUIKCU IF Vljl.'.LE jHt:CN i~ L~SGriYLu. .:hTrtL-Y ~ATi('LI,vi~ I'..;T:cUl.7IL:v~-i.~.t„ V r' EPA Form 3320.1 (08.961 Previous editions mey be used. /REPLACES EPA FORM T40 WNICH MAY NOT BE U8ED.) J J 111 / y h 1 u u 1- L 1 11 PAGE lOF . ~'e.