|
....as y I11C.
<br />,.,..~~~ IevLOer EacLE 1lIra
<br />' 16 EAST GRANITE'
<br />~ -
<br />NADONA6 PDLIUTAN7 Dl$LNMGE ElIMINATDN~SY4EEM hYPf1E$/ Fefm /iPplOVed.
<br />DISCNApGE MOMITORINGWEPORT 10MR1
<br />!1.161• E~-rs/ DSCEG SO PU86ATO:t~etiPq•L.~2vOE'~S~-
<br />{SQEA $Y}PRIov'11 ~14~ 31
<br />PERMIT NUMBER olscNMGE Nu1nBER ;ti ~ i
<br />- ~. F - Fz~az .,
<br />......r. ~ -. ~na .ate vs -
<br />~ ~`ACIErrY `, + , . tdON v
<br />ITO 1 PERN~D •~
<br />~'lOCATION ~ - ~. ~ YEAR MO DA
<br />I Y - ~ ~Y6,4R MO DAY
<br />. FROM
<br />pP`~1ftNi PAUL G4;)fZEPIEIEEe VICE' PYgSI 2 ' ~ !1¢211 !TI-1 / (1s- TO ~ n Boa RQ CI9CHARGIi F~%1 #'^#_
<br />?51 • '-lT ??I 1s8-191 !36911 .; N01'E: ReadlnetnEetfonMlq~e~ mpLEMgEhnFOrm.
<br /> PARAMETER B Grd On1y1 O.UANTITY DR ~~OADING:.
<br />' !e Grd Only! QUANTITY OR C4F1(CENTRATION ~ µ~D";` EREaucxcY SAMF
<br /> 116:5) ~ f5~61 ~ ~t38-151 t653~ (5~-6'1! -'
<br />' •~ DF
<br />'~
<br /> ' 13?-3~F '
<br />~ . ~ : JMKYpS TYP
<br />t' ,. .~ - ? AVERAGE ~ MAXIMUM •VNITS ;~MINlM4IM AVERAG~ ,FMAXIMUM UN~TS~; (:1:11 ~!6•t6e1 169-,7
<br /> -
<br />' ~ SAMPLE ~ ~ IOf### ~ aaa#aa ~
<br />~
<br />-
<br />~ iAt6:4O4 ~
<br />{ ~~~~~ ~~'t
<br />~~
<br /> MEASUREMENT F . .`
<br /> 0!!00 1 0 '.0 R~MIr
<br />
<br />` >at`
<br />iE11rE a „ aaa ,g, e~4 0 ~ ~" CE/
<br /> E7lLUEMT GR035 Ya.LO REQUIR€Ml
<br />Ntl ,: ^,r, aea r t:, t: ''
<br />~: ~'"'"
<br /> S(ILIDSP 5ETYLEASLe SAMPLE
<br />' 1?~-a#t q}4aa# 9~#~ar, ^a>Qas~a { ~5)
<br /> - ~ A~EA$
<br />UREMENT - ~ '
<br />/ s
<br />
<br />~ ,
<br /> 545 1 0: .~ ~, ,Q
<br />~11T ~ a • 1
<br />. ~ ; ~ .
<br />~
<br />` ~ t~ A§r~ ~ - E CB~F '. ~ 6
<br /> @~tLUY11S 6RP5S ' FiLi~ MEIj(T, , s, k, 1~, ~.',
<br />t tali t.. ~
<br />.
<br />~
<br />_,~ ;..~
<br /> aND G86aS~i ~ 'SA L6'' a aaa a#a ~ ° 0 # ( 14) : ~;~.
<br /> MEASUREMENT la .~
<br /> a 1
<br /> ~$EZ 1 Q O ". ~ ~ P~RM1T a:
<br />' ~ °~+a~pea#a
<br />!~" ~*IR '.. 41~' r {1#>t - ~'~.'~ ~ ~'
<br />~ RItXH
<br /> Q
<br />F'tLUEYT ~fHQ~ ~~;~ iEEOUIREMEL~T a i
<br />~ $ 1
<br />/
<br />;. ,
<br /> ,
<br /> LOYi IH TT :OH S.AMPL
<br />M ^A-- © ~}
<br />i
<br />^ .,.E6*#1Ci>Q I~t611PgA >Q#ttlaa
<br />'
<br />.t M$0 TRBalttl:$~l~F ';pLaR MEASURE
<br />ENT .~ - - .. ~ /
<br />-
<br />rF_,r
<br /> • -
<br />l
<br />,
<br />~ 1
<br /> 0050 1 :: 0. .,fl . ,;
<br />`. ~. f'ERMI .il,g1~EL
<br />" ,fa1~gF '~
<br />~ ~">~ ~~~#Ny < sMa'~ ,,s#14!?Oia :~ aar ~T
<br />
<br />rrt.usaz gabss ~ u E7IEDUREME
<br />< . ~..; , hT.
<br />.:
<br />~~~~~ .. -
<br />tat .~x~; }{
<br />_ ';::4- -w .; ..: ,
<br />Ya
<br />....~
<br />o>sa~r
<br />{.;;
<br />,-~,.
<br /> iL AND GYFi*SS SAMPLE #*Of>># ~^,9«. _
<br />•40+Rtt At~1O;a ~R~#~'7 :' +7 ¢' =
<br />°
<br />-
<br /> 2StjAL = - :. MEASUREMENT - :' ,:
<br />f - ~~ ,.
<br />,
<br />i' rid - - .
<br />~' 40bb 1 0. O
<br />' ~. F~ERMIT
<br />I
<br />M --~I 4~-;
<br />~! u a
<br />r.. ". m
<br />ax .a91~t~-~#;
<br />I~
<br />` s
<br />~
<br />- ~as.ol~~a #al~ 41 ~~u
<br /> 3rUSNT GRt7$$,YN;LA
<br />rf REDU
<br />RE
<br />ENT --
<br />...:.n. • ~ ~: ~,. r., ~:.
<br />~+. i
<br />?
<br />~
<br />~ ~
<br />3 .~~ - ~~~
<br />~' ~~
<br /> _ ~ ~ 'F ,
<br />•~: ~i> j~ 5' ~ SAM -
<br />` EA$URE ENT : 4 . ;~ '
<br />'~•,
<br />5~ - t
<br />1 1 ,1,
<br />1
<br />. u ~
<br />~ ~1
<br />I
<br />~~~J
<br />~',
<br />a -~C. ,
<br /> ~
<br />.,~ ~ , i I
<br /> F ~ 1 ~ i -~
<br />ti' ~L ' ~ f ~ ~ - t Y ~ ~ I ~ -
<br /> i N ! Y.
<br />
<br /> SAMP4
<br />~ < ~ -
<br /> `J ~ MEASUREMENT ,~` ~ ~ ~ ~ ~,,. i .
<br />
<br />F
<br />1
<br />
<br />~ ~ ~'i '' 'P.FR. MLA' :,.
<br />~rc
<br />111RE
<br />itF
<br />1{T
<br />RE i - Y
<br /><
<br />_t .. -:
<br />~~s ~.:
<br />k~ qq
<br />-~+~ r..
<br />f ~: -. ..
<br />t
<br />'^s'
<br />Li;t lS-- r r
<br />
<br />i -
<br />y.. '
<br />..:.
<br />
<br />- a
<br />
<br />~~. -y'. ~ -
<br />P 1
<br />- ~,
<br />g
<br />~
<br />...Y. .
<br />3 .. utF.Y
<br />`
<br />' .
<br />:1; it .
<br />.:.lY
<br />~~~ t~• ~~~
<br />r NAME/TITLEPRINCIPA,•EXECUTNEOFFICER 1cERn
<br />l1ND ,ENAtiY
<br />oF
<br />AM -fAMILIM TNF elFOR UwrNAtIkAVEPEN
<br />MAtIDN
<br />4UBM11TED N Y %AMIN
<br />N
<br />MD BA EO%WD
<br />BE DN ,A .
<br />J{A TELEPHON E DATE
<br />
<br />~I}~0~ ~,.j~/
<br />P~
<br />77 1" .
<br />;
<br />MY INQUIRY O JNOSE INOINOUALS IMMEpiAi r. RESPONSiB
<br />OCTNNINO tNE
<br />FORMAT
<br />ON
<br />i BEVEVE T
<br />1E SUB TIED
<br />FONMA
<br />LF i0R
<br />T
<br />N ~
<br />~'
<br />~/' (-/
<br />jtI!-Y ~F'
<br />few ~~-
<br /> 1
<br />' ~
<br />'.
<br />~
<br />J EM ~.
<br />,
<br />I
<br />l
<br />IN
<br />TRVE, ACC AND COMPLETE. 1 ALI AWME THAT. TNE
<br />SIOMIFICAN7 P~
<br />ITfS i0A SVBMITFHID FJU
<br />INC
<br />BE INFORMATION IS
<br />D
<br />AE ME
<br />LUDING a
<br />,
<br />,/1•
<br />
<br />'1
<br />/j
<br /> ;
<br />~ I
<br />~
<br />r f ^ ,
<br />.
<br />.
<br />THE POSSIBIV F RNf AvD IMPNSDNME/lT
<br />SFE }8 U
<br />Q { 1001
<br />B
<br />MD 9]
<br />/ GjfY ~~
<br />/~
<br />ff ~'
<br /> .
<br />.
<br />.
<br />S
<br />C
<br />! fete
<br />Y
<br />U
<br />(A
<br />1W L
<br />M
<br />Yf
<br />1
<br />i
<br />ly
<br />f
<br />b
<br />] 10
<br />000 BIONATURE OF %IINrv~y~~AL EXECUTIVE
<br />^ DTO
<br />V
<br />
<br />TYPED. DR PRINTED .
<br />,
<br />.
<br />.
<br />1r
<br />r
<br />r
<br />.r I
<br />f1
<br />N mPy
<br />x
<br />.
<br />ive N
<br />,
<br />. ro
<br />rd«rwiuuer i.oEr,w.n..rwerArree.nmmsw6r.ret, y
<br />OFFlCER OR A/lF1roRIZED AGENT
<br />~pE
<br />NUMBER YEAR
<br />'MO
<br />D~
<br />_,'
<br />t
<br />'~
<br />4.
<br />vmmcnr~ nnv cnrcnnn..vn yr nnr .r rvcn. wrv fnv«ertce mr nmoumns neEe/ , , ~ -
<br />8'~YLEABLE'9dLIII5-1I8IT lialYEO PCtt 10-iR, 2a-RE PRFCxP $YERi ?U#eEt'1 iC HQRCFB.CF PROOF RC~pIREMENTS'IM
<br />iST I.H.1.Ae P• b. 9TOH1lYaTEH lfAYIGEREii; PLdN .D{f_E,~,1=,3b.98',.. '.
<br />
|