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P[RMITTlE NAM EIADDR!!! /(nClud[ <br />F~Nlfty NllnelLOClfbn IJdiJJETrnf) <br />___~hGL~ 4000 ____________ <br />rw_iurr------------- -- <br />LoewnoR <br />~~_ L-/. _. A. wAL}. F _ 1 -J -_-- <br />NATIONAL FOLLVTANT DI![NAwGE FLIM INATION ITST[M /NPDE$/ <br />DISCHARGE MONITORING REPORT lOMRI <br />z-)s t~ - Farm Approved. <br />~-._ .. - / .. l - L r ' ~ •) OMB~No.•2040-0004. <br />PERMIT NUMBCR msH.wcE HuMlu - ~ , __ Approval expires 630-91. <br />MONITORING PERIOD ~ ~ F a ~ ~ ~ ~ (' ~ ~ - <br />YEAR MO OAY YEAR MO DAY <br />FROM ..~ ~ ~ TO , e. 1 .. :.. .I .. .i.. r ..yy~~ .. <br />/zo.ul rzzz11 /z4~zsl rzb~zn /za-z91 /JaJn ~ NOTE: Read instruLtioro before comBletino this form. <br /> (I CRTd ONy) QUANTITY OR LOADING (4 Card Only) OUALITT OR CONCENTRATION <br /> <br />PARAMETER <br />(Ie-J3) (J4fil) <br />(f8-IJ) (46JJ) (NHS/) <br />NO. TREOUENCv <br />DF <br />SAMPLE <br />TYPE <br />(J:-J7) <br />E)I <br />wNAL V51$ <br /> A VERAOE MA%IM UM UNITS MINIMUM AVERAGE MA%IMUM VNIT9 6741) (64fi87 (69'/D) <br />~. ! .....~ SAMPLE Y. ~ +. r .:%-% t ~ F4`: ( <br />i; 4,,) MEABUREMENT <br />L J <br />_ .. .. ~ ,. o . ...,..., <br />., °PERM'fT+, >f °Lf.3'~a,< <br />§d w °a; <br />.A'^.&„a ey!3(i~a fa,i l,. .; a., <br />aii;'Yg13«~s¢ <br />„ ..., <br />~; a,n .:A ~° <br />°. <br />. <br />ax <br />' ~ A .., x <br />• ®ssce s F <br />w- a <br />?a1p E <br />; ~ <br />F^' <br />a..+ <br /> <br /> <br />.i k...I ,_ F: '. i+Ll%E <br />REqu(~SM'6NT. <br />,~ ,I,r <br />_°,a: ~ s <br />~ <br /> <br />:s":ter <br /> <br />.i ::~+i „ <br />-°'x a e ' <br />`#°° y <br />8 <br />S <br />e s <br />Y,' ~ ~ ~ <br />d% . a <br />: ~ ' " <br />a®. 8 ~.°t'° s» <br />, <br />. o- <br />a . <br />, <br />r <br />~;m ~ <br />~4 <br />-'".<>.;; <br />..Jl~ A- .r .. i;i. U(l 6AMPLE ~ V,~ Q{: i'C r• :Y l;'. I}L'4'. .. <br />.(U .. _..._ - ~ LG, ;, ~~ <br />+ MEABUREMENT <br /> <br />_ j J <br />I T..; ,.x <br />a e °PE#(M y5 <br />~s <br />e ~"~~N1~d.,'e, <br />E'~,~.:1 $1 :t ~iTS', <br /><'~n ~;.i°~Y:y'`y',~°s..~" <br />r.!a a ;.~~.~, £S <br />~'q4~ <br />~'~~s~f~ a~ ;A~ ~<'a <br />lV'.-{: <br />°.. <br />~~1g jffi ~a <br />(S,'}~~~ <br />L U L ' . <br />xR,EOVIRET4BN'L' a <br />1 <br />~r <br />a~ sx <br />® e aw¢a a <br />X <br />` <br />' <br />Y' <br />' ` a <br />° <br />~E <br />® <br />'». _ <br />°s°~ID° <br />`> <br />~'$e 4,€ffi~~¢na e <br />, ' a9n' "~' <br />'» <br /> <br />. L _ <br />a ., x & ¥~A;.~ <br />+>a <br />Y~. <br />P. <br />° <br />14 a~ <br />! <br />. <br />~ • 1:.~L p;a <br />g <br />S <br />~F <br />'a .t; <br />` <br />'e ~. . <br />b~ <br />~ :y Key <br />. <br />nee 1. <br />~ area <br />L_. AML VIIC,.__ <br />SAMPLE .. .. f ,~ ~{.,.~1; ,~:4+r.z;. ko <br />avl.. { ) <br />~ `-_ 1, ,~ ~ MEABUREMENT <br />.. L <br />J °``-r~iii~ir.•a <br />~ .e:.::aa~:ss~exe <br />a <br />'; >;ea°<$~«xy :..=_ °z$~~~~g'e~°, °affixa~~kai~s; ®°~`~ #~,;~~.°.+ " ~~~~~ 1«k~.js <br />~.& <br />CC <br />I <br />~: <br />( <br />~ - <br />~~ R,60UIREMI~rITe <br />" ®bs6x<s ~<m¢r sb t r~yy <br />s~~'((,,•• <br />~ <br />ffi <br />x <br />~ _ t~s ° »n<sa sy~ <»„,.».a <br />~ °4e««e's'n°'1' <br />~ <br />T <br />t °~s~.n n »' re, , <br />xg <br />. <br />. <br />.: 1 _1; <br />J ST 445["~ xd°ax.°¢ ,l @ <br />{L`T'ff <br />i,~) <br />z <br />l/.~ nw :~$~m®5w° q $'s <br />eFa y4p~..1:46 <br />e~ <br />a.4 n °ab ~ ~x$. ~ <br /> BAM PLE ff <br /> MEABURE <br />M ENT <br />~, pp~~ i <br />®of'ERM)TId 55 °$~ <br />nxE <br />i <br />j' <br />' a <br />£s8 <br />na~x °~OID <br />6g a <br />'s.a ae.g~69B~ <br />~zw B®Y °n p ~~a..° a® <br />' <br />~ REgU1REM EN i,. s <br />, <br />« <br />.»n®e <br />x .~nxa~.. lxlg sa <br />~ ~ <br />8a e <br />~axb <br />a"' b a <br />: <br />as a <br />sm %'~na n45¢+ <br />°¢, <.a s <br />p ~ <br />' mB.A <br />°~§4 <br />~x's <br />a <br />c ego- gga m, ,,,a <br />%° Yn <br />®., sA.~ <br />n n A,s ale i+'¢a,R ' ~e t nze., <br />Y.a<¢ s e, <br /><~., • <br />.a. , <br />. <br />as . <br />m <br />,fie ° ~ <br />~ ~ <br /> <br /> SAMPLE <br /> MEABUREMENT <br /> ~~'~t'FRMdt~°°a< a~ssQ a <br />xs ,z ¢A $n<g°'s`~e`vi~¢ aa~ <br />zg2're~`»' <e'., ie'sm~6w <br />~ ®a e'm~ <br />®a <br />S <br />' ba~a d'°'»ea`~~ m <br />a <br />~ <br /> RgpVIRgMENTn .. <br />ex ~v3nna„m %, ar,°ffia <br />°''s<. s <br />do-a xm.¢a <br />a <br />~ <br />' <br />" ¢ <br />~».,°ea„ <br />'® <br />` e <br />a <br />s~.e <br />»ba <br />" <br />y <br />'ffia `g re <br />~ <br /> <br />~a es <®> , <br />s8 . <br />.rn <br />a <br />,'.x„•, „.. <br />• a <br />. '»aa~e a.. sn <br /><c <br />~ <br />a+a ~ •~rem <br />ew <br />e eaw <br /> 6AMPLE <br /> M EA6UREMENT <br />' re'g`PERM`ITe :; ax, r'fl .,®se <br />as :emm <br />® <br />~ <br />~ <br />> ae pa ac az:~~ "°a¢av e# e¢b a <br />e re~S av~~ x.®a'~sffi <br /> EN <br />T <br />REGWRgM ; a sa<xa. <br />n° ,a <br />a.s <br />n <br />x . s~ <br />~ <br />as a® <br />w e <br />as ~ <br />c n <br /> e <br />O <br />~ <s i»ae <br />a <»x as»a'»a• aea x <br />e°® <br />s a®at anreef <br />n¢A s. waa ~w <br />~.® <br /> 6AMPLE <br /> MEABUREMENT <br /> a <br /> RcQIJMEM EN.T. re an ~sx raasa a» ~'e Aye~g° m,aamx $»'® `ffi~" <br />' ¢an <br />'~$a a ~ ~a <br /> ; ~r <sc sg <br />as s» % <br />asan »~ <br />~ ~ y <br />as.a <br />• <br />~ °aa &® aSa~¢ ~ ~ <br />NAME/TITLE PRINCIPAL E%aCUTIVE OFFICER ' CERTIFY unDER PENALTY OF LAw THAr I HAVE P[PSONALLr EAAMINED TELEPHONE OAT E <br /> AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HCIIEIN FND MSED <br /> ON MY INOUIRV OF TNO$E MOIVIOUALS IMNCDIATELY RE510N51BLE FOR / / <br /> <br /> <br />lsa <br />' <br />f <br />J r <br />1 <br />OBTAINWG TMC INFOnMATOV. 1 BELIEVE THE $UBWTTCO MFORMATON <br />15 TRUE ACCURATE AND COMPLETE I AM AWARE THAI T <br />AR _ <br />/ <br />~ <br />~ <br />/ <br />~ <br />rl <br />. <br />• <br />.. <br />. <br />1~~s HERE <br />E SIG <br />NIFICANT PENALTICS FOR $IIBNITTING FALSE INFORMAi1pN INCLUDING ~ <br />~' <br />, <br />~1 <br />1 <br /> <br />-.vironrnenta i,~-L,(Te- <br />TN[ PO$SIB~uTV OF FINE AND IMPR50NMENT SEE IB USC S IODI AND <br />]] u5C . U19 .Prnalem <br />rdrr rhrv ammi <br />n , <br />ld <br />/ <br />L _ _ <br />61GNATURE OF PRINCIPAL EXECUTIVE <br />(1•IO~ <br />a r1 <br />IIJU-•' / I ~ <br />O7 q <br />~L <br />S~1 <br /> <br />TYPED OR PRINTED r. <br />n <br />nr <br />r <br />n ab <br />mr. •Y e. <br />~•d... manmwun,PV.,nmrru„/A.mvnAm,mlA. ands.w.•I <br />OFFICER OR AUTHORIZED AGENT <br />A EA <br />NUMBER <br />YEAR <br />MO <br />OAY <br />. / <br />EPAFor1113320=1 (Rw:4E8) PiavJoudediflDnB maybe"used.' ~ ~" "'" "iwEiLwcE! iPw'FOwr 4-.e WNICN MAY NOT BE UfID.I PAO[ OF <br />i 1r `~-~-_.-.. _ <br />