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. _ - - <br />PERM(TTEE NAME/ADDRESS (/nirb FaAq NwdracaUm lfDrgu.wQ <br />NAME 4F Y'rn:.> _rl'L:. ;- l.;~n i'i~h.dlll.ti <br />ADDRESS r t. J 1. h U o <br />r <br />Ck.+l~ Gu u1D2u <br />FACartY i,irr,uS cHr'!kE 1, ..riri,kaTlL,A <br />LOCAnoN~KA lu GLi r161S <br />AITV~ M1LttAtL'.n• ~ ~-11)i I:N. ..tnIFRA1 MI.Jt <br />NATIGNAL POLLUYANT DIBCMAROE ELIMINATION STSTEM (NPDE$) <br />DISCHARGE MONITORING REPGRT IOMR) <br />n-1si lv-1s <br />1.~ 7 <br />PERMIT NUMBER DISOHAROE NUMBER <br />MONITORING PERIOD <br />AR MO DAY YEAR MO DAY <br />FROM ~ Q 0 TO 90 2U <br />'F2'..231 !14151 !1617/ l18-191 /30.311 <br />Form Approved. <br />0 8 No„ 204--0004 <br />~~ ~5pprovel expires 05=31-98 <br />F - rilvat <br />ti!~•JR <br />NOTE: Reed Instructions bel co latinp this form. <br />PARAMETER !3 iJ.rd On/P! QUANTITY OR <br />" /1 Grd OnIPI QUANTITY OR CONCENTRATION NO F OUENd SAMPLE <br />(3I-371 /46-53! (546(1 <br />. (38.15) i4G53) !54611 EX OF TYPE <br /> AVERAGE MA%IMUM MINIMUM ~ AVERAGE MAXIMUM UNITS /e]-e]I ANN.YSIS <br />!84681 <br />!6&701 <br />1L ahi. G,~EAjE SA PLE ~}#ii## <br />'4 <br />i04•>~6 +rs~+•xi•,• t•.•,•.'p•.: <br />V 1.:uAL ' <br />MEASUREMENT <br />'IVUb 1 L u :~~."~."~..R.ML.}~s~.:~. ~:`~'~~I:~±Y;~ti'i <br />` <br />',AL. <br />.?Y.....' ~:~"~~"~~<~[:.:;.: <br />~::~ <br />~~~ <br />1 <br />' S ~~"?` <br />~ ~. ###iT4# <br />' #4tt#~~k~~ tirv:• ~ 1i;L.! ia:J::L <br />FY-L <br />NI URF`S <br />YA~ E REOUIH~ME <br />N~: , <br />. <br />. <br />:: r <br />~:' <br />~:. <br />~ <br />~: <br />. . <br />. <br />:'...:.: ., ...~...".~,: :;!~si~ <br />s :: <br />:: "" <br />t <br />UC <br />$ . <br />. .. <br />.. <br />:.: <br />.. <br />• <br />. : <br />,::: ~.,,...., .~ <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> <br /> SAMPLE <br />. MEASUREMENT <br /> ":~.: ~: PER 1. ~ ..; , :. ~ .... :: ~ <br />, <br />~ >:~... .~.:: <br />. <br /> ... ..... <br />,. <br />f;EO.y.IR6MEFFt <br />.. ~ ... <br />.. :~. <br />.: <br />.. <br /> <br />...:. <br /> . ;....?4::...;:r:;::. <br /> SAMPLE <br /> MEASEIREM~NT <br /> <br /> fiEUUIgEMEfSt`. <br />,,; <br />""" :' <br />., .. <br /> SAMPLE <br />• MEASUREMENT <br /> <br /> <br /> ..:::.. <br />,.. . <br /> SAMPLE. <br /> MEASUREMENT <br /> ~r: PE~kiTy`:^ : ,.. <br /> , <br />;HEau1. M4N~, <br />~~~ <br /> SA Plfi <br /> MEASUREMENT ; <br /> <br /> <br />NAMERITLE PRINCIBALfXECUTIVE OFFICER ICERnFr uFtDER PENALTY DF Uw THAT (NAVE PERBO <br />AM FAMILIAR WITH THE INFORMATION SUBMITTED N NULY ExAMweD AND <br />FAEIN <br />AND BASED ON TELEPHONE DATE <br />' ; <br />Mr INQUIRY OF TNOBE IND(VIDUALB IMMEDIATELY RESPONSIBLE FOR r '~ <br />' <br />~ - " <br /> <br />Richard hhIIS OBTNNING THE INFORMATON, I BELIEVE THE SUBMITTED INFORMATION IS <br />TE <br />T( <br />A <br />ET <br />3 <br />RE T : <br />/ ~ <br /> <br /> <br />E:IVirolTlnental Nlana er (UEi <br />CCUM <br />µ0 COMPL <br />AM AWA <br />HAT THEPE ME <br />E. <br />SIOHIFIDANT PEHN.TIE9 FOR SUBMITTING FALSE INFORMATION, INCLUDING <br />THE ROBSIBILITr OF NNE ANb IMPNSONMEN T. BEE IB U.B.C.l 1001 AND ]3 <br /> <br />SIONATUIIE OF P111NCIPAL EXECUTIVE <br />I L)70 $~O_'t~''l <br />l <br />~ ~ <br />~ <br />~a <br /> u.s.c.tt3ts.ln.I.~/.•uwr rn.w mem, .I.r ilcNd.l .IprosrD,000 " <br /> <br />TYPED OR PRINTED <br />wa>mu:m.n :rwrmn.nr o/arwwn a A~.a,..e s vwr>•i <br />OFFlCEA 0A AUTHOAI2ED AGENT <br />CODE NuMSEA YEAR MO DAY <br />COMMENTS AND E%PLANATION OF ANY VIOLATIONS /Rate/ante e// sttechmsnf] here) <br />~~il~LacLc ~,~LIUS L[MiT HpIYtU FUR LUYIi324M1+. P1t4IF' I.Yc,vl-.iE~ IAA.St PU lYr FGk kt~UlrtLMrhTS. ',.LL a <br />untaat u.an SAMPLE AnAIYSiS RtdU11iEU 1F VISIBLE SnEEr~ IS l,u:iLKYtp. •.1RTRLY SAMPLIIv(, 1(.STRUCTIu~+S-l.u. ~r <br />EP Form 3320-1 108.951 Previous editions may be used. (REPLACES EPA FORM T-0O WHICH MAY NOT BE USED.1 UU 3 71 / ~o l uU l - i j 11 PAGE 1 OF <br />