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PERMITTE€ NAME/ADDRE6511n[lude <br />F~clllty N~y~ne~/COnatlpn if dl/lerentl ~r++~~ ll <br />NAME ~ S T F. -. N~SL:~.:1= ~...JJL~ n-J~-~ LS.i~ - _ - <br />ADDRESS~{~T)~!Fi'r..17,~.~~~ __-------_ <br />---p,Q.-~lL~2-~------------- <br />---NUCI,ls---------- CtZGU~.~4-- <br />FACILITY _ <br />LOCATION _-_-_---_--------_--_---- <br />A1'TN: R. LA0.Cc L'ADc. NINE "IANAGfR <br />NATIONAL POLLUTANT pISCHARGE ELIMINATION SYSTEM (NPUES) <br />DISCHARGE MONITORING REPORT (DMR) <br />(1-I6) (17-19) <br />cn000u::1.3 004 A <br />PERMIT NUMBER 91ACHAwcc NvHeew <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM .~ 70 , <br />Haul marl naasl rzs-vr na-zvr cro-.rn <br />I:I!.OR <br />(5 U 8 R Y C) FjgrOgVlyp~oved. <br />F - FINAL OMB No. 2040-0004 <br />pOND RL'NOFF~A~~P"~I!lT~PL3E'g6RAY <br />sot ND GISCNARGE ~tr4 <br />NOTE: Read InsfrucUona before w { IeUng this form.. I <br /> (J Grd Only) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION <br />~ ~ t <br />PARAMETER (46-SJ) (5461) (38-4J) (I6-SJ) (3461) NO. <br />Fx ~ <br />ANALYSIS= BABAM~ <br />(JI-J7) : ~ <br /> AVERAGE MAXIMUM UNITE MINIMUM AVERAGE MAXIMUM UNITE <br />(6}6J) <br />(6148) c <br />(61~701 <br />it SAMPLE r##;7tr: #r;.0 ~rfls #s}Qt#t%i ( I2) <br /> MEASUREMENT - <br />OvUJ 1 •- PFliM/T ±s.#s+ar~~--- `-aanl>xt~rf :~ ::::: :..;.-. - - - - ua#rb~sTS_ .. 9,~; '~ <br />r-~-~--....._ - - <br />F't•'LUF,NT :;ROSS VALUF. 1°sG!J°'~'~ - :x;"%;: !!ZNZffUfs "117 !?•d!flf: 5U <br />JLIDS, SF.T'PLEARLti SAMPLE 1'~r`#~"~'~ ~~"s'~Zt` { 25) - ~+ <br /> MEASUREMENT _ <br />w" <br />0545 1 0 J PERNUr a#+2tlr,slz ,a>Tatt>':a a;T OPYZONAL. I?EPORT Q.S~. <br />..-.. <br /> <br />.FFLUEN'T GROSS YALUE <br />.RE000io.1~NT <br />QRTR AVG _ <br />30Ok. AiG . <br />.D1FiLY- Mx <br />r1L/L .. <br />'`' -s' <br />IL AND GirEA$~ SAMPLE ty'#1(: 1Ft rff}If YS ak :} #I}y .',. i::~ Ot rA i}IFr.:f { 19) ++ ~ <br /> MEASUREMENT <br />'3:'162 i 0 J ~,,;,~ o>~o~anlly #aacl#a :xc:v +.#a##, >r~#a4ra " .1 ~, -•a, <br />ZFFLU6NT GR055 VALUF. ~~I~'"E"n ~"F'+~' 'S 1' AY NG/L <br />FLU4, IN COt1DUIT UR SAMPLE ( ~j,~) t#s}:/rtyc tP###rA ~IG~R44 - I <br />flflU Tfl EAT'1°N: PLAN"' MEASUREMENT ... , <br />0050 1 0 0 ~(,yT ~ REPORT RE7?OFtT #####t yf Cllpo #IOlgl 6 ~ ¢44+'t <br />~ <br />FFLUENT GflUS; YA:.U.°. ~G~~"~ 3~rDA AVG DA.L:Y -!4Y r,GD - '"' 'klra~lr ?. ~{. :~ <br />. <br />"OLLDS~ TOTAL SAMPLE #t##t~: Or:ta1?t:s 4tr,::}4t: ( 19) - k <br />I55ULYF.G MEASUREMENT <br />- ~} 1 <br />0195 1 0 0 .~,;,~ arloOfilC anaaa#o s:::x #al###a RE?Di1T ~ OPi!$ L <br />:.FFLUENT GR055 .VALUE REQ41R~"~. ~! ~'~~,zl; RTR'IYG= 7i~tlt4'tl+kY. '1G L t <br />IL AND GRP,AS' BAMPLE +:-rA#V#rA ~ ( yU) 4•}r;.>z.~;- ##qrA#:} O#6Q0# ~ ," <br />' <br />I S U A L MEASUREMENT <br />- ~` ' <br />..4066 1 0 J PsRMIr: ~g9>ay11?i c5=i ##ri##4t mOQ70~O.gs'i! .. ~qr;. <br />' ##IG- <br />%FFLUrNT GRUS'S VALUE RE4uw~e^!i' ZfiST -sEY N0=0 c .:,: <br />,. ''.r<t:,'" Op#(1 <br /> SAMPLE - ~ <br /> MEASUREMENT - - <br /> .. ~ PERMIT.. _ ''I ,_y~" .~~'~ :-> ' <br />~ <br />NAME/TITLE PRINCIPAL EXECUTIVE OFPICER I cERnFV uNDEw PENALTY DF Law THAT I HAVE PERSONALLY ExAMINED ~ ~ TELEPHONE r ~ D A T E <br /> AND AM FN.1AJAp WITH THE INFORMATION SUBMITTED HEREIN: IND BASED <br /> CN MY INpURY CF TFpSE NpVIDUAL$ IMMECUTELY RESF`ON90LE FOR <br /> OHrAINING THE NFCgIMTICf1 I ~J.JEVE THE SUBMITTED INFORMATION. IS ~ \ ' <br /> TRUE ACCURATE AND COMPLETE I MA AWARE THgT THERE ARE <br />F ' <br /> SGNIFIUNT PENALTES FOir SUBMRTYJG FALSE IN <br />ORMATON. INCWpNG <br />THE PossIBLLfTY OF FwE AND WPRISONMENT. SEE IB u5C 1 loos AND <br />]] U$ <br />G 1 1319 <br />u <br />der IhuA suN(eS Hu <br />'n[lude fine u <br />ro <br />A <br />ltl <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />' <br />TYPED OR PRINTED . <br />y <br />p <br />( <br />aA <br />a <br />n <br />f10000 And ar mASimum impriwnmenr N 6etRevn 6 months uM 5 yurs) OFFICER OR AUTHORIZED AGENT p` E NUMBER ~ YFjLR MD DAY <br />COMMENT AND E%PLANATION OF ANY VIOLATXJNS (Kellrsn[G !ll A7RCBnlentf Hers/ <br />SET':LEABLE SO:.IDS !.IMFT 7IL: GS kAIVEA gqy >]QY3A~'ullit 'rR2CIP ~VP.NT-:;EF I.A.1{D), PC Y, FOR R2QUIREMEATS• <br />QSTRLY SAMPLING LNSTY.UCTZO!IS-I.C.U, PG vI, ?^ DAY AYG LS 11iGtiF.ST Y,ONTHLY AVG DURING PERIOD REPORTED. <br />EPA FO7T 3320.1 (REV. Q-aB) R'CVIg15 B(flfip+ls T8Y bQ 16Ed. (REPLACES EPA FORM T-<O WHICH MAY NOT BE USED) PAGE , OF <br />~d/i~Sl?I ~"7_l l.n <br />