P[RMITTFE NAME/wDDREf! (InCIYdE
<br />Facelry NamalLoca/bn ifQlJfnenl/
<br />NAM[-=' --! -----_- -
<br />~_-_.~LbM00D -------= --
<br />IACILIT1f__-_-_----- _----_
<br />LOCATION _
<br />--+ 1. r, ul. A • Yi M i. ---- -(--L.: --
<br />N IITION/1L FO LLUTIINT OH[H ARGE ELIMINATION fYlTCM /NPDESJ
<br />D ISCNARGE MONITORING REPORT /DMRI
<br />1 /6 17-/9
<br />,.,....7111. ~I
<br />PERMIT NUMBER RncwwwuE nUMevw
<br />MONITORING PERIOD
<br />YEAR MO pAY YEAR MO PAV
<br />FROM ~ I .r. ~~ TO J I . • -, .:
<br />nn.9/I /n.7 r1 n1.7v zTe. 771 na-Tm Ixnx/I
<br />- Form Approved.
<br />1 ~ ~ ;~ • '~ ~ 3 oMB`No.4o40-oooa.
<br />• - I ..• ^ :. Approval expires 6-30-91.
<br />. .. C I L -, .~ ~. - J f l i_ t _
<br />NOTE: Rewd inleruetionE Mfnre enmpletine thif form.
<br /> (J Curd Only) QUANTITY OR LOADING (! Card Only) QUALITY OR CONCENTRATION
<br />
<br />PARAMETER
<br />(16-JJ) (J16I
<br />16
<br />(JA~J
<br />73)
<br />J1~1
<br />NO Fa EOU ENCr
<br />6AM PLE
<br /> ) ) (
<br />,
<br />(
<br />) . of TYPE
<br />(31-J7) EX ANALr51s
<br /> AVERAGE MAXIMUM UNITE MINIMUM AVERAGE MA%IM UM UNIT9 6I6A (616X) leg-JO)
<br />... I .V •fLL 6AMPLE '-..,- ri:J:. ~. ( ) v.. ~ l/
<br />(„ ~ F .~) MEABU REM ENT
<br />1. .. 1 U U
<br />' « .~. ,gn
<br />yh M~E?a
<br />g aaa;~. ~~r'>~dg.s<.
<br />
<br />s °~fvmt'.' 9~",r
<br />~J3`
<br />, if _~i: ., JJ '~-'Y~, &• ~
<br />., a .a, ~0
<br />~ p {„fig' ..a ~,
<br />+kE ~a a, a emme ^¢
<br />~ti,~., e.,,
<br />~
<br />~ a
<br />°8; •sa<' ~~
<br />RY..~ e
<br />~1~~an
<br />'_ _ ,FiIJ;~ 6'ALUi ~`REMEM'(a
<br />;R Ir
<br />>s> e
<br />>
<br />;;';mT.v,»o~l~a:e.g: ,.i.:.,: ma'~
<br />g a~
<br />a a;iii.Yl4od~f"I~.~a ~;;;y'a~e;
<br />y5{
<br />,°~CBJ~ ~e .f~Y8}y g>
<br />Iva a ._. ~(. ~i t~IJ ~ Vl( L SAMPLE ( G3) {S.j xS y:vr ;%i~:k ;21} r}4TFr.t4 ( )
<br />i I ; ~ _ Y : _. L ~ •( It. MEABU REM ENT
<br />. ~ ~.. i
<br />. - w _ . ., ° , el
<br />¢ `°I+ERMIT~:%
<br />x e n s~<Kn~
<br />,°.~"
<br />n
<br />`~ ,
<br />~"~•,ar8~1',.~~ge e ".A~'7A``Y.~y, Y~.rc ~<
<br />>"n ®
<br />' °"Iyl R4. d"'!6'e' e
<br />%
<br />a'°
<br />'
<br />e . ~ `+lm$ ° •
<br />'a
<br />' v 1.= ...
<br />nos a Vx
<br />°.,sw~, ~ y C.
<br />`,c~';.&s
<br />~
<br />i~ I f I ~
<br />i~'
<br />L .R
<br />liLtaWM 6N'K~
<br />~ z
<br />.
<br />± s a ¢
<br />° s @rs
<br />(
<br />~ ¢ ,i
<br />'
<br />~
<br />~
<br />"
<br />° .. c s-a n
<br />s
<br />.
<br />'a«°, e „
<br />dam
<br />a
<br />~ ,
<br />.."
<br />~,
<br />~p,°
<br />~¢~`<,x
<br />a4
<br />' e
<br />, g
<br />,."k,a. ~aa<
<br />&~'ti
<br />Y n,'xe
<br />
<br />" .®
<br />g 's e °
<br />°o-s
<br />.
<br />.
<br />r
<br />~.
<br />L .~xa
<br />o,- .° v"a;
<br />~~t4~a#~
<br />C`..3 a xt
<br />~
<br />~~
<br />t~.a'
<br />as ~..,L s
<br />~
<br />s a:.'g _°
<br />°:~..'. „
<br />a.
<br />~
<br />_ga gga ~ .gym ~
<br />Ong .%-
<br />¢', :;::. s
<br />a, el
<br />„g
<br />„~: a,
<br />..j~
<br />... nb~ iJ{:;:0-., ( yµ ;: r
<br />: S~'r is ,
<br />, `:}:: i:.°-.;::
<br />::
<br />
<br />SAMPLE ) ,
<br />. .
<br />. , ( )
<br /> MEABUREMEHT
<br />
<br />s _ :, '~ r ,.
<br />e ° `'PLtRNIT a <"
<br />.°;Id;N"3` 3t9}«rC¢ e~` s
<br />1."•r».x n -z s:r^;.«.,}
<br />i .J = .
<br />'x a Sj p~AY; m ~'R a ,
<br />~ m 4,w
<br />..i a".~~ n n
<br />g a ~S .w .. ~.@}x ai
<br />-
<br />s
<br />^
<br />' (y ' t«
<br />~ ~^
<br />"
<br />
<br />)~hl (!
<br />":
<br />L
<br />r
<br />L'J>;
<br />RfQDIR"
<br />fillT,
<br />M
<br />e`,g`Ae
<br />~6
<br />§
<br />~~1
<br />'
<br />-~
<br />~~
<br />_
<br />°°~°e»aA~¢» a
<br />sa
<br />%a
<br />®
<br />aa
<br />nt
<br />,
<br />~e p
<br />~
<br />~a a
<br />b
<br />- .
<br />,
<br />.
<br />I.
<br />+ w'"
<br />a sia,
<br />° ~
<br />~•
<br />s
<br />~'.
<br />.¢a a ~
<br />a
<br />se; 3.~f
<br />®ee« °a `o~. a° ern
<br /> SAMPLE
<br /> MEASUREMENT
<br />
<br />.r
<br />/°'g.P,C[~MfT.a ee 8
<br />!&d 84 Ls.~iYexi ~~e~
<br />x <, .
<br />.
<br />sa
<br />°
<br />I,~°se)8¢a¢a
<br />~
<br />as
<br />~«sTIIY~w se ~~g'
<br />v
<br />A
<br />°
<br />'a°a¢.e &~g'svsae
<br />Bs s
<br />°~
<br />anwy.,aa leas
<br />®
<br />ar
<br />a
<br />ab
<br />V' m. a
<br />~»
<br />„~® ase
<br />g
<br />a
<br /> REQ(J1R[MENTS
<br />' l
<br />z
<br />J.q
<br />~f°.
<br />r~
<br />"a
<br />s44 s.
<br />sssa.
<br />8 g
<br />L4
<br />-
<br />~ a„q
<br />ta
<br />a
<br />S>a
<br />'
<br />•
<br />~~ Ya e®;
<br />%~
<br />P~3
<br />atl ss®ag
<br />_ma
<br />g q
<br />g m
<br />a~. n
<br />~
<br />,
<br /> p4
<br /><x x° g
<br />f~
<br />w 48Ya'~ c°
<br />q<
<br />S
<br />IIA ~>x
<br />e
<br />emM x
<br />®Rce 4
<br />`e 5n &a
<br />a ($~.gg
<br />n ebg t.&m ~~e%'8
<br />
<br /> SAMPLE
<br /> M EABU R
<br />EM EHT
<br /> y
<br />a
<br />y
<br />PU k ~
<br />,
<br />~ a,
<br />~ ~ s<
<br />s
<br />°
<br />l x
<br />g
<br />' ° ~a
<br /> REp
<br />EMEN? n
<br />a¢°s $eaa
<br />x'»ags s~ ~e®Sa~»~' ~
<br />~
<br />®
<br />~
<br />a ISS
<br />$
<br />e
<br />@~ °% ~~ xas
<br />®
<br /> ,
<br />®s
<br />wg
<br />az a
<br />s g
<br />~®m a
<br />a°x
<br />g @
<br />a
<br />~ $ .
<br />~ ,n
<br />r
<br /> SAMPLE
<br /> MEASUREMENT
<br /> 9
<br />~ °
<br />a sc
<br />°
<br />~ 'v
<br />a a«zs~a a® ® gag as
<br />, ea sc a~ ~ 1
<br />s
<br /> N~6VIR[MENT a
<br /><°
<br />°
<br />aes'
<br />~°"0 as.
<br />IIa«~nx a
<br />a¢ ~z g
<br />a
<br />~waa
<br />'~ <~~®~a »:n .~
<br />° n ,n s®
<br />¢g®~
<br />asp<.a°a <
<br />sa ~s ~
<br />a ewa,~.. ~
<br />g
<br />.s
<br />m~'x'e<.
<br /> ,
<br />°Baa g
<br />eM~9° Fe< ~
<br />®<
<br />.Va° ~egga '®° <aa
<br />g~3g°g°' gSe B ~R'~a+° g&. ®9w~w
<br /> SAMPLE
<br /> MEABUREMEHT
<br /> a~ ®
<br />" ~
<br /> sREOE~REAfENT$ 3n.i
<br />~~q °~
<br />~ aa
<br />g~
<br />Q g
<br />~sa g@®°.%'~'S
<br />g~a4m~ g 35®~° .AaS S
<br />ffi
<br />> ~ ~~geb
<br /> p,
<br />g,m ps
<br />a
<br />a
<br />g
<br />e ~
<br />v ¢~4a e aa
<br />it °~a P a~g
<br />. ff
<br />aw
<br />~
<br />NAME/TITLE PRINCIPAL !X[CUTIVE OFFICER I CCRTIFr UNDER PENALrv OF LAw
<br />TNAT I NAVE PER50NALLr EEAMINED TELEPHONE DATE
<br /> AND AM FAMILIAP WITH THE INFORMATION SUBMITTED HEREIN. ANO BIISCD \
<br /> ON MY INQUIRY OF THOSE INdVIDUALS IMMCpATCLY RCSPONSIBLE iOR
<br />~
<br />l "aka rd ILI~I--.
<br />' OBTAINwG THE INFORMRq>I I BELIEVE THE SUBMITTED INFORMATION
<br />IS'TRUE ACCURATE AHD COMPLETE I AM AWARE THAT T
<br />A /F
<br />~///lll /
<br />~
<br />~
<br />~
<br />
<br />T
<br />P
<br />ivfr
<br />r
<br />-
<br />i
<br />T
<br />t HERE
<br />RE SIG
<br />NIFIUNT PENALTIES FOa SUBMITTING F4LSE INFORMRIpN IHCLUpHG / ~
<br />Ln''
<br />j/
<br />~
<br />~// pry ! O
<br />R7019
<br />C-L7~/ l~
<br />C p
<br />7
<br />^
<br />,
<br />.
<br />.
<br />,
<br />..anL.
<br />r,)
<br />~a~~
<br />~
<br />- D
<br />THE Pp55101uTr OF FIN[ AND 1MPR50NMENr SEE IB USC f 1001 AND _ /
<br />- U l. 1,
<br />
<br />33 V S C 1 1 l19 IPrnarfv. u/Idrr Ihrv Iulr" n nrl
<br />Na lev I
<br />dr /
<br />I
<br />lII
<br />IM SIGNATURE OF PRINCIPAL EXECUTIVE
<br />
<br />TTPED OR PRINTED u
<br />r.
<br />Inr. liy
<br />I
<br />/I
<br />a•d~~r maalniwilnlprl ovlnl.lil•,/M~tu.rnfim..nlA.andi•wr.,
<br />OFFICER OR AUTHORIZED AGENT
<br />A A
<br />NUMBER
<br />YEAR
<br />MO
<br />DAY
<br />-.~ 1. .41 i.-. ., . •. F .. ..a ra:. ... ..~ .. II: I l..r .,. ~. .. -_. Imo. .. ~ .._.-.__ ,..~ ~- '/
<br />E
<br />EPA Foti113320.1 (REV. 1I-8!) Pr[vhu9 etlitiolis maybe used. • " y ~ - ~ `"~jweiLwce! iPw'PORAi ---ao wNIEN Mwr nor BE ufcD.l _ PweE of
<br />
|