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PERMITTEE NAME/ADDRESS (fnrL4 FarO,ryNaw/Loeenaw dDl)/awq <br />NAME L1h'r...~ .. .`r'1.,L .... -~.••1 . <br />ADDRESS Y ., ~ L :. U .; <br />S <br />LKM IU LU .. J <br />. A. <br />FACILITY C/r'n.,~ cf.l''14':. t,0i:l~LiitAF{(7N <br />LOCATION ~ .;~}.'aL6Z5 <br />E,nAav <br />:Tlh ,li.nac~ ... _t; ., LA, .,, i'NERtt MGK <br />NATIONAL POLLUTMT pISCHMOE ELIMINATION 9YSTFM 1/VPDE$1 <br />DISCHARGE MONITORING REPORT (DMRI <br />l1-18/ 17-l91 <br />R 1 4 <br />PERMIT NUMBER DIecHMGE NuMeER <br />Ali <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM U 1 TD '~ o v > >'~; <br />!167/1! .431 171251 116171 /78-191 l3P37) <br /> <br />Form Approved. <br />.. ~ . ,. ,, '.: f. - .y 1 n I ; ~. QMB T~o12~440--0004 , <br />ppro a expiree.05-31-98 <br />r ~ C 1'+4L <br />ri 1 i~...l <br />iV~ 1 ~i'~:a r'~I .<iap <br />NOTE: Reed IrLStructlons belw' eletln0 thls 1wm. <br />PARAMETER l3 Jp only! QUANTITY OR LOAD/ ~ <br />~ 11 Qrd Onlyl QUANTITY OR CONCENTRATION ND. FREOUFNCY SAMPLE <br /> ~I*6531 151-6/1 <br />''~' 138.151 14653 15b6/ EX QF P <br />131-371 YSIS <br />M TY <br />E <br /> AVERAGE MAXIMUM U T6 MINIMUM AVERAGE MAXIMUM UNITS reveal l61-BBl 16&70l <br />r:n SAMPLE ... {..y .,t# r.#{... der ~.{~.;. ;.:. ,. ~ 12 <br /> MEASUREMENT <br /> ~ <br />~ <br />~ .. .. <br />.. .. <br />' <br />' <br />~rf LVL..1 ur.,,7~ r..LU ,JREMENT <br />. <br />. <br />: .nI <br />'Mu,:.::: .. .: ..,~....:...~fY... '• <br />. IP~M•h ~'.~ :: .~. .. .: ': <br />~. <br />,,.Aj.:' F~$'?.pr ' <br />~.-L L.. ~r ~t TTLL1I. L:. S~PLE ;•,.., ;... ,. :.4#*6# ~4a#4# L~ <br /> MEA6UREMENT <br /> <br /> :ilrr#«.~~ ~:..>r#>~~1::: #K... :.,~~;,~t* ; -;G.,-I;ar ~..~ 1.~~ :~til, . <br /> :REQUIREMENT ~ ~~:' ~ ~ ~~~~ <br />r . <br />., a~ .:L~ ~nL,+~L SAMPLE ,.t###%• 4Y:. ,,.:. ,.: ,:. ~•~#4 #.?~..}h.,. 19 <br />LItL~~.. L41 n_ .~..r ytT MEASUREMENT <br /> <br />Vv»v . ~: ., <br />~~ PERMIT <br />tS•M;!rF #r :'~<. <br />~~:: `:~I#k~Ork iL <br />: <br />,. •:~ <br />,: ,:~~:~w::::~~ <br />;: ur~l~##+~ .. ... <br />~i:t~.:~~~:<:~;~,...~ .. <br />~:: <br />~`J~~r-~:~i~ <br />~~ta:.' . <br /> <br />~Ft-LUL~+1 hkVS~ YAL,r <br />'REQUIREMENT <br />: ..-: . <br />z:`:_':. ..::: ~~.: <br />.};..; ,. <br />~ <br />:::`:~.~ ~.: :' <br />.:. ~.: ~ <br />, <br />N~ . <br />,.._~1 .:~~. <br />~~. <br />l L:,nr 1'V 111NJU1T L7 SAMPLE u1 ${. {•a•r i+ #{•rt# <br />{~~h <br />1 Hh, i1 T`~t r.TNt:JT h•L Ai`rI MEASUREMENT <br /> <br />:~.i~v 1 U U <br />PERMIT <br />kL_r ~;^;( <br />~~~~: i~E~?C1~it.T ~.:'~ <br />~ <br />~4r&iid•s=•t <br />v#+fil#*~: <br />~~~~IF 01&~+R~i~# <br />..•,} , .. <br />~I~L:../ <br />i'i :i T:. f: <br />~Y1 Lui :.T t,hU~S VALUC REDUIREMENT j{i:iA. N1't, uAl 'Y. MX" ~ ~ :•r?•ti• ,',: <br /> SAMPLE <br /> MEASUREMENT <br /> ~.~.~ PERMIT ~.. :. .. .:..::. .: .. .. <br /> <br />~ <br />..;: <br />~ ~ <br />:~ ~ <br /> <br />~ <br /> REOUIREMEW7 ..... ~ .... ~ :. . <br />. . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT. ~ '~~ ~°~ <br /> REOUIRENIEN7 ~~ <br />., :.. .~ ~ ~ ~. <br /> SAMPLE <br /> MEASUREMENT <br /> ~+~A PERMIT <br />~R6.QUIREMENT: <br /> <br />c. <br />NAMEITITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF L <br />AM FAMILIM WITN THE INFO AW THAT I He PERSONULr E%AMINEO MD <br />RMATON OMITTED HEREIN <br />M eASFD ON TELEPHONE DATE <br /> ; <br />MY INQUIRY OF THOSE INDIVIDUALS§~MMEDIATELY RESPO}l9BLE FOR _ <br />r„ <br />IC11FI r(! 'VIIIIS <br />OSTNNING THE INFOMIATION, 1 eEUEVE THE SUBMITTED INFORMATION IS <br />I ~ .~+ /~ , <br />~ i• <br /> <br />Fr <br />i <br />t <br />l "' TRUE. ACCURATE MD COMPLETE. 1 AM AWME THAT THERE ME <br />SIGNIFICMT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING ( ~ ;~! <br />~ I <br />~97~~ R'0-271 <br />1(1 <br />~ <br />9f, <br />.v <br />ronhen <br />a <br />~na~~er , <br /> THE POSSIBILITY OF RNE MD IMPNSONMENT. SEE 10 U.S.C. 1 1001 AND a] TURE OF PRINpPAL EXEpffIVE <br /> w. ~ m 1/0.000 <br />~c~ <br />a <br />/ <br />~ tLIONA AR A <br />TYPED OR PRINTED ~ <br />eM Ormv <br />inun <br />i.~+ialnwre/a « <br />.na+rab n.s OFFlCER OR AUTHORRED AGENT <br />CODE NUMBER YEAR MO DAY <br />GOMMtN IS ANU [AYLANAIIVN Vh ANY VIULAIlVN5 /RB76/iOCI I//IffeCOOlenr90e/i/ <br />,Lif~L.pLaL S,;Li:.; Llhll nA1YCU F„~ 1~Y~rZ'rlit Fr:Luar' :',._:,l-~~_ i....5r I'•,, Lyr rte:. n:_IUIr.~`!l~rT;. .,IL <br />vn~N~L UI.M."i .:A1~1 f'~LL .. .AL.Y ~1] Kt JUin~.i 1f' J1SIULL -+~t~~t. 1~ _-..iL:~.Yk J. 1; 1KLY ~E. 1r'L 1:i I. l..~T4uL~IL.~. ~~l el.. ~r <br />3320.1 108-96) Previous editions mey be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.) v v i / 1 / y v i u u 1-1 311 PAGE LOF <br />