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PERMITTEE NAN1F/ADDRESS QrM4Fed11yNwWLunm 1JDIQnIeD ap:fea _ ~„NAT ~}~,Q .E$J - ^ - - ~ :r ~~,,,,-f-p~~jJ{jPC2vrQ., r g- ,., ^~ NAME. POYDSbAORN C011L COEIPAIiI "` I - ~ : _ TE / HO193.2gE lf}~•`7~. ~~Y~~; r. se pTave a Ipy ADDRESS 90ADSIDI; FINE, N 5 POA?ACS 00002714E ~ ~ Q (SUBR iC) P. 0 e [1 U X I4 3 ~ PERMIT NUMBER DISCMMGE NUMBER F- F I 11 A L PALISAD~ 1SZb CO ti MONITORING PERIOD MIROR -:'si~ FACILITY . , YEAR MO DAV YEAR MO DAV ~ LOCATION FROM TO ### NO DISC HA dG +^+ :' T N : J 0 H N A e !! C N ~ f; , F:i c. `~ I D E N T 17671/ l77-131 111-I5/ 116-771 I1B-I91 !3631/ NOTE: Rrrd InrtruetiaFU brtorr complrtlnp thu form. PARAMETER 13 6rd Ontyl QUANTITY OR LOADING !1 Grd On1Yl QUANTITY OR CONCENTRATION NO. FREQUENCY SAMPLE 146-531 !54671 13645 !46531 16L6I1 EX of TYPE l37-371 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS le7r]1 ANALYSI@ !54661 159-)OI ~:1 SAMPLE .~'.`G#~S v##### #>:?#a~:l ( 12) ,[ / MEASUREMENT ./ ~,~ j(J uGUOO I 0 0 aERMIr ;-##q~l:ip...: ~Im#.>i~>~# a## 6.:5. #a>~.apa 9.0 :- :. :. ~^ B! LY NS2TJ E'FF'LUENT GROSS YALU REQUIREMENT ... a##a RI 11i l4U lI . ... . )~fAI; MUtt : 9U . . . . ::JLIDS TOTAL SAMPLE #; #3#3 aaaa+-# osa>aoa ~~ ~ 19) ~ // :,GSPEhUED MEASUREMENT ~5 , / S 10530 1 0 0 3 .. ~ AERMIT ,,..... ~. ~ #i~M1+R?tl":.. #ICrs ,. .. .:.~~?R1A?IrJ~lp~ ~.5 :: ..: %.(~. ::..:...: ~: - ,:. v::. :,FE'LUENT GROSS YALU :REQUIREMENT a4## 30DA'A.rG .:~A ~ i1Y NG L I k "?•-~` LkON, TOTAL SAMPLE i=f:###t- C#a###, >aaaaa~} ( 19) (AS TE) MEASUREMENT / Q /i~ / ~ ~ L~ q 1045 1 0 O PERMIT ~#afi##~ .. .:.. #+CfAq+Y#. #ri.C 01R>P7?4+R ~3e5 lad ~: ~ .~NCE~. ~. i:aA.$ :.'FFLUENT 680$5 VALUE REQUIREMENT #c:=a 3fl A. AYE DAT Y .M G L .: . M R!8 -.. AIL AN V E SAMPLE :##':# $#:##;: ~ ##aaao / ( },9) ~ j ~ 1/ U/ MEASUREMENT ,(,J ~ q1 ~ 7Q ' '7 ,Q . L~,. '3592 1 {~;. U PERMIT #:x;cq#~ ... . #aaaa# #t# tlraa»a RBF€TR2 10 S .ONTIN ;RAB. i:Fi'LUENT *~SS YALU .REQUIREMENT #### 3DLA Ai6 .IBSZ RAE RG/L ~' . .6EiYT ^L V, N UIT OA SAMPLE ( 03) #0431: ##A #Xr: #Q##O# .IiHU TREA'~BBKT PLAY MEASUREMENT ,'drLd~ O.LB~ ~~ ,~ 0050 I U 0 PERMIT REPO.AT.- :. -:..REPQR T a$aa#G. aaEs~4eY . la:~z;~talt ? 4#~ E°K:LY. KSYAN ~fPLUEd11 &RO5S YALU REQUIREMENT 30D1.AYfl . OAIZ3 ilX t1CD :: ::.... . .. -.:`:`.: ... s~za# ~UL , SAMPLE ## .^•.. #04# .# aaa400 19 . ( ' ISS ULYEU MEASUREMENT JJ~'~.J ~S¢/a ~Zp ~~ iU295 1 0 0 PERMIT. #".r.<q:R# =~#0$## ##'X 04fiOio4 REFOAT :. RBfCkT TNLY iRAB ~.YPLUEVT GROSS YALU REQUIREMENT ~ #G## QATB AY:G ¢ATA MAX [7G/L v .a SAMPLE ### '.# ( 94) #4#t#4 44#0## 0L4k#>7 / L S4 A L MEASUREMENT /a /r 4Ubti 1 0 U ....PERMIT.:: . .'~ :+- : :.R' '. fi1'.T ES=1 ~~ ~~ 71D0##1C . :##0#;f 4. ? ##~ EEALY ISUAL YFLUL'NT 6A0S5 VALU 'REQUIREMENT' jA'$!r b:~.~ NO=O *#~# NAMElTITLE PRINCIPAL EXECUTNE OFFICER I cEPTI AM FA FV uNO[R PENALTr of MILIM WITH THE INfO uW THAT I NAVE PEPSONALLr EXAMweo Mo PMAT10N SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE ~K, S~J'eh E J MY INOUIM OF THOSE INDIVIDUALS IMMEDIATELY PESPON@I@LE FOP OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS - . . I AM AWME THAT THERE ME TPUE ACCUMTE MD COM0.ETE . . SIGNIFICMT PENALTIES FOP SUBMITTING FALSE INFORMATION. INCLUDING THE POSSIBILITY OF RNE MD IMPRISONMENT. SEE 1B U.6.C. ] 1001 MD ]] _ /BIORATURE OF PIIINCIPAL EXECUTIVE ~ .~/1 A/O / LIF~J T ! ~ ~ -J 'T ~? J TYPED OR PRINTED U.S.C. E 1 ]1 e. lFMraY. uK~r tlww NeM. nvY Ycpb rwea K ro S IO,OOD rMnmu:.Nnrlro+lwmwrce/Mlwrn emenehaW 6Twa1 OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV COMMENTS AND EXPLANATION OF ANY VIOLATIONS !Re/erencs s// eThcnments nerel TiiiS OUTFACE IS NOT SLIGIBLF. FUN [tiXst;P'fIONS FitOtl TOTAL SUSPFNDAC SCLICS ('ISS), TOTAL IKON AND/Ort 5L"ITLEAHLE SOLIllS LIHI~CATi0N5 - SEE I.A.2. i ,w ,3 EPA Form 3320-1 (08.951 Previous editions mey be used. (REPLACES EPA FORM Td0 WHICH MAY NOT BE USED.) C C 3 3 E / 9 8 C 2 2 3 -12 5 o PAGE I OF , ]