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PERMITTEE NAME/ADDRESS (IwdidrFaAlnyNaw/loculon UD+d..+.p <br />NAME KERi{ CAA I. Clr?q fiY <br />ADDRESS N A Nri FIN 6 <br />P.O. oJL 77iu-,7 , <br /> <br />FACILITY <br />LocnnoNAhLJcH CU !iU{ iJ <br />;rr,,: c~aaae v. Paer!~.._+~~, nlNc ~:a. <br />NATIONAL POLCU~66~~ !tl70E~E~f.1MINAnoN SVS7EAH'.,,~ S~"'~ ~~ ~~~~_~-~~~fomi'APProved. ~~ ~ ~~~-~~ <br />DISCNARGP.KIIgNISORINO REPORT lOMR1. ,. :.-- gN 040 004 <br />1-.f61` + n-rei POND C/TRIG TO r. AR'~,,,~t ~I r,~. R <br />~Jo950 ~ ~ (SC9R HG) Approvd l{~irlep 031-98 <br />PERMIT NUMBER DISCHMGE NUMBER E' - FI-.!AL I <br />MONITORING PERIOD `! I N 0 8 <br />YEAR MO DAY YEAR MO DAY <br />FROM J llJ TO Yo li ~ 'F ~*~ VC, DI SI'~AAGE ~ ~~ ;rrs <br />116171 121-231 !14151 116-171 119-191 136311 NOTE: Reed Imtruetlaa before completlnq thu form. <br />PARAMETER 13 Grd onlYl QUANTITY OR LOADING !4 prd Ontyl QUANTITY OR CONCENTRATION Np. FREDUENCr SAMPLE <br /> l/6-531 !5457 I38-451 !4653 /54511 <br />EX OF <br />TYPE <br />131-371 MALrss <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS let-sal /S4-sg) 159-701 <br />I'f~ SAMPLE !:~GC2rs p:+•::xY~^- r+4# ~++ ( 12) <br /> MEASUREMENT <br />J U'1'JU 1 U U PERMIT: :~. a#~fi q'!h~ r,: .^:;eaa~s C :7.ytF ,'S ~ ;:IIgl'k {e ~ 9.0 .. ~~ ~.. ~.. ~~EKLY :~TfSY~TU <br />:~. E'f'LU EHT ~RJ:iS YAL'Id REQUIREMENT ~ ~ ~ :=?Qa ~~1.L.ilauri ~ ~ !y: ~ XfBtt. '!1 <br />;ULIUS, ;;~SSL?A~iL£ SAMPLE 4~rR'kGO :=~x;ua~z aaauoa iFl:•. #. ( 25) <br /> MEASUREMENT - <br />JJ:;GS 1 0 D PERMIT R;t;:FY;s <br />.. <br />...~C~ ,. !::~!: eaa*~:ua itaal,a .>~ a.5 f ^N.^'.Ea< - i'~'~~I. <br />•.r FLUr:NT i:RJ3~5 YALUE :REQUIREMENT rAGRx ~ ~ ~ ~ ~ IIAI ~ l1ON ~~ <br />.JiL AND .vAP.AjE SAMPLE ~. ~:. :: ;r ;c :::: ~ .'h u::;~~~~~ rtir;r #0 ~ ( I9) <br /> MEASUREMENT <br />~33:iL 1 U 0 PERMIT .Ik°'r ~^•: ~~`e ~.={~2."F +lt tF :;: ~P.FrG #t.: is !: LO .t ONTIN ;RA3~ <br />::FFLUEhT CRU55 BALU° REQUIREMENT Y9t.x 17AILY NY :!;/L uHXT <br />LJ,t, I"7 COND'JIF JR SAMPLE ( ~Jj) a;: ;.;:v;: Ya# as ;:s++?'-~='~ <br />P,!.tL' TRk:Ai'!(ENT PLgNT MEASUREMENT <br />~UJLJ 1 , ~;.sl U PERMIT IPrIJNAL RF.F'JftT a:grrfc:a >ru;=# ;: ar;#r°f# "•`-:: ( KCE:l 'NStAN <br />~FFLUENI' ri 55 Y;LU° REQUIREMENT #UpA AYG GhI6I YY MGD ~C4'S< MOf,TN <br />JIL ANU G~~BA4E SAMPLE ~ ~3 ZG'F .'- ( 9'{~ 4V;~5..:C :F4t IY ~Y ~#+?'.`• <br />4 I~ U A L MEASUREMENT <br />iaJ66 1 D D PERMIT r:.+,cay,~.k 8£POAT Y ES=L 3+h'7>kGa >~!<+Yat p z~aILE#t+~l ; #u!+ ! t1"`E/ 'I$J~L <br />,FFLUENT (iR'755 VALJr .REQUIREMENT IdsT `]AY NC=O ~{'~~ t10NTfi <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - : <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERM17 <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I cERnFr u9otR PENUTr of LAw THAT I HAVE PERSOnaLr El(AMINED MD <br />AM FAMILIM WITH THE INFORMATON SUBMITTED HEREIN; MD BARED ON - -- <br />~ TELEPHONE DATE <br /> <br />Richard A. IRWIBDII Mr INOUIRr OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br />OBTNMING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS ~ ~ <br />~' <br /> <br />Yi <br />id TRUE. ACCUMTE MD COMPLETE. 1 AM AWME THAT THERE MFG <br />INCLUDING <br />TIES FOfl SUBMITTING FALSE INFORMATION <br />I <br />IF <br />T PENA <br />C ~~i NA41J {{{~~~ <br />d Prse <br />eo<It , <br />S <br />GN <br />I <br />M <br />L ~ - 4 Tl <br />~~- Dl <br /> THE POSSIBILITY OF RNE MD IMPWSONMENT. SEE 18 U.S.C. ! 1001 MD 7e / gIONATURE OF PRINCMAL EXECUTNE <br /> U.B.C. 1 t 3 t e. Ih++Wd„ u.e~r m,., ,vrursa m.P Nrca:ds ArwA ~ ro i 10,000 ~ AREA <br />TYPED OR PRINTED .nenmuim.nhw+'a++IA+r otbM.rremonNS.nd6TAra1 OFFlCER OR AUTHORRED AGENT CODE NUMBER YEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANV VIOLATIONS lReterence sll sttechmenn here) <br />:i<'wPTLEAf+Lfi SOLIDS LI1Lr NAIYED F03 10-1'8, 24-d3 PAE:IP °PE,.i ~U~Ji.;T YO 9URDF,N ~.JF PROOF RFOIIIRf:'IFNT:; IN <br />"PAB,T I.tl.leU, P. 6. STOFf1i+ATER !SA9A~El7ENT PLAV DUE 1-1-a°. <br />EPA Fam 3320-1 108.96) Previous editions mey be used. (REPLACES EPA fORM T<0 WHICH MAY NOT BE USED.) U ~ 6 6 / 7 7 0 d l 9 - L 2 5 ¢ PAGE I OF <br />