PERMITTEE NAMEIADDRESS R.•Yb faWryNor'lxuls. l/Dls r•nq
<br />NAME CDL^,7.AJ~ [A`1PA C041. ~OY=~'A+Y
<br />ADDRE555I V'~-, t,l`3 5011'"y, E'CK°Ah tK
<br />LJSLti RC'; Rll
<br />JAK :=RE3K ~:) tiJ~6/
<br />FAdLm
<br />LOGTION) A r: '_ f' E ° " .:1 P (l 4 b 7
<br />"Pk: x'I': r1431. L!l ~i i.(1:_ PN SF M;3.
<br />NATIONAL POLLUTANT DISCNMOE ELIMINATION SYSTEM NPOESJ
<br />DISCHARGE MONITORING REPORT (D RJ
<br />^~in7 T'l' •~
<br />PERMIT NUMBER pSCNMDEMUAlET
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM 0 06 UL TD 1 6 30
<br />A) 7': ,
<br />' • 'I~'"D F TO FOZDF.L ^PFFY.
<br />NOTE: Rud IrutnletloEr•Eda~ eompbflnp fhb fam.
<br />PARAMETER QUANTITY OR LOADING Quality or Concentration No. R1ED
<br />FEN[Y SAMPLE
<br /> EX O
<br /> MKYSIS TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br />:LV•::, ='.TF'~Tf':LLY SAMPLE ;:r•axn~ p>aa#Rf: ^saa#? ( ~
<br />-.._1LV. .1 MEASUREMENT L.~I~( <Ol boi I~F ''~x~. -,;119
<br />
<br />,. f,. .1 i ,) .PERMIT:~~ :''::
<br />
<br />,. .: ~: !? a;'1ti:4:!4r::
<br />
<br />
<br />' •
<br />'
<br />' 's!i*.3f,3/f:t~,t.~L~.. ~ ~
<br />;.triiiti0i~%;" . _ti. ..
<br />;: .l<'p:Ei$.T'; .. .~ .. ,
<br />'.'.R:~:':P!J#i,;:.. ~
<br />•,•.r..ic/, 1.
<br />;a
<br />... ~ . :.i.
<br />. .,. ~~.• C'aO:S VALGr; REQUIREMENT:
<br />~::...,.:'.;~'~:':..: .
<br />..::.....
<br />.;.
<br />.:~ .. ~ .:~...:~:.: ;::,:,
<br />'<":.' 3;;':::.~:..~
<br />.
<br />
<br />....,
<br />
<br />.. .
<br />~
<br />~
<br />~ 3il_a:A~.~~~:'i+,~
<br />~(311:T~:~~.Y=~.~~;d~7F'.
<br />."i(:/L
<br />:'cY!,T!=
<br />c .
<br />Of. ITI.4LLY
<br />~ SAMPLE C 'r
<br />-a4.s=a z
<br />acFS.R ~'~~
<br />~`
<br />~~` ( 1
<br />~SJLYt'D
<br />' MEASUREMENT ~~~ro5 ~O+oDS ~/: ,;:". '.;":'
<br />'1J'Jb 1 -0 J :::..:.PERMIT":. ~'oaa'4.:... .E:..oarxax:'r t .trt ..;:tir,.dfk r ':0.73 ~: ~ ~F°1'3'G-:;.: ' ~'.;'r~:/"
<br />•
<br />~'FL!IC:ST ';t!O
<br />S VALIl
<br />: ~REQUI
<br />IiEMENT :..::~ ~
<br />.
<br />.'':.
<br />.: ~~'~
<br />Y3 ©
<br />AY'-
<br />':aix`[
<br />11
<br />i'T
<br />#i
<br />':i;
<br />t^
<br />l';9':
<br />:,
<br />r .
<br />,:. .
<br />,
<br />,. .....' ... A::'
<br />~: :
<br />.
<br />.
<br />, 1 .
<br />1'1 jll", SAMPLE Raa7y# ,t .7-u.~c: -.:~~~h# ~
<br />c '1
<br />(
<br />~
<br />7
<br />~
<br />. .:+ ; f A L 1. Y ;1 I " ] i, U ;~ MEASUREMENT ~Q I (~~ LQ,(lp
<br />j ; •?p (°.
<br />i
<br />J
<br /> :::, ~.'.PERMIT:.'i'~~:' :::~t'4+'f.;~:R:ai: ; :. :UI:4 ~r.~Hk ? .a^ .g,;«?:.yLy:._6: '";'"
<br />
<br />P ~';R'~r.:::
<br />li' ~^, ~ia'TC
<br />•
<br />,
<br />" .
<br />-, w• - -
<br />. F L J :, ', C ., H 0 5 S Y A L U E REOUIREMENT:~
<br />i.:..:.....:: ~ ..:.:...::. : .:.. .:~~~...:.::.,...::.
<br />::.....:....: ~.., ~:.. ~•'~:~~
<br />..:.....:: ~.:. :~ ~.... re :~:•- •:: a:
<br />':V;,'' :.i.:. .:.
<br />:.....:'::4IX
<br />. ~.~/ pp)~('x
<br />'.E!: :4 n: n:.i l!,~ SAMPLE Ic ^.aaya r, r,`+sy~ ..:~.yaEk ( ~ }
<br />'7i.'':~^LALLY DIS~'JLVU MEASUREMENT r ~ C / ~J ~_ l-':l~l _~
<br />113!1 L U O :.::.. .PERMIT.~ ~'..'G#6Y7c>t..~ ."`'$R.a~+R iY 'S ~, ~.., :... ~14i'i1r:;L~4.Y~.:::. Y.3r;'::'`b'L
<br />~Q14S':`.::i
<br />' ~~:Tj~:(..~y'f•:~:T~::
<br />.~:':.' ~'t ri'G(+l:'.! 'll~'•
<br />
<br />'PFLUFtiT Jk')S Y U REQUIREMENT
<br />
<br />
<br />' ~
<br />
<br />,.
<br />~
<br />
<br />. .
<br />i
<br />IC•~~~~ .
<br />1tY ~: N?F:.
<br />`"/••
<br />~:: ` r~
<br />!t,'r'T'
<br />.
<br />~I1. ='v ;?SAtiE SAMPLE r.OG#4 ~•aa•rt .:Y:I:3 64~a•'~4 ( 1)
<br /> MEASUREMENT A ,~ ~
<br />'d .)7~• 1 1 J U :.:tr.:'~PERMIT%:; ~' `. ^'r~~~~l:~:di:b'!R":::':; :'~`s:~'#:?df:~ift.;t.'. .. t'u. ,:: ~.~.;~r,. 6~-ist ~.:': :,.>.:~:?~Ykit?~34f':r~: '~:: i:.:.i.:~;.::::' :..: :.:.:.::: ~': '~3.N~~.;E !!: f:A?
<br />. c.' 'J ~:^ (:40° V L't, ..:.:GUI EAAENT-
<br />~ ~':: ~:: r'.':?:,::';::..'~'i:~Cl~:
<br />~ ~ a>%~!::.:.:~..: ~'.::<:: ~.: ';.
<br />~ .,. .., :".~.' ~ ~ : :'~i;'~....,-. ~.,.-~:.'.j ~~i s'< : .. .. .::.:.:: .. ~, .: ::,.:: .~.. ,
<br />:. i=, I °1 :JVDU IT Jk
<br />" SAMPLE
<br />" ( n ~) ..... ppr.y tit: ?-t*^.• r.
<br />1~~~
<br />r~
<br />IN5(~
<br />'
<br />'
<br />°
<br />"
<br />r`
<br />' " MEASUREMENT O,(
<br />~~I O,~Q~~ ~ .
<br />:!
<br />M
<br />HT FL.4 Lit
<br />~
<br />::
<br />~~ 1(.~) i 1 J ~`:: .,PERMIT::::.:~.. ;.:.:."R&1J~O.I~~T~',-; .: ~a:#~E~POi~~T~'.
<br />A
<br />vY:%r.~:'. ' ">:..~13?.R 4'#:>XRi:~'. :::~~~~;`:~~#fi;"; ,. ,.:, ~:. ~f;~`'.~i.(.L[ :y5?4i1
<br /> 'REQUIREMENT. .. ' .... -
<br />.30.Ir A.: A Y:~ . ;,.::..:..
<br />:::Qjk'...LY P i.
<br />. G ~'
<br />
<br />.......
<br />,.,....,
<br />~: ~: ~:.
<br />.......
<br />:. ..... . Rr:c:
<br />'
<br />
<br />
<br />..
<br />.
<br />':.:... .
<br />
<br />
<br />.
<br />.., i.: 7S, T.TAL
<br />", SAMPLE .~'*rtaRC RR'+R (:- .. ~
<br />( )
<br />iQ
<br />~
<br />,J/
<br />LTC. (
<br />; "
<br />•
<br />'
<br />~ MEASUREMENT J !OD ' ~, (a' 9
<br />. r
<br />: :
<br />. _
<br />!'. <:-~5 1 J 7 ;:.::PERMIT':::::` ':".{+9~E?'0 :::; :::aE~xi!ir}g' ;•.-r: =: ,F ::,!ir,.±.. ;;-. Rt5YOR3'. `: `:RLsPCaR.2° 1"R 1.Y .uA.y
<br />
<br />'. F' F L it L :~ T G Si 7 S 5 V A L t! 'REQUIREMENT'
<br />>'<'....:' .:::..:..:....:.:. ';. ;.. ~' .~
<br />::.::.::. ;;' ......:
<br />:"..,::::.
<br />o-:•.
<br />,;'tAT:$':;tY::i
<br />.'. J fi.7:>;*.. ~,.;! 1<.
<br />N ~/ L ..
<br />NAME/1lTLE PRINCIPAL EXECUTNE OFFICER 1 aeon, •n rc pna, n l.. mn 1m
<br />Prcvrte nldrc m, elrtcnon er•uP• . aavmem nna .E.u.cn.:ent•.m
<br />nlNOnd.rtore.rte .un.•1•Iem aee
<br />.a
<br />TELEPHONE
<br />DATE
<br /> p
<br />I
<br />Ib
<br />I
<br />IlnN
<br />l
<br />T
<br />P, i c h a rC M i 1 ~ n aeurt
<br />•
<br />qu,
<br />Rronne
<br />I.Wrl1 i•Ibrc •M e.•lu•1e Ine:nforo•11on
<br />a.bmin,d. eda nn ml Inqulr, .r Ne penpn a prom.nn mange IM r,Nem
<br />/ ~ ' /J
<br />r
<br />~~
<br />Fi~vi ron:lle:; tc) ,Manager ,
<br />o.,,.~.P.r,m~n,~n„rcP.,~b1~,,.,M~M U.. rn,b„n.Ibn.,Mln~,,..1mn ~- a:
<br />2712
<br />0 8 70
<br /> abmlllen b, l01ne bYI •I m, •ne.kd,e nna MMer, Irve. •te..nle, •na aomple:e,
<br />Lm...rtu.un.rt.n4T^lnmrpnmm~ rar rubmlm
<br />nM rnronn•n EIONATURE OF ryIINdFAI EXECUTIVE , -
<br /> nE
<br />on.
<br />b
<br />n
<br />al
<br />n
<br />bn
<br />rn
<br />TYPED OR PRINTED ,
<br />n
<br />nT l
<br />e POr
<br />u,o
<br />.e..a rmvN>anm.m m.Lm.mE •la:uela OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV
<br />COMMENTS AND EXrI,ANAIION yr nnT vwLA I IONS lRI/IlIOCI NF 1fr~e/lmPnta h~ry
<br />;LI:.'96'E LC"ri'.. ^1:~~ :~ :FTTLEABLE SALT-~° (L~-: ' " •.':='i "];v[.Y I? <= 10-Y?• ~'U-"i• PR~CIP ~V?'.H9' ,'
<br />..LaI°YD. iEF. I.A.4, P; Y, FOR dURD69 OF PRO">~ °.";~'::~ ~':?`. OIL ., S,E.4SF-SF.E I.'~.1.D, PG. 11.
<br />EPA Fam 3370.1 (Rn. 3/99) Previous editions may be used.. ~. This i~ 4- COTm. PAGE OF
<br />ooa~o/oli,3~~-fi`~~ z
<br />p,~.., . ... .. . ,. .. =r.:..,:.~3~e. ~ .
<br />
|