Laserfiche WebLink
PERMITTEE NAME/ADDRESS (/ntlr4FatbyNar/Loealm UDISrrrnQ <br />NAME yl„Yr'rtl.~ crl'Ir_ v.;-.r~.;Ai 1L... <br />ADDRESS N U ., L A O o <br />~ t;aAlU l:J e1cLb <br />FACILITY I.YF'KU~ t,lF'lnL :.Uk'rUKATIIIy <br />LOCATIONLkAlU GU bIU27 <br />ATIi+ Y~1l,nAtL .+. LUULt+:.r t,LNEKAl.. M~II <br />NATIONAL roLLIJTMT DISCHMOE ELIMINATION 9YerE1M //NPOESI <br />DISCHARGE MONITORING REPORT lOM91 <br />4-~ :. I I <br />PERMIT NUMBER D19CHMOE NUMBFA <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM V TO tl <br />l20-271 122-23) i2~-26) II6271 128-29) i30-37) <br />Form Approved. <br />QMB rlLo. zo4o-ogo4 <br />,~n~. r: ~I;-/ln TJ A ~ ,u.~ 6 <br />~Utll. Nn PProve~Lx~Ye 5="31-98 <br />r - FIvAL. <br />If I ~. ilK <br />NOTE: Reed Imtruetlale bef • e pletMp thM form. <br />PARAMETER !3 6rd On/y! QUANTITY OR LOADING !I 6rd Onlyl QUANTITY OR CONCENTRATION ND:' FREQUENCY SAMPLE <br /> !16-53 !50-51 38-15 46-63 /5L6/ <br />~ OF <br />l31-371 <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM - <br />UNITS' EX , <br />162-ssl MALrsls <br />/80-681 TYPE <br />/69-701 <br />ll_ :a~lU vrt=HSt SAMPLE ${<*4+f<.t yt, $v•: •:. :~~,• ...,f.< r. ;a{<rf4ta <br />ti 1 ~U,+L MEASUREMENT <br />J 4l,Gb 1 Li U .PERMIT 'Y•**III.$# : :~:.~~' <br />~.~:~ :~.: tS 1 *q..G +r i'<# ,,. ¢.~{.dap ..~A~#a$rk ff:q.. :: *** ~~~ <br />y:: <br />iATi. <br />Ir <br />I,:~.~.A.~ <br />~Y!-LUL~'.! u-U:iS VkL:.t REQUIREMENT ~ : <br />`~tN5L .M,R ](. ht? U ~ ~ ~ . <br />... v'**N . <br /> SAMPLE <br /> MEASUREMENT <br /> .. PERMIT <br />,. <br />.... <br />~~ ~.. <br /> <br />~~~ <br />~ ' ~ .: <br /> :REQUIREMENT ~ .. ~ .. ~ . <br />.. <br /> SAMPLE <br /> MEASUREMENT ~. <br /> PERMIT ;i:. .. <br />:.. :..:: a.~..~:. .:. ~;: <br /> <br />: <br />:~ <br />.....:a3a•: <br />: <br /> REQUIREMENT ::r ix~s:: ~ ~ . <br />.. <br />. <br />. <br /> <br /> SAMPLE <br /> MEASUREMENT " <br />~ <br /> pEHMIT:~: - ..:.. .:~.:.. .. :: <br />xf%T''^ <br />~ <br />~' <br />~ <br />a ... <br /> REQUIREMENT ~. , <br />~ <br />~ <br />: , <br />C . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT:..:. ..::.:. .~: :r:::::. ~. ..~ <br />... <br /> <br />. <br />: <br />~ ~ <br />:• ~~ ~~ <br />~ <br /> ~(iEQUIREMENT . <br />: <br />. <br />.:.: - . <br /> SAMPLE <br /> MEASUREMENT .. <br /> ~~ .PERMIT. ~:. ~ ... <br />: ......, : <br />... <br /> <br />~ ~~~~ .: <br /> REQUIREMENT ..::. . <br /> :~ ... <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ . . .. ....:.. .:.... ... <br />:. <br /> ~REQUI.REM,.ENT: <br /> <br />.... .. <br />,: <br />: ~:. .. . ,... <br />.... .?,k :: .... ~~ <br /> <br />......... .. ....~.... <br /> <br />~~ ~~ <br /> <br /> <br />~~, <br />NAMElTITLE PRINCIPAL E%ECUTIVE OFFICER I CERTIFY UNDER PENALTr Of LAW THAT (.HAVE PERSONALLY E]tAMINEO MD <br />AM fAMILIM WITH THE INfORMATION SUBMITTED HEREIN <br />MD BASFD'ON TE EPHONE DATE <br /> <br />- <br />~ ; <br />Mr INQUIRr OF THOSE INDINDUKS IMMEDIATELY RESPOH90LE FOR <br />T <br />E <br />"' , <br />~ <br />:ICh. E <br />CI :~dli, OBTAINING THE INFORMATION, I eEUEV <br />THE SUBMI <br />TED INFORMATON IS / r/ <br /> <br />C 1VIr'ar;'?n~+[~I 1.',~n,:rlpr TRUE, ACCUMTE MD COMPLETE. 1 AM AWME THAT THERE ME <br />SIONIFICMT PENALTIES FOR SUdMITTINO FALSE INFORMATION,INCLUDING 1 <br />~ <br />If;170 87~-Z7~Z <br />T~ <br />ir~ <br />';~ <br />- THE POSSIBILITY OF FlNE MD IMPNSONMEMT. SEE 19 U.S.C. 1 1001 MO S7 gI <br />NATURE OF P111NCMAL EX <br />T <br /> <br />u.s.t. r late. /Aln.rs...aaa drr mtvn. mrr 4.rA,sr ra...y to sro,ODO Q <br />ECU <br />IVE <br />AEA <br /> <br />TYPED OR PRINTED <br />.Me.muinun Mp~iansnt olbMwl6 mmtA. alOSYwa/ <br />OFFICER OR AUTHORRED AGENT <br />CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANA LION Oh ANr VIOLAl10N5 lROrerenCe e!/ sttec/lmenrs nets/ <br />~_1TLt.:7~~ S~Lf~S i.ln1l nAlytJ tVrt 1LiYnr24Nx l.itCll' ~y_.7-,~.~-l.A.3r PG IVr fG;< rcc..I-:t_McATS. t.1L G <br />t,hlA~t unit SAr1PLi AIVALY;T:i riE.aU1RtJ IF VIS1dLt ~rit~~ I:, Lo~tairi:. i,IkTRLY SAMFLI~II, I/I~TItUCTIUNi-I.i..~r <br />1~;. , . <br />EPA Form 3320.1 108-95) Previous editions mey be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.( PAGE OF <br />JUl4t,/yb1U~1-1311 i <br />