Laserfiche WebLink
PERMITTEE NAME/ADDREBB (Ind14FrWryNa/Lru1m I/Dlps.n9 <br />NAME CYUR'.l' YA"'+4 VALL=Y' ^I)1L C74P. <br />ADDRESS ~ I V [. ~ I ~ ~.- : C x111'^tl F ~ c ~ A -~ A V rt r <br />91UJ ~25t ~ITu''pni ^T•1C4F <br />FACILITY <br />LOCATION <br />).T:,~: 91)'(FI':. %"rLf•°- _'-.,~~.RAL AP!I° <br />--- - - --- - --- ----- -- --- ----- -- <br />--- <br />NATIONAL POLLUTANT OISCHAIIGE EUMINATON SYSTEM lNPDESI Form Approved. <br />DISCHARGE MONITORING REPORT IDMRI y 7 •i v r'n p ~ .: ~n,.~OMB)No12040-00041• •• <br />12.761 lI7-191 ~. <br />~ U'12 7 15 7 .fin : T (- r o O .: ;) Approval expires OS-31-98 <br />PERMIT NUMBER DISCNMGE NUMBER v. v,L <br />MONITORING] PERIOD V •~ ) n <br />YEAR MO DAY YEAR MO DAV <br />FROM '~ '.! _ TO .1: 7 ..^c ;- ^'t 1T^~ ii 1,; .: ;. f ,. y. <br />/zazn rzz-z31 rzaz5/ rzs-z71 /z8-z91 13a3n NOTE: Reed inBtructionB 6Nor~ a pletln0 thin lorm. <br />PARAMETER !3 Grd On/yl QUANTITY OR LOADING !~ G/d Onlyl QUANTITY OR CONCENTRATION NO• FREQUENCY SAMPLE <br /> !46531 !54611 136-451 !96531 546J1 E DF <br />137-371 X <br />ANILLYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 167-s91 (5/-561 /69-701 <br />i ., .,N/ C)': 'I f. SAMPLE 4+X ra... .-: 1X .: t^: i~;•,.:•^-r: ( 1'1) <br />(Ag v1.1 MEASUREMENT <br />G7t)45 1 D J PERMIT 'kkS~'?t 1xx'Fvr# t 'kr~ tTt>~a^.:n 3,5 -t,n r •a<?F~ '~FP <br />~`'~LUENr ~PlS5 VAL!lr REQUIREMENT :;,Yzg 3npA AVf f? Tt./ MY AI:/L +r )N ;t <br />rL')'; / I V .:7 ~:!1'1I* C 4 SAMPLE ( 7 31 ; 4y'rY=` ~s;*t~~~` * .: 7,^^.'~ <br />i`. °L' TASATh':NT °LAN MEASUREMENT <br />JOii50 I C~ i PERMIT REP~R£ PP 1011IIG t4rtOt# ?!k dt4fi# !r=F TysX {:~¢~ t ~.t-= ~BERLT ;MSTAN <br />'-.'F?,UdNT `)'. )5 i VALII- REQUIREMENT 30DA AY:. t1'AIL7 !!E !16D ~ t.C='~ <br />)SL AND Gf'F'? ;' SAMPLE ~~'k.C: ( 1'1) ,.`-'k: .. .. ^:Y^. .:.:At:.- <br />"~ I~.. IJ A L MEASUREMENT <br />~~'EUbb )- ~ PERMIT t.:::k;;n4` Y °. i_ <br />-L «•^rq;. ....xw±..v.. .Yrp:}~:is v <br />EE. Lr r r <br />. i5)19,. <br />?iL'JENP ;,R7:,: 9ALtic REQUIREMENT I45* "1118 Np=0 <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER I CERTI FY UNDER PENALTY OF lAW THAT I HAVE PERSONALLY E%AMINED AND // TELEPHONE DATE <br /> AM FA MIl1AR WITH THE INFORMATION BUBMITTED HEREIN; AND BASED ON ~ <br />/ <br /> <br />MY INQUIRY OF TNOBE INDINDUALS IMMEDIATELY RESPONSIBLE FOR / <br />~ <br /> OBTNNING TXE INFORMATION <br />I BELIEVE THE SUBMITTED INFORMATION IS / <br />r icl la rG 11/1115 <br />~ , <br />TRUE, ACCUMTE AND COMPLETE. I AM AWMF THAT THEiiE ME <br />SIGNIFCANT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING .[~ <br />(~~y~Cj/ ~~ <br />1 ~VII'T` Igp'n -,1 -'1.•;Ir-1pr , <br />THE PGSSIBIUTY OF NNE AND IMPRISONMENT. eEE IB U.S.C. 11001 AND 3] BIONATURE OF PRINCIPAL EXECUTNE 7n R70-?'7)Z Z _V ~n <br /> U.S.C. E 1 ] t B. 1A^Wei. W~/ 04Br mroNa mry i1[kdB lxwa 1q ro t 10,000 AREA <br />TYPED OR PRINTED rMrnwrim.n lnpiavrlnrolMMwnemrldx rld6YrA1 OfFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS ANU tAYLANA IIVN OF ANY VIVLAIIVN~ I/fI/B/BOCB N/BRICOTMf50B/B/ <br />;~L'I'f.4NAi. LISI" cnr. - -~ E7': ~ =L-.~TL~4;L~ =~LiLS (Ll~ F~F' qno*.° ^'T.Y T^ C- ~C_n`r 7'I-~r, p:-'.- 'r~,.., <br />IJ Cj..li`IGJ• i~ T_• •~F ii{F f7D l~~)°j~ n,~ (:]l^f :v' IT.+p rG.Nm ~T• /~ .~^.v-• n/~v. -)-.o p/ rn~ ~ <br />-Dm:dry ae ACf TN9 ~ 49 Dn.-TT`_r FI)C`TU'I ^PTnV _: •1n11p nTn ^/ <br />EPA Fwm 3320-1 108-951 Prevloue admone may be used. (REPLACES EPA FORM T30 WNICN MAY NOT BE USED.1 O n ~ n ~ ~ o n r•, /: n -±_ 1 n ~ '; PAGE OF <br />