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PERMRTEE NAMEJADDRESS pnrhde FaclAry NamrJlarminn ljDi erenp <br />NAME BOTTLE: RESOOBCBS LL17Ii£D <br />ADDRESSy04IE YO. 2 >"LNF. <br />P.O. R01( 11~?3 <br />FACILITY PAt7SIR CO d1u29 <br />LOCATIONflUM I c CO H l u 23 <br />n :'>'N: iIL LLLAH 1. PF:tP .iR._ M7RM' +'t:R <br />NATIONAL POLLUTAM DISCHARGE ELIMINATON SYSTEM (NPDES) FOrtn AppfoVed. ~ R ~ <br />DISCHARGE MONITORING REPORT (DMR; OMB No. 2040-()Q04 <br />a-rsi rn-s) MI'i03 uas©5~1- <br />Approval exp' <br />(SIIpR WC) <br />PERMIT NUMBER DISCHARGE NUMBER ^ _ FL IY 1 L 8L ,~ <br />MONITORING PERIOD DSCHS CF 59 SO DPPR T4ALL DTrA ~'~ <br />YEAR MO DAY YEAR MO DAY _ <br />FROM OL OR 01 TO 0 OE Q >~` v ~+ <br />(zazl! (zz~z3) /zazs~ (zs-zT/ (zaze/ (3oa0 NOTE: Read Instructions belore pleting this form. , <br /> (3 Card Ony) QUANTITY OR LOADING (4 Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-87 (38-45) (46-53) (54-61) P~( OF TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />(62fi3) auALYS16 <br />(6a-69) <br />6370 <br />OLL -ND caeas~ SAMPLE '•`'^##RC ( 44) #:#^~+ ##~#9a '..~{:A9 <br />Y C SU 1 L MEASUREMENT <br />~'lUb6 1 0 0 rc- TERMI'F~ ~YAU S s ~ ES=1 ~~ +Ra #4#1MMtiR "- .#~ v .` <br />r,FPLU£NT GRO55 YALU , E4UTAENiENF ~ t .` ,ask,*~; "~ M =0 '.-, ' ~ ~ '" x #### '"~"s,l 4~: '~•' <br /> SAMPLE <br />- MEASUREMENT <br /> -i- <br /> <br />~ - -- +~ ~' '' SrT ~ -T3~ <br />~ r ,t r xC ffi <br />z i ~` +,,~~ ~~ .'. <br />~ §= <br />.fa• <br />~ <br />ffi <br />~. <br /> 1i <br />ENT ;y. ~: ~ y I a~ 4 <br />z , .,t -s~;t <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ._ <br />~- -" .. ; , n <br />j <br />' ~, <br />? <br />~'. <br />-s <br /> ~EQUTAEMENT ',,,, . a <br />i 4 <br />; <br /> SAMPLE Y ~ <br /> MEASUREMENT ~/ 6 ( '~Cv <br /> <br />- PERMIT -~.. <br />( <br />- -.x, :: <br />~`~ , - .. <br />'~ "~ <br />- - <br />- <br />- <br />~+ <br /> :REOUIREMENI ;: <br />- d'-j :; ~.,„'fir-')-,~ °. - - - L'~' <br /> SAMPLE <br /> MEASUREMENT <br /> ~ <br />r <br />` ~ + " ''~ ~" <br />- <br /> REQUIREMENT t <br />n - <br />~ <br />sY c ~ <br /> SAMPLE <br /> MEASUREMENT <br /> ' <br /> AEQU CEMENT - _ - ~. '' , <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT' - <br />'~ ~ _ <br />~ r <br />~~ <br />~ ~ <br /> REQULREMENT i <br />` <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMILIAR WRH THE INFORM LAW THAT I HAVE PERSO <br />ATION SUBMITTED HERE NALLY EXAMINED AND <br />IN: AND BASED ON MY TELEPHONE DATE <br /> INQUIRY OF THOSE INDIVIDUAL <br />THE INFORMATION, f BELIEV S IMMEDIATELY RESPONSIBLE FOR OBTAINING <br />E THE SUBMITTED INFORMATION IS 7RUE, <br />i / J ` <br /> ACCURATE AND COMPLETE. <br />LTIES FOR SUBMnTIN I AM AWARE THAT THERE ARE SIGNIFICANT <br />G FALSE INFORMATION <br />INCLUDING THE !{ ~a(%~y.~ ~/~ <br />~ _ <br />~ PENA <br />E A <br />R , <br />I <br />O <br />T <br />SE <br />AND ~ <br />/ <br />' <br />// <br />~ ~ ~ „_ r 1, t ~.~i( ND IMP <br />POSSIBILITY OF FIN . <br />E 10 U.S.C. § 7001 <br />S <br />NMEN <br />33 U.S.C. <br />I SIGNATURE OF PRINCIPAL EXECUTNE /~1J 7 Fi'- „lS ~ l <br />~ GS ~' ~ <br /> <br />TYPED OR PRINTED nclude Imes up m 510.000 erltl w <br />§ 1318. (PemMas antler these sfelutes mey <br />nax+mum tmpASOnmenl o! baMSen a marrths entl s years.) OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Aelerence ell attachments here) <br />~E.TLEABL.°. SOLIDS LIAIT APPLIES ONLY IP C10Yk,2dNR 2R?CI? ~7oUT i> !'L?a71"F^. iP C]. Ain AFPROVPq gY v:; CD, <br />?5i G IAOV LIAITS VICL MOt a'". APPLIZD T7 REPORTP.D -1£ASU33'"?!VT`-CF.R L.1.2, Pr 5 FOF 9'.IRDFF OP PRO['F <br />EPA~orm ' 61 OB Prev use Itions n5"ay dt be used '(AE CES' A` T' HI AY O7~ ED.) '' ~ ' ' ` ' ~" PAGE OF , <br />