P[RMITT[E NAM[/ADDR[SS (/nClYdr
<br />'FeAiry MMe/Lomrbn if di/JerrntJ
<br />NAMi_LY P_w_ Y~. ~rt_~, 4~LL=t CLrL Cam), L•.--
<br />wDORinylt,c_1~~f.? sGU?`i o EC~1MA:=F-_
<br />___y=._ Y.A=T .fl4t;., L Cl.iCL~ _ -_
<br />___~I-t=~aCGG_-----_ i.u oL.1~~ -
<br />-wcrurT------------- --_-_ _
<br />LOCATION
<br />n wTloNwL PoLwrwnT oracN AwcE FLIM rNArlon srsreM (NPDESI
<br />DISCHARGE MONITORING REPORT /DMRI
<br />a36 lLl9 I:AAI;.fi Form Approved.
<br />::L'J(;171'/4 lC'% A r~ULi+ LA)OMB~No~2040-0004.
<br />PERMIT NUMa[R PncNwwc[ NoMPU r - Ei .,n L Approval expires 6-30-91.
<br />..~ni. ~r FCAI, k ] c~010- ~r5
<br />MONITORING PERIOD
<br />YEAR MO DAY Y§AR MO DAY _
<br />FROM ~,J c.. v. TO ~.. •-c ::'Li. :.:. LI::CkI '. ['Ir f. '-~ #Vi[
<br />rznan azz3r rz1.z^ nn.nl nx.lm len. err NOTE: Read instructions before comDlannB thin form.
<br /> (3 Card ORIy) QUANTITY OR LOADING (1 Card Only) QUALITY OR CONCENTRATION
<br />
<br />PARAMETER
<br />(1633) (3161)
<br />(38~J) (1633) (316!) ' NO
<br />
<br />
<br />EX FR EOU ENCY
<br />
<br />OF 6AM PLE
<br />
<br />
<br />TYPE
<br />(31d]) ANAL V51s
<br /> A VERAOE MAXIMUM UNITB MINIMUM AVERAGE MAXIMUM UNITB 67631 (6168) (69-JY)
<br />LH']h ,...::o:. +i 'F4f;ayt;,t ( ~ ,:;•r}v; y:. 1J)
<br />
<br />IC'L'iLL Li_U".uitkLL'. SAMPLE
<br />MEASUREMENT
<br />~Jjk;U i '. G a. °P
<br />ERHIT w'° •$a;„vi':?X~+' .: ,ay, i<:Y i+ ,'-Xst::oy: e.~^, i~s.'°a',,; x'< „~i4I~~ °4
<br />~ Lw~/
<br />w~ ~yA
<br />O"`
<br />$
<br />:ilur:t:i CL(O$$ VALU ,
<br />I?EtiutR6MEN'!'~
<br />tl ak.RS +
<br />° if'v~Y Ry" '
<br />'
<br />:
<br />i}
<br />S
<br />'fo;
<br />° q,
<br />~
<br />;~
<br />°~
<br />li3F'
<br />`
<br />°
<br />; fg
<br />i'<
<br />C
<br />hT
<br />~1 ,
<br />F
<br />@as
<br />,.
<br />m a,
<br />° Sa
<br />•
<br />i
<br />;n+1
<br />)t. r
<br />.~[3.x
<br />t~
<br />, tll
<br />/i i
<br />#
<br />°
<br />. e
<br />•ILVEP
<br />rUT~hTInLLi #{r^''"i•i` ##4### ( ~ Crt;:;v,o~c ( jd)
<br />P SAMPLE
<br />1J..ULivJ MEABU REMENT
<br /> °P
<br />'ERMIT~ .~'C
<br />~O as
<br />~ i'pce
<br />a~}~}~.
<br />li s~ "'-
<br />1~ Q3r6.sys
<br />k
<br />F
<br />'LJ
<br />i•i ,'
<br />7$$ YA LUr "
<br />`RE'DULREM.HN7,
<br />@ {LOi=,ep as+. n.,
<br />` of°'"'
<br />`
<br />~ s
<br />`
<br />a g
<br />;
<br />~
<br />k
<br />7
<br />'
<br />~ ~
<br />.
<br />a f
<br />f
<br />'
<br />°~Y
<br />~
<br />'~°
<br />'
<br />/L Ig
<br />x m
<br />'2~
<br />D~7
<br />'~ a'st<s
<br />.
<br />.
<br />D
<br />.
<br />' •, ..-~
<br />m
<br />F 'a1"°.e.<a`ar
<br />a. gl
<br />: ,k
<br />"
<br />~
<br />i
<br />Ga
<br />~". ~..
<br />r
<br />I
<br />,
<br />>~
<br />`> !1 L
<br />, affi ..
<br />.
<br />. : `s"
<br />~J~ i
<br />i,x
<br />r':,18N1'IALLY +:; :;t;.-.• ##fi...:-i ( ) ##~::;:#:- ( ly)
<br />.
<br />P SAMPLE
<br />U L.I :.ULYLJ MEASUREMENT
<br />I-,
<br />~i~Ll) ~ C q,, ., ...
<br />P$RMkT
<br />`° a;~# risx.
<br />~2 ;#' ~#Xb:[~,"''
<br />~~ A:i}# a°°+,,I#EVr~±'@,
<br />¢ 'e•'°
<br />63..>a e~"
<br />x
<br />~
<br />e' ~ Gc '3~°°,'`; i;` '~ ,4~I~~fR ~~„,&.`
<br />
<br />} ,
<br />'8E47U (REM ENTs ,
<br />„
<br />Is;a e .a a w
<br />@
<br />.
<br />F
<br />~~
<br />~° ~4 sad yy
<br />~}
<br />~
<br />° ~
<br />~/ L ~
<br />~
<br />~~~~~1
<br />
<br /><x
<br />°
<br />+
<br />tl s.
<br />;Fx .i
<br />'
<br />sle(}s`. .t !° =
<br />nr A
<br />T(.'f ~
<br />l i.Ati LJ ri%k vl.•it '
<br />r.~~b.:#
<br />i•17 l ~ r.%.•S:i %Y•4
<br />.
<br />..r
<br />.. SAMPLE
<br />` t
<br />6nCt.Yt.1~r.JLL, MEASUREMENT r ~
<br />
<br />L I:_L.7 - l ..
<br />eP,LRMIt
<br />RE
<br />M E
<br />fF3'as l"~43'F,~
<br />h1F.J:x$ai~,`ai
<br />a
<br />."`.,F,7
<br />°~fi4l~l i$
<br />e
<br />%
<br />~
<br />g
<br />4'
<br />n~ g[~''~aEy}~°~l`4'
<br />n ° r
<br />F.y`' k~4''
<br />~
<br />'ai
<br />µY t~Z+sA~ ~{'
<br />'2~.~.5`4a~
<br />[F
<br />JS
<br />t;fi
<br />YtiLL
<br />E
<br />FFLU N7
<br />O.UIRE e
<br />%
<br />~
<br />' ;r~_~
<br />' t
<br />h
<br />a f
<br />M
<br />~
<br />l
<br />a
<br />€
<br />• a e
<br />~
<br />'~ t~x
<br />1Ek
<br />'
<br />'l~
<br />§'
<br />1E°
<br />MG/L °
<br />' • 4 Y,
<br />.
<br />.
<br />L!•
<br />c re. a, ~« .e
<br />a
<br />e t
<br />,
<br />_ Q
<br />,: y
<br />.
<br />a.
<br />a s{s
<br />t « ~:r r.
<br />'1
<br />Il! LCbL'V it r, ft
<br />kLi)li (
<br />Lj) #OC#,i ~i %}i#ii#%. #~00#~ ( )
<br />r SAMPLE \
<br />rrf ;tL 'i Y. L.n'i ~...tii PLF•. ~.y MEASUREMENT
<br />
<br />S'JJ ~ V 1 U V
<br />p'"'F
<br />cIT' p' W ~a
<br />
<br />a,
<br />~i ~'
<br />+
<br />~• ~ry
<br />
<br />ek°~r°<
<br /><-~,.
<br />~'
<br />~
<br />$ °Ai ~l°~}`+~,re~.°
<br />
<br />8vs*@«x
<br />i~ ~n
<br />Y
<br />
<br />'re '~" je
<br />a ~'k?^r
<br />»
<br />~v
<br />#r'r"
<br />
<br />"
<br />s
<br />.~.i9 Ai,~s'Y
<br />+
<br />~e~+~li 9l
<br />
<br />~
<br />h'L' GPO$$ YALU
<br />U
<br />•
<br />' ER M
<br />AHQUIgHNEN3'. I
<br />,
<br />erd
<br />°.t °
<br /><
<br />~
<br />>;3`~Y~
<br />J .
<br />4
<br />Y
<br />`^L'
<br />'k(
<br />Y° ~~~°
<br />..
<br />tl Ps
<br />°°s. °s
<br />r' „
<br />'
<br />;;s>£. €
<br />t
<br />.y8 {€Y.n"@ a¢° re
<br />€ o
<br />#fXf
<br />S L` .t
<br />`¢e F
<br />d
<br />.
<br />.i~
<br />~
<br />r
<br />L
<br />L g .?
<br />j:+
<br />,
<br />t °
<br />.
<br />ll .,., @
<br />> a . > ~ ,
<br />JiL ANu '~HEA$t: #~F #'.k## ( ~4~ ##X":vr #41M r71,'Y r3 v#>..-:r# ( )
<br /> aAMPLE
<br />YI~L~L MEASUREMENT
<br />
<br />r V'J (- U L r L
<br />.4 °'O ~~ `v.
<br />sP
<br />RA1
<br />'
<br />'.¢ ~, °~
<br />,e O'
<br />~ ~~YY
<br />V'p:9" ee Y t
<br />t$=I
<br />~% )8,lt,'ykwi~~'<•,
<br />d
<br />~ a
<br />.n~, b~x6~x~~~. a,
<br />°~?~x
<br />~:K
<br />~,v~~,~'a
<br />1"- ^
<br />' ~~
<br />9
<br />` aim
<br />~
<br />°~s
<br />~'
<br />L•.T: T 134,
<br />L[~J'B.f P`:1.'•
<br />"'EUSJ YALLE
<br />' IT
<br />E
<br />ag pillREMaEN?
<br />~ ,
<br />p
<br />,
<br />x su
<br />,fy •i,:
<br />,A
<br />~
<br />a
<br />~'C
<br />l°
<br />~
<br />t1J= .
<br />"n+
<br />a
<br />``j:;. t
<br />~#~`~:~
<br />'
<br />{t
<br />~ p
<br />,
<br />sax''s :'~'
<br />:
<br />~
<br />'
<br />~
<br />°:k+:a ~
<br />, r
<br />~
<br />.
<br />
<br />;'
<br />'
<br />iLUtt.9 .,
<br />ef ~ .~.. Y°
<br />~
<br />t
<br />x3 l, .
<br />e
<br />; ~r"
<br />a
<br />.,~
<br />,
<br />, ,; e
<br />.
<br /> SAMPLE
<br /> MEASUREMENT
<br /> "r~~ERMIT@n e,~~8`gt B•xa ~e °Bne sa s~F n85 axp
<br />gs
<br />& .",
<br />.i
<br />ei'
<br />r a`
<br />°a
<br />°
<br />sa 8x:@.a OFF
<br /> RIOUIREN EN't'~• 'g e @~ ~' .° c
<br />i
<br />s ~ r s
<br />e
<br />x
<br />R
<br />o-x
<br />a
<br />a-
<br />,l °g x
<br /> 9
<br />° ,
<br />s N ~°x
<br />•
<br />~s
<br />_ a
<br />m c
<br />NAME/TITLE PRINCIPAL EX[CUTIVE OFFICER I CEwTIFr uwDEw
<br />PENALrr
<br />OF LAw THAT I
<br />NAVE PERSONALLY ExANINED
<br />1ND AM FAMILMR WrTN THE INFOPMITION SUBMrTTCD MERLIN wND BwSEO ~ TELEPHONE E
<br />A T
<br />D
<br /> ON MY INQUIRY OF THOSE INDVIDUALS IMMEC,ATELV RESPpNSrBLE Fpa / 1 /' ~' ~/
<br /> OBTMNING THE MFOIaMAT08 r BELIEVE TNC SUBMIT[D INFORMwTION /
<br />/
<br />/
<br />
<br />Richard :.rills
<br />IS TRUC. ACCURATE wND COMRETE I AM AWARE TNI,T rNCRE ARE SIG
<br />NIFICANT PEM1ALTIES FOR SV BAITTING FALSE INIORMATgN INCLVDING
<br />/~
<br />/
<br />/~)
<br />'O
<br />
<br />nvlrnn^^ental "•Aananer
<br />3]U5~1,B„TBr F.n 'NE ~ rIwFPRISOeM[:r^r[5E[wrirBdO%C, yV COtIA'D __ _
<br />SIGNATURE OF PRINCIPAL EXECUTIVE
<br />(°70
<br />fl70-2717.
<br />3
<br />26
<br />9tz
<br />TYPED OR PRINTED md... moamlunumpn.nnmr.ur ..l M1.mwnFm.mrh. ond5,rar.' OFFICER OR AUTNORI2ED AGENT AR A NUMBER YEAR MO DAY
<br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Nr/nrn[r ull ulruchmentr hrrr)
<br />ALTERNF.._ 115IT-, :} ~ r, an.;?,L.,uL.. ..uL_`i.. (L~;'_ sC.r) :,rkLt L; .h L: ,.: ~= L.,-L.'r '+-.-_~_ d-'-_- V _ :.:
<br />(-LAIMEilP CL IAA. :P kV 1.1r }Cp _IV I'. C]t.l U[' tTU:,F F.cMLlh L:':..•>.~• l_la, ~ ~_'n~:-.~ .. (-a. :.r ~.. }/F L'„ L•
<br />EPA FOTm 3.I' ZO'1 ~RBV•Y~BB) Pt0VI0UB BCl~OR5II1dy DB USBd. (REPLACES CPA PORN T-.0 WMICN NAY NOT sE OSE D.) PAO[ OF
<br />
|