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PERNITTEE NAME/ADDRES$ l/nrfudr <br />huuluv~\'amr/Lorauon iJdr/ferenrl L <br />NAME _ h!J 1:15 L.ir Zl~ L.1'. ~. Ly 1N ~ ~ ~ S.J ~ lio c.} <br />ADDRESS i; I. F. N }: A 1L( Sl E1 L1 Eip 5T lti G1 c1AC.fitLJ 1iL - - <br />_--illlF_t~51iLL Y1 LLt;E~~1.ILF:~L_--- <br />---1bhb5Y LLLt_--___JiL ~SSZ_ <br />FACILITY _ <br />LOCATION-_-_--_--__------ ---- <br />a i I:11 uAV In :I naco~IlGAi.I P:Su_---- <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT /OhfRl <br />11~I6/ /17-19/ <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />/161/1 /11-131 /14-171 /16-171 /18-191 /30.311 <br />F - FINAi <br />PIT i3 LSCHHG TO GRASSY CHEEK <br />MINUH (BURN tiY) NOUTT <br />NOTE: Read Inslructlons before eompletlnp this lorm. <br /> (3 Card Only/ QUANTITY OR LOADING (4 Card Onlyl pUALITY OR CONCENTRATION <br />NO <br />FREQUENCY <br />PARAMETER (4673) (JI-61/ (38-4J) 14653/ (J4-6// . <br /> <br />EX <br />OF SAMPLE <br /> <br />TYPE <br />131-37/ AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS <br /> (6163 (61-68/ /69-7U/ <br />rH SAMPLE Y~+/:k #'Y` #####'+/ =}.i#'•iv'v <br /> MEASUREMENT <br />t,~4i,0 1 G O PERMIT ###### ####;:# #v;: 6.5 .#;t#### 9.G 8CE/ RAB <br /> <br />O REOUIREMENi <br />YYY%J . , <br />N <br />:,..LLOJr :iL•T'I'LcAE;LE SAMPLE YrY'IYY •y <br />%!'rrf'fY•F ,r, <br />Y'fYY•f•F #Y#YYY <br /> MEASUREMENT <br />L 11 L <br />L L Jy J ~ O Q <br />PERMIT .4 .4 <br />#~#### -` <br />Y###Y# <br />Y#Y ,y ~y <br />rfY#### .,y µ <br />~r####Y <br />O.5 (~ <br />RCL/ <br />RA8 <br /> REQUIREMENT <br />r =F'•~$ <br />L1L ANU I,fi PASS SAMPLE Yv4%i ii'Y` %.:#YVii it #A'hv##%: #ii##:rr <br />FhL'0d I:%TH-GIIAV (QETI MEASUREMENT <br /> <br />1i l~~;i0 L V V PERMIT #'v#### ###### 'M#%i ###### ##~#%}# IG ONTIH RAB <br />_ ,/, M REQUIREMENT v'M'r# <br />(y~,+l SAMPLE ~`i• e"%kvv %r +}'-}•i#r YY.;:%}%1 'k#;F#=}# <br />~1V 16L nliCLVENABL F, MEASUREMENT <br /> <br />ti~Jol. 1 0 O PERMIT ###### ;;##### ~:#:: ###### ###### OPTIORAL 'ONTIH RA8 <br /> REQUIREMENT <br />` -k v i ~: <br />1 / ~ <br />1' LCJr jr/ LON OVII' VR <br />SAMPLE <br />Y•f#Y'rY <br />L`Y re'#'fY <br />~Y#YYY +V +~ <br />YYYYYM <br />1H6U 'lHfsAThntlT PLp N' MEASUREMENT <br /> <br />~~~.^.L 1 0 0 PERMIT #0##;~# nEEOfiT #####+} ###### ###:## ### NCE/ NSTAN <br />_ REQUIREMENT <br /> Y YrF <br /> <br />J ~.J L~GSr 'TOTAL SAMPLE 'v%f #vi%%~ .YYY•:=i it Y'~r %i%.i vv#%i'v'v` <br />I. ~ J.i li L V }. Q MEASUREMENT <br />Jv~'JJ 1 0 0 PERMIT Y###;:# #1G#;r~# v;:=: Y##### #~#### SEPORT TRLY RAB <br /> REQUIREMENT <br /> <br />L.1L AHL' G}iEASE SAMPLE X: ~:#%.f#i #'V 'r'v## #v##r=i 'v `v ~7 +'f## <br />u 1 ~ U p L MEASUREMENT <br /> <br />04GCu L 0 C) PERMIT <br />REQUIREMENT r###%}# O r.S-L .Y###Yyo <br />1 <br />1 <br /># <br />IS~ <br />A~ <br />~ <br />#~Y~Y# <br />'FY'v <br />NCE/ <br />ISUAL <br />c -_ 1 <br />, TI <br />U <br />NAM ERITLE PRINCIPAL EXECUTIVE OFFICER I CERTI FY UNDER PENALTY OF LAW THAT I HAVE P ERSONALLY E %AMINED TELEPHONE DAT E <br /> AND AM FAMILIAR WITH THE INFORMATION SUBMITT ED HEREIN; A Np BASED ~ .' <br /> ON MY INQUIRY OF THOSE INDIV <br />S IMMED <br />D <br />TE <br />R <br />S '~ <br /> IA <br />I <br />UAL <br />LY <br />E <br />PONSIBLE FOR _ ~ <br />1 -J <br /> <br />Karla Rabuck OBTAINING THE INFORMATION. I BELIEVE THE SUBMITTED INFORMATION. <br />IS TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIG ~ I / <br />~ 2 ~ ~`~ A~ L ~ (~~ ' <br /> <br />Vi Ce PreS ~ dent NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING <br />THE POSSIBILITY OF FINE AND IMPRISONMENT <br />SEE 18 US <br />C <br />6 1001 AND <br />f <br />GOH 754-2291 n11 <br />9 <br />03 1 <br />3I <br /> . <br />. <br />. <br />]3 U <br />S <br />C <br />1]19 <br />P <br />A <br />l S GNATUREOF PRINCIPAL EXECUTIVE A <br /> <br />TVPEO OR PRINTED . <br />. <br />. l <br />mu <br />ues undrr r <br />. 6 <br />ese srarures may mrlude (nes uP ro tfa.fAO <br />and ormeilmum imp.uonmenr ofberweenAmonrhs and Symrs.l <br />OFFICER OR AUTHORIZED AGENT ARE <br />NUMBER <br />YEAR <br />MO <br />DAY <br /> COD <br />COMME NT AND EXPLANATION OF ANY V IOLATIONS (Referenre a!1 aflachmenrs here/ <br />L;1L ~ GHiASE: SEE F'00'tn0'ft F/e FAGH 3 OF Tlie PEhHIT. FOHDEfiLY UISCHANGEU UNGEH CO-OU35653. <br />EPA Form 33201 (RRV. U~BBI Previous editions may he used (KEPI Ar,FS EPA FDRAI T anwmr,H MAY Nnr De usen I race nr <br />