|
P[RMITTlE NAM EIADDRla! (In[IYdf
<br />FecdllY NRnr/Lacrrbn iJdiJfennr),
<br />Mwrae C_tP..l~ YA_^._~A JdlL~Y CG9L CDf.:.--
<br />woeREnilD_S i -'" .]i':1(i L iS.;~~6h P=:
<br />1-= -L--------
<br />..,, _
<br />----`-t_ ,cur, ------ cc a_,l~s -
<br />/ACILITY-
<br />LOCwT10M
<br />i .~P-: L...C i.' ..L: k._ -.L L.C Ii S:y l:u
<br />NATIONAL wO LLUTA NT DIfCM wRGL ELIMIM ATION fYST[M lNPDES
<br />DISCHARGE MONITORINO REPORT lDMRI
<br />I-/b 17-l9
<br />(..(: Li <]L/114 SUS, L
<br />PERMIT NVMeIlR olscwwwcL w~Mfrw
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO OAY
<br />FROM - y~ y y TO ~ o ..
<br />/202/1 /11~IL /14131 !Ib-171 /18191 l30~3l1
<br />Y a J C ° Form Approved.
<br />{ S'. t: F .r .) pMB(No?2040-0004.
<br />i - f L v :f ;. Approval Expires 630-91.
<br />tt l_~i i, tO~J ~ T.. y'~iD L Chh
<br />NOTE: Read instructions before eompleLing this form.
<br /> (3 COTd Only) OU AHTITY OR LOADING (4 Card Only) OU ALITY OR CONCENTRATION NO Fp EOUENCr SAMPLE
<br />PARAMETER (4613) (1161) (JB~J) (16.73) (JI6!)
<br />E% of
<br />TYPE
<br />(32-37) AVERAGE MA%IM UM UNITE MINIMUM AVERAGE MA%IM UM UNITB 6163) ANALrBIS
<br />(6168) 169-7!/)
<br /> ~
<br />~ ~~ O 1'
<br /> MEABUREMENT 1 1 -rr Z$ Gr.~y~y
<br />JU~LU 1 1: '~ $R
<br />Ir~'°
<br />°~ ~~..
<br />., ~6k ~~ng ,rs $r~ ~ -~ ~16~': P* °ce sx« s °.y ''1$e~gfdi s° ~,'f°"v.'s`•.
<br />'< ~ W
<br />~~:.A~e ~~ `~~a.
<br />
<br />t
<br />'
<br />` A,
<br />M
<br />:RlRUf EM EfIt-
<br />s p
<br />`~:
<br />:r
<br />: ~,'M°
<br />p'
<br />' °
<br />°
<br />~YI`
<br />~'T °y°
<br />: ~
<br />vRSa a
<br />"~°
<br />AYk'~~°i
<br />Sli ¢+
<br />< &
<br />g:
<br />Lt
<br />FL(i
<br />_ Yni.:J_
<br />;Ni L;rOS .. .s
<br />x .
<br />. p
<br />s
<br />,
<br />+~
<br />. °. ~
<br />se.'
<br />, .
<br />J )1.IL5, =:.lAL SAMPLE _., ~~ie: Yi' #3}h7 is ~. i
<br />( ) +.
<br />N
<br />~I ( 1'~
<br />)
<br />O
<br />~
<br />D~jP t.SU~~ MEABUREMENT A A A
<br />L15J L ..
<br />l ",,~
<br />.EERM
<br />'IT
<br />'
<br />9 kyF'yX~<
<br />~ ;m?~%c~~`sA'
<br />a Gt:# i`s~
<br />°a~~~
<br />~„ t
<br />-s r•,
<br />` ~wi ~. l~ae "°$m4~~,h9k~.`
<br />s
<br />~^
<br />` ~".~~'/~ ~'3~.'.
<br />
<br />' .
<br />.
<br />OkeREMffNT
<br />'RE ,° a a
<br />Fit ° ';•°Y~,,.a~: ~
<br />~ ag
<br />,
<br />SLY °Ff
<br />/L ,
<br />s
<br />#
<br />'
<br />~ ~'~°~
<br />°s°
<br />Ln Ll1i., .
<br />1, t4cLOn ~
<br />e
<br />p
<br />tl • _ °
<br />'OLl D7, l.~i '! ~L. 6AMPLE -r:.:.i isri~l %},d 'i~~f i°~% ( ) ~*~~`~~~' I 1 -J) /~ ) Q n
<br />I~-i l: u~(•-LU MEABUREMENT 1~ ' ~ p
<br />/
<br />V Z$ ~J(1:J
<br />. i~
<br />~1i J
<br />~ y °<.P
<br />£kMiTx ~` A`!e"°v°
<br />'+~:~. is ~lt s'~~t$K's~A~
<br />+R viiv °,'n ft%~~~•,i~r~a' tJ,,e°.„e s,,``•.„ ~
<br />~a ae
<br />sa :'nx'
<br />•i °>, i.i~ ~1'
<br />>:4.~~n°<,
<br />.
<br />. ,
<br />•$EOU.IR EirEMT` ° ,
<br />f°
<br />-°
<br />'
<br />°
<br />~
<br /># ~ j9~s ` s ~ °~' °< .~ts ,,,,pp
<br />l
<br />:~~
<br />'
<br />~'°
<br />~ r
<br />,
<br />s
<br />°~
<br />~1<°I
<br />~~
<br />1
<br />E~, a.
<br />-% .
<br />it ~y,~
<br />1f
<br />T''~:` %, ~`^r<
<br />cFf LI/i.' r .,RO:i: ~ nL
<br />,
<br />u ~ ° .sn
<br />l
<br />.-
<br />:. f
<br />Y a n
<br />.
<br />s ;
<br />lf.
<br />f
<br />A .
<br />.
<br />=
<br />a ~
<br />I.
<br />.. 4 : IR .
<br />:
<br />~L7illl5, .Dr'.ili.r.r...L:_
<br />6AMPLE ;y:il;rrl;- *:###,,-:: )
<br />( :-#1Q
<br />i'-i
<br />N
<br />
<br />~ ( ,.
<br /> MEASUREMENT f`r A /\ O
<br />..~4;7 U u v ". 'PERMIT ,'~F`'~. r< l~s .L,~.°,ya
<br />'°'~ J#>d °g'ed~S'f~•`vs~•< ~~'.~i~s7~;~~re ~' +4 v° ~ sg 1. .r~ .~I'~e
<br />~~'x i .~s8'°{h s a
<br />JuL' C; t]fl f:Lp :J Gr. L(i ~+.' .
<br />•p'EgUfNEM~ENT
<br />a .,~s
<br />
<br />p ,
<br />'4
<br />°
<br />a<RO#
<br />a~<
<br />p
<br />° ~
<br />a.3,~?t~•Ili;: i+& °y. w~±~ ~~
<br />d+ a~:T;~t€~'
<br />aL/L
<br />` ,
<br />g
<br />+-i~~%')"tt. `
<br />° 1 .
<br />iJLiJS, ~u _. Lr.uULL 6AMPLE yi'~ti"'°'"0 ~'P~JS: :T ( ) CF 'Fv rtf ' ( LJ) - I
<br />
<br />MEABUREMENT
<br />~
<br />O I'
<br />I
<br />~ O r ~j
<br />~
<br />`!
<br />2~ ,r~
<br />la._A~
<br />S L U tl
<br />.'S~ o°a GERMIT°."°
<br />°
<br />.., .~~'~~'1~~':' s a'1drAf tlrFSl~lif~
<br />`~ i:Yi' $.~,
<br />ena,`~
<br />M'd~;`r'
<br />`.°
<br />T s~.
<br />s~T
<br />.
<br />•ia~~'Is~ `~,
<br />m~
<br />S9 grx~~t~A~
<br />d n,`x '.... ~~.+L~m, ne.
<br />:
<br />~
<br />.
<br />tFiLULbT GROSS VALUE R_EAU,IREM ENT'.
<br />
<br />• A ~x ~ .sa.
<br />°,~._. _BA ,
<br />
<br />~
<br />{: a: i.
<br />' ,
<br />,
<br />~ _
<br />s
<br />y f o-
<br />~;~$'>L2Y.~^A~.~°': ,
<br />s
<br />~":;)'I'~'L)T°~°,'~
<br />HL/L ;f
<br />°,r,.
<br />!'~d°,rYA: y
<br />.
<br />-~"~
<br />..h~'.'°
<br />:ii, ANL GREASE eAMPLE 'f''dsfD''' #4;i#rA
<br />~ )
<br />( 4'~>x#?# ##3xfOC ~ ( 19) N
<br />X2A-GRAY METH
<br />I'
<br />{:(
<br />N t MEASUREMENT
<br />.
<br />,
<br />.
<br />JJ~J 1 0 O
<br />ERMIT `°
<br />`~~
<br />f
<br />#
<br />p 5.
<br />~.1~ikA°
<br />.
<br />•2~fEl,~
<br />°~le ~s
<br />s-#
<br />i/V=i
<br />."`•~~~f~'.~),1F~n'°
<br />`~
<br />°1C;~S.~e °~r
<br />isQ °a
<br />~~~ ° • ` <
<br />'
<br />~ ~.@
<br />13 ~11a'~Z
<br />•
<br />, 1,
<br />,-~.~"•e..
<br />firE^
<br />- .
<br />'
<br />;RERU7REiR~E:f{T• ,
<br />i
<br />' :; a° .
<br />,
<br />s
<br />' q .` x '1'M ti<
<br />~ ge"sa.°s s exxsF;x ,° a
<br />s • g"°'
<br />`a °'
<br />T;~
<br />'~~s~R~: iG/L ' l
<br />s
<br />~~~+`
<br />tFFL'JEN1' i;HOSS YALUE o a
<br />' T . ` x ~ .
<br />LduN, TGTFL SAMPLE 'FY4i4rtiL ~#4ifi~'i ( ) iYi<3i`~r1fiL w' /
<br />IV AI/
<br />1~1 (19) ~ N
<br />
<br />(~5 L)
<br />MEA9U REMENT ~ ~ /~
<br />JLV45 G L v ~
<br />P ':ft~ naf44~ai.YSas>a ;~CA
<br />'•+Sa"~n:?~#~; xxc~~~~zs#~
<br />~.3'.~
<br />~t`~: ~,~{#A`~;:;
<br />IT'
<br />°'
<br />'
<br />° B~_a ,~A~~~~ .
<br />ERM
<br />VW 'REOUlRE
<br />3 L
<br />~
<br />r
<br />~ „
<br />,
<br />,
<br /><
<br />~
<br />¢
<br />M'ffN~'.y~s° ..~
<br />, `es a. aa
<br />' al ~°IIe a4~k 1,•.;< ay neya°' e°¢ e'b 33 y~ ~q s •jd: 5s`r.
<br />.
<br />1
<br />f
<br />.
<br />L15 COhl f.:.M1 ~
<br />,
<br />a
<br />NAMElrITLE PRINCIPAL EXECUTIVE OFFICER CEPTIFr uNDDp M:NALTr of LAw THAT I NAV[ w[R90NwLLY [xAMINED TELEPMONE.
<br />I
<br />1ND AM FAMRIAp WITH THE INFOpMATION SUBMITTED NEPEIN I1ND MSCD .. D A T E
<br /> ON MY INOl11pY OF iNOSE INDVIDUALS IMMCp6iCLY RCSPOn91BLE FOR
<br />/ ~ _
<br />'~
<br />p
<br />kichard ~/11iiSY7 OBTAINING THE INFDpMATIO`! 1 BELICVE THE SUBMITTED INFORMITION
<br />IS TRUE ACCUpATE AND COMPLETC I AM AW/.RE THAT THERE ApE SIG r
<br />~
<br />
<br />BMITTING FALSE INFOFMATION INCLVDING
<br />T P
<br />NA
<br />T
<br />FOR S
<br />~ ''
<br />r~
<br />~ ~f
<br />6 `
<br />L
<br />^
<br />Environmental M11anaq~r
<br />- ICS
<br />NIfICPN
<br />E
<br />L
<br />U
<br />THE Pp59Bn Rr OF FINE wN0 IMPP50nMErvT BE[ IB u5C f 100, AND
<br />ld
<br />!
<br />1w '
<br />~
<br />SIGNATURE OF PRINCIPAL E%ECUTIVE (
<br />70
<br />J e-271Z J Z J
<br />
<br />TYPED OR PRINTED n
<br />r l.nr. uy m
<br />/4
<br />3] use f ,),9 IPrnalur. uMn tllrr ,mm,n nmv nr
<br />v.d ~.•moslurwn lnlpr,ennnrrnl.,l M~rY..nfm.,nrh. and .i .ra...
<br />OFFICER OR AUTHORIZED AGENT
<br />AR A
<br />NUMBER
<br />YEAR
<br />MO
<br />OAY
<br />COMMENT AND E%PLANAT,On OP AnT YroLAIIVrv3 1^rlrrrnrr uu u..u.nn.rn.. nr•r,
<br />dLTt,Hti}q.- LI:Mii_ E')r =5~, ani)[. L SE:,L A:JLc. _u1.iL_ (LGU 'Us) Sr['Lc .,hL! a <= i.-::, ;.')-. ., rdtCll- eVi-•
<br />IS (-L.11N.:._• ]'EE SfA.:, i'G 1$, E'C:k LiCNULh of 6d:.Gt hEteUIiter;[;±'15• ~.L.. D '..._. ~.-.. - r..:;.:.Ct: F/• cv ,:•
<br />EPA Fdi11i 33201 (Rev. ASS) PisvloD's Peoria inay be used. ~ ~~ ` ~-' ~ ~~ ~ IT+ciLwce's iiw'FOwri -.a WNICM MAY nor sE useo.l ~ Pwee of
<br />
|