|
r[RM
<br />-T
<br />(lndude
<br />~~~~(~--
<br />K /~~__--
<br />2-------
<br />rACIUnJT1pA~~51/~LE~LU~ ,~S~Z~--
<br />IOCATION ,~ ~~
<br />r , r.:~~i ~i~/Y.R,tSif7 ~iS'11,P~ tl J~/N4%~~~"-
<br />nwrloNwL ro LLDT wnr ol[cNwwo[ [LIMInwrloN [rsr[M /NPD£JI
<br />DISCHARGE MONITORING REPORT /DMRI ,
<br />I~llf 17/9 ~~-•
<br />
<br /> PERMIT NUMBER on<Nnwc[naM[[w
<br /> MONITORING PERIOD
<br /> YEAR MO DAY YEAR MO DAY
<br />FROM _ ~ TD , - ,; •3
<br /> /IO~I(I 111~IJ/ (SI~IJI 116- 1 /78:91 /30 !1
<br />*I I !~ i) I` .'R Form Approved
<br />(S11 i'f: NR~ FI IOM B'rNo. 2040.0004
<br />F' - F'1 .I A 1. Expires 9-30.91
<br />P1'C A2 D=%C;iIRG TO GRASSY Col:";
<br />vt=~ tug UL:C4LftGt: ~-~ =~':.
<br />NOTE: Resd instructions Wfors eompletinE this form.
<br /> (J Card Only) QUANTITY OR LOADING (I Card Only) OU ALITY OR CONCENTRATION Fw[OU EN(:Y BwMI•Lt
<br />PARAMETtR (16-JJ) (5161) (fe~J) (1637) (5161) NO
<br />E% of TYPE
<br />
<br />(31-77)
<br />AVERADE
<br />MA%IMUM
<br />UNITE
<br />MINIMUM
<br />AVERAGE
<br />MA%IMUM
<br />UNITE
<br />
<br />616)) •M 1L Y51!.
<br />
<br />(616N)
<br />
<br />(h4~)tll
<br />_-_
<br />I II BAMPLE :: I:.::Y:i r;F oy l=~: rp ( ) .e v'+4: ( T ))
<br /> MEABUREMENT `
<br />(. ~ ; (, :1 1 1, 0 ~ ,a.(IKEVMrt:~ ma
<br />~.
<br />~%g'QL
<br />S.~~Y~Y Yxawy^T? ~3'-.''MV
<br />~,v~ Vw:3r n z y
<br />`5~~~~+~I°; .
<br />~ n. ~=
<br />~x.Q~;t~ +f: ~~~ $ F a.. a.w. x~
<br />~'°,~mR~~.
<br />~
<br />- ~•
<br />w~ • p .
<br />[sir°^rvy~1
<br />t/'
<br />,~;
<br />!
<br />~
<br />'Ll
<br />i C9OS5 YALU RCU1RE1i16~~' ,&
<br />,. ~ma '
<br />s
<br />~'d
<br />" P
<br />~a~m z,.o-«« "a~
<br />a
<br />~:«
<br />t~ .$ ~ a
<br />:
<br />P~~$Ix ~r r .«,~~ mx<a .
<br />g w _
<br />I ,~xN
<br />l
<br />I
<br />r
<br />e: ~; ~„' ,g
<br />z
<br />. .
<br />x
<br />~.
<br />~>e a ~ ,
<br />.
<br />)LiGS, .: [:TTLEAi;LE BAMPLE '~,-•'r, :;: {:vr ( ) + ~iY~:Y%: +: ~`-M'f'J is ( :S)
<br /> MEABUREMENT
<br />1 .1 L. 11 ~) L r D w~+kK#MJT,`'?°' .{.;
<br />x a>~x~~
<br />~~y~ ;..Yi>~~'t~~
<br />1
<br />' Ip ~:: a.~n`
<br />s6~ :y`+s4 wag r,~~
<br />`%v~s~s . '~
<br />~ ~
<br />l
<br />~
<br />r $ `
<br /> #RQL((#tMR~gR ,
<br />,
<br />~p~.. ~ . r,' a°; .
<br />s'a
<br />«~~rere xa
<br />a ,
<br />as 1 ~ £ ' ~
<br />%
<br />~ `~ e v' tea.,
<br />~
<br />'~
<br />'
<br />" ~
<br />.
<br />k - ~'~ e ~r ~" h
<br />`~ .
<br />w
<br />~`
<br />4 'r'I Iltl+P GF.OSS VAI'I :x
<br />.r.a.c-~x ~.« ~~.m"aa gk ~
<br />'s~y*
<br />S ~s~&~' Y„t:,k: %
<br />~a ~~
<br />>, a
<br />~«
<br />`a~~
<br />~-; ~a wT r -
<br />^ ^.~ _
<br />i.l :. Af: (/ iHEA S~' BAMPLE $Y r~v;% r$$1;Y ( ) :Y,::;trY,:! .v:<:=i::.: ( ] f)
<br />i1.:'Ud E.KIH-GRAY nerl MEABUREMENT - -
<br />
<br />I ~l 1 L, t: ] n G
<br />~s'a ''R ~~x<
<br />Ry F11T4
<br />I'r 1~{.~`Y4t ~&~
<br />.
<br />m
<br />^
<br />° ~.,~ ib,~t%YEtr`<'
<br />~#%k
<br />'Tea ~Rt''~''~t °~
<br />~ ~~yy gg,
<br />'A• gm
<br />~a7¢t ~4~.
<br />~ ~
<br />r~'~R~";;~;;'°~~°e:cn
<br />..
<br />~
<br />.;~ m
<br />-¢ j
<br />~. l.~
<br />~~'a?
<br />l
<br />`
<br />:
<br />
<br />' . ~QyiRL' E#
<br />~ S ax
<br />. m,--,T
<br />~g'~..t
<br />a F
<br />g @ s~o-y .,; x,~x ffiY
<br />&
<br />3
<br />' a.e.g
<br />S~ IDr.:gK
<br />Y
<br />~
<br />~ ~
<br />' .
<br />"~ aR
<br />°~
<br />`~ A ~
<br />A
<br />' .1 ~, Po'«,
<br />~ a;y-
<br />a< s a Y ~
<br />~« t
<br />y
<br />.
<br />,
<br />a
<br />'
<br />:tI' f
<br />'11li:fr]
<br />1:HD5~ V9L11 .
<br />..y .~.
<br />:~, ~
<br />, Po
<br />..bp. w«mBr xB x
<br />r?;:
<br />,:,. ,.,x e.d
<br />:
<br />g.A.s~
<br />.
<br />. r
<br />q
<br />.: <. &. n
<br />tt I.. g
<br />`:rs.`(P ~
<br />--
<br />-
<br />
<br />i 1.54, a tr COND(ITT DP. BAMPLE ( D 3) 1xa~l^~`~ • ^Y • • ~` ~ • ( )
<br />~i.l,:l: 1'hr.
<br />11'nEN1' PLAN+9 ME
<br />ABUREMENT -
<br />.
<br />.1 '.1 ~. (1 1 G (.! ))Il
<br />'~3< tRMI C~
<br />A.,:~( T..%V
<br />~ ``
<br />~ °gp~ {~~M1~.°„
<br />n ° U'~- &~
<br />' 1y /~. q{
<br />a' O~aR~V~:[ d x
<br /><ea
<br />t= +yi/. ~,x
<br />«„P2 Y:Y Y r°.°~'~ w°+.~. 'e
<br />Yp
<br />s
<br />~'
<br />s ,~'c.«~~~A.4"~1'
<br />"x: r+n ,~a ` 4'8 a~'
<br />°Y~
<br />.. « •,
<br />4~;` .1~
<br />1' (;RO'i5 VAf
<br />r
<br />I U~:
<br />U >AS~fulgtM
<br />T
<br />a
<br />r
<br />a
<br />~ m.
<br />.s . ~.~
<br />°x
<br />~
<br />~ s ,
<br />~. % ~ y
<br />; „
<br />~~ ~~ ~
<br />~.
<br />4i
<br />aw ~ ~
<br />~;
<br />~
<br />~~
<br />. a
<br />~
<br />~ • ~ ~,,; ~A m.
<br />a'
<br />~
<br />-a ~ 'r
<br />a
<br />(
<br />!
<br />+
<br />.
<br />F ~
<br />~, x
<br />r~.
<br />5
<br />. .
<br />s ( A.
<br />s
<br />s~ ~
<br />.
<br />,
<br />,.. ;
<br />d
<br />1..]DS, IOIAI. BAMPLE ( ) Y' pTY ( 19)
<br />L1_r :, 1)I,V ),U MEABUREMENT
<br />__ __
<br />)'.1 .."J :I ~ (. D ~ %~'I+KRMIT .., p# ~
<br />#'a~~re
<br />" $ s aQl Oaf
<br />$ ~4
<br />+~~K r`.>r i
<br />~ '#
<br />~N
<br />''
<br />1r'.~
<br />'
<br />+~~« r^-: +. .s
<br />~~
<br />~
<br />` i r. .: .. .i x:
<br />~L")~R~'
<br />s9~^
<br />'
<br />~ n.c.'°,
<br />L~Y: _
<br />'~I(
<br />r'~1.0c9T GFOSS VE I
<br />L 1 r #rt~Ulp MBNT~
<br />~
<br />c„, a.: 9. m.. .:
<br />;<x
<br />~e r~~t$ ~ § ~~a x ,
<br />.,
<br />, a,
<br /><~R~ :~ma-
<br />L•`[:;. '
<br />.
<br />e-
<br />.
<br />g
<br />•~: ~;: &q ~r-s :
<br />s
<br />a
<br />«~~a'x{ ~;~. g.
<br />~~-' 4
<br />.,~,
<br />,
<br />rx
<br />.
<br />'~
<br />r.
<br />..
<br />
<br />.
<br />.
<br />~:
<br />~~~" ,
<br />_
<br />-_
<br />It. alit/ ..a EASE. BAMPLE "''"!` ( 94) k`:7:GC::.,~ rr •oY rr...<+ ~
<br />)
<br />~ 1 ;; I; AL MEABUREMENT _
<br />,~l li Oll i .. ...u ,. $.;:= '~8.;'Pi'^a'k ~~«& ~ ax.£~°"'~~+~.°•r~
<br />R L:]=1 ~ n,: ~J1<$~!~4 n 5a~~ .a+rT~ ° mw a+~
<br />.{+YF, vTro)}.°v
<br />~ ~~i ?+f...~
<br />A~'E e}:. } .
<br />' htaut#cM t~T ~x~:~~ m .gx~,
<br />& m
<br /><~ :m~ '-a;
<br />. s~«; a~. «
<br />:.ro
<br />~
<br />' ~g,a .~~.
<br />k
<br />'
<br />ID ~
<br />.rte Rx,
<br />'R
<br />`
<br />~~ m
<br />.
<br />k e.
<br />r1.Ur:l.T .ROSS VALU
<br />r;
<br />~,s ""'~4 ^•~ 8
<br />m~m~ :?a.
<br />°c„
<br />v. ~..
<br />()_(
<br />y
<br />... .. °a, 3.r.
<br />~
<br />8.,. :~h ~
<br />$-
<br />.
<br />y
<br />ar .
<br />~'S --
<br /> BAMPLE
<br /> MEABUREMENT
<br />--
<br />_
<br /> ~a~lIKRM;It'.. ,~ ~.~~,~~ ¢. `:'~°. ag ~@.~,~ . ~# m~arag' ~.g~
<br />'s c:.:~,.a8,~ '. ~'rx °< a',:~;.R
<br />'~' ,ny ~ F~. ~y pe :0 ,
<br /> QSfIpeMSNTs ~
<br />~~
<br />%
<br />~
<br />~=~
<br />~ aqA; F
<br />R «
<br />"
<br />a a
<br />t
<br />'~ sa;
<br />G
<br />"= `
<br />•m« °
<br />
<br />Po <
<br />;.
<br />a;
<br />:
<br />;~
<br />a „
<br />.
<br />2m a
<br />m. ,
<br />, •
<br />,
<br />e ° J
<br />NAM E/~1TLE PRINCIP L tx[CUTIVE OFFICER CERTIFY UNDER PENALTY OF LAW TNAT I NAVE rER80HALLY [%AMIN[D
<br />1
<br />AND W fAYILIl1R WITN THE INFORMATION SUBWTTED N[REM AND BASED
<br />'
<br />/ TELEPHONE D A T E
<br />
<br />~~~~~ ~~/ //n
<br />••
<br />f~
<br />o LC (•
<br />CN YY INQUIRY pi TNOrE IMpVI'JUALS IMMEdATELY RESEYJN5IBLE FOR
<br />OBTAINING THE INFORMRbN I BELI[VE THE SUBMITEO INFORMALONC ~
<br />~
<br />y/ ---
<br />,
<br />l
<br />IS TRU[ 6000RATE AND CCYRETE I wM AWARE TNAT TN[RE 1qE 56 ~
<br />J
<br />,t ,
<br />//
<br />N
<br />
<br />/
<br />~
<br />//-
<br />
<br />MflCANT MNALTICS FOR SUBMITTMG FALSE IMFIXiMATgH INRUgNG I`
<br />/
<br />W
<br />O
<br />^
<br />/~
<br />_ _
<br />(
<br />~~~~~~
<br />/
<br />/
<br />( C~
<br />TNF POSSIBwITY OF FINE AnD IMPg150HN[NT 5[C IB USC 1 1001 eND /
<br />~ l 7(
<br />\
<br />~
<br />/-~
<br />~ ,
<br />J
<br />/~
<br />
<br />yl uSC 11)19 rPr
<br />aler. uldn rhrv uemrr. nur mrlWr /mo u
<br />a. tl4nn 81 NATURE OF PRINCIPAL E%ECUTIVE l /
<br />C c
<br />_
<br />TYPED O# PRINTED y
<br />n
<br />.•d~..ma.•m.m lmpn.~v~.,.•1r.~l n. ru..n [mi,nrA. and.i .ra F.1 OFFICER OR AUTHORIZED wGENT AR A NUMBER YEAR _
<br />-
<br />MO [lwY
<br />COMMENT ANO ExPLANATION OF ANY VIOLATIONS IRr/rTrncr oil urrurhmrnlt hrrr)
<br />Llil"1L;iAELE SOLI US LTlli'!' APPLIES ONLY fY <= 10-Yd, 24-n}2 YRECIP EYE:IT.IS CLA7nEC, IF (:LAL^I APFRI)Vr.'~ '~7
<br />k ~:~L, T5:, F LPOk Llt+i'f5 dl Ll. NOT 'BE APPLIED 'rO It F.PO~RTED `: F'RSI1Rdn(•:N I'i--SEE; I.ii.l A, Pr. ': AN+.f I. H. LI`, ;'.: ~ .
<br />EP drm 1 (REV. ) oiwbuB iUOll9' ynB sed. IREPLwc ee erw FORM T-t0 WHICH MAY NOT eL UBl D.1 ~ FAOC DF
<br />1'1.',7 /'r -.. ',;•;,-1
<br />
|