|
J~
<br />PERMITTEE NAME/ADDRESS (1M:d.FrWry NawdL«snar r/D/~..wp
<br />NAME hA]iTJIU.. ..~.-LL .7''c.4~ (, I'. .'..
<br />ADDRESS EAS T:;IC ~' ~*~TL~q
<br />P.7. P7v 171JJ7
<br />SAa ha:.l^iI7 PR 7x210-1777
<br />FACUm tASTSiC' 2J?.L CJKPA';Y, IN~.
<br />LocAnoN ~ I L r ~] d 16 s 2
<br />.-rPG7 SfEFI.?'I SFLP_ ?4ar !agar. a
<br />NATIONAL POLLUTMT DISCHMOE ELIMINATON SYSTEM (NPDE$1
<br />DISCHARGE MONITORING REPORT (OMRI
<br />12-761 lI7-191
<br />-~-u',nnT~ ~
<br />PERMIT NUMBER DISCHMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAV YEAR MO DAY
<br />FROM 97 U7 JL TO 97 J9 )0
<br />!2621/ l22-231 !14751 126-27/ 118-19) !30311
<br />Form Approved.
<br />;i F. D I : J\ D 1 S D y_AO~vSF~. 20~J0004 v
<br />ADDrovel ez~iree OS-31-98
<br />r" - FI^AL ~
<br />(SLIER .+C) VIII IIIIIIIIIIIIIIII
<br />MItiCa f~ ess
<br />~C~ _~. b 1JJ1
<br />:.~ ND nlscrlA~~F .~
<br />.NOTE: Read Inetructiom bstors latlnp-ihb }orm.
<br />PARAMETER l3 GrA
<br />OUANTITY
<br />~OADING
<br />~ l4 Grd ~~
<br />QUANTITY
<br />0NCENTRATI~
<br />CD Ul IWdt'f SAMPLE
<br /> I
<br />s
<br />46-537 51
<br />6f1 11V151
<br />/46631 E% DF
<br />l31-371 µµV513 TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MA%IMUM UNITS /sa-F.TI 764661 169-701
<br />?f~ SAMPLE #::Y.`-C ++F: ~.': ,;::}r..;: ( 12)
<br /> MEASUREMENT
<br />JJ4UU 1 0 J PERMIT :y.::xa; ~trsr~t- ; ~#~ 5.i #>rYx y 9.0 ?ELKLY CNSIF(I
<br />~e 'r LU 3NT ;; :L1 ;5 IRf f1F REQUIREMENT >:, y~r yF :'rt'1 a+avrKFl cn
<br />SOLIDS, .icTPLER9LF. SAMPLE t:.~~:¢ gy~~gy ,rv:fr,:y ,,. ,, ,,, y: ( 25)
<br /> MEASUREMENT
<br />GD~47 1 0 D PERMIT yy-xxx ~xa*,Ta=}d z st;=~ x:»~'~~ ya;,# y 0.5 ~ iN,;E/ T~dR
<br />•~FFLUa!:r ~JRJ55 G4LJi• REQUIREMENT r,~ M MT t a ru ~
<br />OLL AhU iREAS[', SAMPLE 4`:AFL:`-~ .,-:R^-' .Yr:3,•{- k'r ~iF ( 19)
<br /> MEASUREMENT
<br />U351S2 1 0 D PERMIT .#?aS¢~.~::... ;:'R~FD.M` ; y1:y rrGGU«= :fS=r',: -A ib ~ ~ ~7N2IR 'sc.at:
<br />vFFLUK'IT uR7S$ YALJi REQUIREMENT .. yyyy ~ ~TaTT,f 'R *I~1 T ^c•NT
<br />'L )A, IH CO!IDUI~`. .73 SAMPLE ( D3) ,;p;;:::.c '.k:=e; ': M1- :.;+y'::':a
<br />Ih.:J TRSATL+3Na' PLAYj MEASUREMENT
<br />SJ'Ji0 1 D .:fl PERMIT JPTi7N;aL REPORT. asaa14# 4C3# # rr;=:r~Yt;: ;:`::~ IE.',KLY [?'_tA•<
<br />bFr LUENT GHD55^AL:i _ REQUIREMENT ; D R Nr.
<br />-
<br />`
<br />50i.IDS, TOTAL SAMPLE yRxxal,: srAS::r,- i:~;~k~:: xr# .'.= (
<br />1g)
<br />DI:;SOLYED MEASUREMENT
<br />7U~3S 1 0 0 PERMIT ,'"-:-Stt;F} Oy~00Sr ; y'SC .-trtk=:;;: .-,..-: r, g
<br />p0E r
<br />FT.:LY Bp
<br />+R
<br />LF'FLUENT .;R755 '/11L[1F REQUIREMENT y~~ ~i
<br />X4 M-/T .
<br />DIL AND JnEASE SAMPLE t:r L::P :.': ( 94) +:-~+-~+• #~ ~.`• ,^-fi• #::+',`•:::`'`.
<br />4 I J [: A L MEASUREMENT
<br />duUUt 1 U rj PERMIT ,.,..,.~~ R$PORT I ES=1 ,=!:k:cr.",:,Y ;:#;:>~ :~ .Yyti:;.;c;t ^,: r:~; f lpCg/ !ISUAL
<br />EFiiUEN'C SR755 VALUF, REQUIREMENT INS'P f7A% NS=O A;:r:y s•~;T~;
<br /> SAMPLE
<br /> MEASUREMENT
<br /> .PERMIT -
<br /> REQUIREMENT
<br />NAMEITITLE PRINCIPAL EXECUTNE OFFICER I CERTI
<br />AM FA FY UNDER PENALTY OF LAW TNAT I HAVE PERSONALLY E%AMINED MD
<br />MIUM WITH THE INFORMATION SUBMITTED HEREIN; µ0 BASED ON TELEPHONE DATE
<br /> MV INQUIRY OF THOSE IMDINDUALS IMMEDIATELY RESPONSIBLE FOR
<br />
<br />.STcdH~J SEZF OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS
<br />TRUE, ACCUMTE MD COMPLETE. I AM AWME THAT THERE ME
<br />SIGNIFICANT PENALTIES FOP SUBMITTNG FALSE INFORMATION
<br />INCLUDING '
<br />/~
<br />CAJY71,dL I~~ ~ )A/. RQ ,
<br />THE POSSIBILITY OF RNE µD IMPIIISONMENT. SEE IB U.S.C. E 1001 µ0 JJ
<br />SIGNATURE OF PRINCIPAL E%ECUTNE
<br />~/G c s c
<br />~ /, -~,G~ 9
<br />~
<br />~
<br /> U.S.C. f 131 s. IAwWtl,. udr eYrr ,bean, rnFY a%aa !M./ w b S IO,OaD AREA
<br />TYPED OR PRINTED .Ma•mvinun inpnsvnwtt of MfwwnsmmNa rH SYrn.l OFFICER OR AVTHORIZED AGENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND E%PLANA I I V N V h ANY V I V LA I I V N5 lHB/BTBOCB e// effeCOTBIIfJ bile/
<br />J6.PLEAiL~ SDLI^i LI'.Li a4IY0 FJ.! 17-Yk, 24-9k PRE~IP ?VF,Ii ~JuJc~'i 'j'0 ;f7kD^;; DF D3~0° R'.',fUTaCiFYTS TN
<br />FART I. B. 1. D, ?,. 5. iI7~:~A1°R `fAnA7"'SEN° PLAN D11, 1-1-3J.
<br />EPA~Fwm 3320-1 108-951 Pravioua editiana mey be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE UbED.) PAGE Of
<br />9251/97~.+1~-157:: i
<br />
|