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PERMITTEE NAME/ADDRESS r/MIJ. F:ugN../to~.uw, lD~Gm,q <br />NAME ~ }.. Y~,~JJ :. ril'i.:. L. I•~.:. T1~`. <br />ADDRESS j/ lr ,y'L,x L~„ <br />FACILITY LYF'r.l.~ LIgF'1F.L. Eli^:r'UrAT:L.+r <br />LocAnoN ~;,. a i t, L'u o i o t~ <br />.: 11:. M11 Ml.~1 _,.. I :~.:1 :1,~._ !.1 st .. el M,.J <br />NATIONAL POLLUTMT D13CMMOE ELIMINATION 6YSTEM pVPDESI <br />DISCH1 R6 E MONITORING REPORT IOMg~ <br />R IT NUMBER DISCHMOE NUMBER <br />MONI70 I G PERIOD <br />YEAR MO DAY -~~YEAR. MO DAY <br />FROM d ,TO' v' .v <br />n6)n n .2m ro~eri i. naPA /~8-191 /36311 <br />Fonn Approved. <br />OMBI No. 20460004 <br />,; I' /I ^l~ . c T .~ IAPPr'DveTisk' piiee'0531-96 <br />')U Sri 1\It 1-3'+`> <br />r - F ir~aL <br />P;IrIJN. <br />%:4 PILL J l SChAI:LL "+N'•' <br />NOTE: Reed Instructlons Wf • eompt~ting thh form. <br />PARAMETER !3 Qrd Onlyl QUANTITY OR LOADING ~ , ~ <br />' (A dOnNl QUANTITY OR CONCENTRATION NO, FnEDUENCr SAMPLE <br /> 14653 /51-6'7 <br />f' 38-15 16-53 6-51 <br />EX OF <br />TYPE <br />l31-3A MALYSIS <br /> AVERAGE MAXIMUM UNITS '~ MINIMUM AVERAGE MAXIMUM UNITS /et-eJl ~1d1-dq/ 15x701 <br />ul~ .AhJ .;kt ASE SAMPLE ~!a.,lp;. :•4 ###t~lR ,t,~~'r4ti• ~ti•ti•42•i <br />r 1 ~ 1i ,1 L MEASUREMENT <br />~. •tv~u i U U ~ ~PEP~+IIT~. ~ ~ /t#~iia i) <br />~ I <br />~~.*>K~.;~;;:.:. <br />::; #f«.+0.~QI~*?Il~ <br />~':#'ik+$+4+ti~.f`., <br />yt,•4 <br />., <br />~piL~:~:~: <br />~~.~1}.AS. <br />•. <br />Lr. Lu.r.I ;,kQS VALUL .REQUIREMENT: <br />:.. <br />t <br />s ;'::.:'i..r...: <br />r'-.. .: k##a <br /> SAMPLE <br /> MEASUREMENT ~~ <br />~ <br /> PERMIT ~~ ~ . <br />~ ~ . <br /> REQUIf1EMEN7~. ~ ~~F <br /> SAMPLE <br /> MEASUREMENT ~.?~~ <br /> ~~ PERMIT ~ :•: ~~ ~::< .... <br />, .. ~. ~ .::.:. ,:,: <br /> <br />~ :. <br /> REQUIREMENT ~ .. , ...: ..~. <br />` <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIj. ... .. <br />.. .. <br />;. ... ., .. :... <br />:. :~ <br /> REQUIREMENT "~~ ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> ..~. PERMIT... ....... <br />. :..:..:.. ... .~. ~ <br />.:.. . .:. .~~: <br /> 1iEQU1REMENT. <br />:,.;. <br /> SAMPLE <br /> MEASUREMENT <br /> .. PERMIT . ~ .. - ~• <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT:. <br />. <br />. <br />. <br />~. ~ <br />~:- <br />. <br /> REQUIREMENT' .. ~ ~. .-:~~. . , <br />. <br />:,~.' <br />:.. . <br />,;,.. . <br />NAME/TITLE PRINCIPAL E%ECUTNE OFFICER niN <br />~ F~ <br />n <br />wDw <br />µ <br />e MW <br />7 <br />DS <br />E <br />Y MD <br />IA <br />T 3E <br />ox TELEPHONE DATE <br /> r <br />all <br />l <br />T <br />i+ <br />NFO HER <br />IN <br />O <br />R <br />I1 <br />10N <br />SUeMITTE D ~ <br /> MY INQUIRY DF THOSE IN <br />THE INF <br />BT <br />M <br />T <br />N DIVIDUALS IMMEDIATELY RESPONSID <br />EVE THE SUBMITTED INFORMA <br />FFL LE FOR <br />TION 19 t~ <br />I :I (:Ild rd ~/;Ills NNINO <br />OR <br />A <br />IO <br />O , 1 <br />I ~/ <br /> 7RUE, ACCURATE MD COM <br />T PLETE. i AM AWME TNAT THE <br />IN <br />ALSE INFORMATION <br />IN RE ME <br />CLUDING <br />~ i <br />~9] ~8]Q-2]~~ <br />TIT ~,t <br />9 <br />'?1'1P <br />'1ltBl Manager <br />11'1Vll"O SIONIFICM <br />PENALTIES FOR , <br />SU3MITT <br />O F ~I .1 <br />. <br />_ <br />' THE POS31elUTY OF RNE MD I MPRISONMENT. SEE 16 WS.C. 1 1001 MO 77 T <br /> <br />, ~ ro tlo,ooD <br />p <br />~ <br />3 <br />' <br />om <br />~ g1pNATURE OF PRINCIPAL EXECU <br />NE <br />AR A <br />TYPED OR PRINTED iTein ~aaw .nr~aM..n <br />e <br />mm <br />N <br />~rmu <br />. ~ <br />~L~~/ OFFICER OR AUTNORRED AOEM NUMBER <br />CODE YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IRslwence e// sffschments hsiel <br />~cTTLLA,I~c S~LI.;~ LI"ITT ,raI~tLi Fmk lOYKF~hH1 PKtl:li' ~Vc+T-oL.c i..,.3F H~ I'Jr I'~rlt na_Jl)I~LMEIVT~. L/iL <br />L.kcA~c ~riaD SarIF'LI: arraLY~l~ K~LIL1IrtEJ Ir vIS[~L'c :iHtth i:i L~~Cr:vt_U. Nr':TnLY SaNNLIrd~ I7v5Tkll(.TIL.NS-I.C.a, <br />:J . t <br />EPA Form 3320-1 lOB-951 Previous editions mey 6e used. IREPLACE6 EPA FORM TrfO WHICH MAY NOT BE UBED.) ~ u I U J / ~/ v i U t; l -1311 PAGE lOF <br />