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PERMITTEE NAME/ADDRESS (lnrli4 FmWry NaWluaua,dDt))irv0 <br />NAME `- v -. - ... . - y ~ J ^ "7 4 P . <br />ADDRESS i~IM1i... -~7-: i ~" ~ - F' ;Ari ~4 <br />L'NI',.": ~-~~ .:; H^.155 <br />FACILITY <br />LOCATION <br />rTTK: .°.')•:il~ .'r,[F'Y ^O.'r'9AL '. !'V" <br />NATIONAL POLLUTANT DISCHARGE ELIMINATON SYSTEM (NPDESI <br />DISCHARGE MONITORING REPORT (OMR) <br />!1.151 I7-191 <br />J0~27I''F lf: R <br />PERMIT NUMBER DISCNNtGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM ~ 1 1 TO 'Irt t <br />l10-711 !Z1-I3/ (1415/ (16171 !I5-?91 !3631) <br />Form Approved. <br />Y T tl r t n /~ U n r T r)OMBtNO.~ 2040-0004r :- <br />~ Approve; ez ilea 05.31-98 <br />_ rT. er, <br />y. ~,. <br />A NOTE:• Reed InetruotltNU befor~ ompletinp thb form. <br />PARAMETER !3 Grd Onlrl QUANTITY OR LOADING !4 Grd Onlrl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE <br /> !46531 154511 l38J51 !46531 154-571 EX DF <br />l32-371 <br />AN,uras TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS fe3-671 !54581 169-701 <br />I Hi)N/ T7"'1r SAMPLE .'-##:# ?: ^:h h:^.t #?.#':.'`-t. / ~7~ <br />(Ag -• ) MEASUREMENT <br />;)1U47 1 :.• i PERMIT #::#r~=' -^#aa4t% a'.-k 7:#"%t'n 3.5 ?.~ . ~H^_r.~! ~7\P <br />~F'FLUF:'iT ~'?S~ lAL1ir REQUIREMENT :Y'kk7 30j;A ~Y!~ ~ATL! ^TX '+~/L SONT? <br />`.•L1ii. IN C.^.';~nIT GR SAMPLE ( ~3) -';':.,.»#.. ..;,.t#~.: ..#i....;;. <br />i h! ? U T$ ~' A T'" `"I P D L A N . MEASUREMENT <br />TI)USU L ~ ~ PERMIT R°AOR'C PTIO{IAL ?+kk#~~ #r,#rX~=`- #'-!::k~'.-'* #.# Y$KLY Fl$SAN <br />`_:FFL'J°+T uR`ii YALI)- .REQUIREMENT 300\ AVG GAILY MC !1G/ ###:: <br />!i: ?.ND riRE~A ::? SAMPLE '~~k k:c#:: ( l'l) r'k:y;•ir .k #•••: •t •; •. :y {.#:.v,r <br />y ~~ c r) ~ L MEASUREMENT <br />'IiCnb L 0 0 PERMIT #;n#?4Y J Y F~= ,. •;#;: ^,. r.: '.:t'.#.~". >•;'}'.. 'r <br />'i~'LU EN? GROSS.'lVp 1, l'~ REQUIREMENT ~ I::~i y,y~ NE'=~ <br />G;:., <br /> SAMPLE <br />' MEASUREMENT <br /> PERMIT,.,:` ., <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> . PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> Dcnl_RRFMFNT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT. <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENN.TY OF LAW THAT I HAVE PERSONALLY E%AMINED AND <br />AM FAMILIAR WITH THE INFORMATION BUBMITTED HEREIN; AND BASED ON TELEPHONE DATE <br /> <br />MY INQUIIIY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br />OBTNNING THE INFORMATION <br />I BELIEVE THE SUBMITTED INFORMATION IS / <br />/ <br />t <br />~' <br />~ <br />r~ICF:iIrCI ~ III is , <br />TRUE. ACCURATE AND COMRETE. I AM AWME THAT THERE ARE , <br />7 / <br />~ <br />~ <br />, <br />~ ~~/~ <br />. ., 1 <br />I c.•9'1n,, E. <br />~ <br />I_ ~"\-~ I~(J ~ <br />`~=~ ~ ti: SIQNIRCANT PENALTIES FOR BUBMITTNO FN.SE INFORMATION, INCLUDING - <br />, <br />/ <br />1/ G70 87Q-971? ~ 7( ~9 <br />• <br />. THE POSBIBIIITY OF FNE ANO IMPNBONMENT. BEE to U.S.C. f 1001 ANO 7] <br />. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br /> U.S.C. L t7tB. II <br />rWE~. Mdr tlwr .orwb• ,n.r Ne/I.F. /w. y ro s 10,000 AREA <br />TYPED OR PRINTED .rMnnu..im.n hrpiaomwntdMMMnemenrh.WSnral OFFICER OR AUTHORRED AGENT CODE NUMBER YEAR MO DAV <br />GVMMtN I5 AND CXHlgrvq I wn yr nm Yw~n t wlra Inarerence en arrscnments nerel <br />:. [.. .:?'1 :. T'. L~". =(T' ... .,F T•.,0.1 r ;c~rTL~. '.PL° SJT.rn'- (LO'. F.FT ~~~T•a -.r,.r rc ~- (`_y- 7q_, ., o. T <br />F ~i' <br />,:~ '. L.4 I'"..D, - ' T.F'/ C', taF ..o °7H"~'i ]^ ~?)nc ^m9JT?^HCp, ~ r,T• •- _9rc_•-i't• rr. .o-'. c~ ., -. <br />lN'r ':T V r'p+Or T r D •ur'r Trr TV _n•GI; ^wr'tv_c-: ~Tma n~. •: -~/ <br />EPA Form 3320.1 108-95) 'Previous adlttona may be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.1 t' ~ ~ ~ T ~ .~ r ~ It ~ 7 -) ^ I ~ PAGE , OF <br /> <br />