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PERMITTEE NgME/ADDRE59(lnd.b FeculryN..r/fec.ao. ~JD~f..ml <br />NAME „jr'nu"~ : .~'i~~c Cam;".':..t .;11,,;, <br />ADDRESS {' iJ Jul o . <br />i.KAlu <br />CU b1626 <br />FACU.ITV ITPItUS kMPllic C1Jk?;JkATIUN <br />LOCATION(~A lu .-CG dlo2'3 <br />a I TEr M 1{HAtL ~+. LUl)LLL r ,thkKA1 MG12 <br />..- <br />NATIONPI POLLUTANT OISCNMOE ELIMINATION SYSTEM (NPOESI <br />DISCHARGE MONITORING REPGRT lDMRI <br />12-181 ;~ li]-19 <br />PERMIT NUMBER DISCNMDE NUMBEn <br />MONITORING PERIOD <br />" Y .MO DAY YEAR MO DAY <br />..FROM ,~ y 70 3 0 3G <br />l1 -231 1162 I • :~ !16171 (18-191 I30-311 <br />ForB~r,A~m Approval. <br />r. J L . ~ _. iv' 1. ,. 1 ~ O"TB No3 ~nD`N)t-QOC4 <br />Approval exglres ~-3'I-98 <br />JUDM1 NN L 47 <br />F F 11i:+L <br />M lit lJ~~ <br />NOTE: Rerrl instruclone bsf eo bUny this form. <br />PARAMETER' !3 Card on/yl QUANTITY OR L .. 1tGid Onlrl nUANTITY OR CONCENTRATION NO. FREOVENCY SAMPLE <br />l31-371 ~ M653 15s-e1 - '+~,7-' -151 146531 /5467/ EX DF TYPE <br /> AVERAGE MAXIMUM UNIT " '~'e IMUM AVERAGE MAXIMUM UNITS <br />la7-a J/ Maras <br />151-881 <br />169-701 <br />~L,L1J~r )uTAL SAMPLE 9~#Y~~if ~~4+••?,••• fiP*>f* 1`? <br />J1~J~LV", MEASUREMENT <br />T~L`Ji 1 (i J ~":,..?E.RNIl7.:::~.:.' :..:~:.il!O"#(!Ik~... : <br />.` :.. . iF+llif::~?1'~".... ## t~.i~~y:. : <br />. <br />il~~f'1~~T'~ l~i~l"~L/7ti li:I., ~ ~TYLl.~~ RAtl <br />;.rrL~~nT ~k'~5 bALJ ":R.EnUIREME.KF; <br /> <br /> <br />...:.... ....": is ":: <br />: ..":. <br /> <br />... .: <br />'... <br /> <br /> <br />.. <br />Sir%4.t <br /> <br />..'Ri:i.`c:...H .. <br /> <br />a": . <br />.. <br /> <br /> <br />... <br />` . <br />" SAMPLE <br /> MEASUREMENT ~ ' <br /> ~_PERMl7: ~ ~ ~ :::. . . <br /> ~ ~ .::,y,., ... .. <br /> .... <br /> SAMPLE <br /> MEASUREMENT <br /> •:;;:~:.PE ........ <br /> <br />=:: <br />.: <br />..;; .:[i.E.fTkILREMENT. <br />.... " ~ ... ~ ~. ~ ~ . " , <br />:...: ~~. ;`..':'. ',:::yri .~ ~" >.::~ .. <br /> SAMPLE <br />" .• ~ MEA$1{REMENT <br />" " <br />.... <br />,..... <br />..,.... ~ MIT- . <br />~:. . <br /> <br /> <br /> SAMPLE <br /> MEASl,~REM~NT <br /> ... .. <br />'. a,:~~.P.ERMIT s....., <br />... <br />:.. <br />. <br />..... <br />... <br /> <br />~Hfit2UIfaEMET1T~~, . <br />. <br />~-. ~ ~~~ <br />~.-s. .. ....~ ~, <br />~ ~ ~ <br />~ " <br />" SAMPLE <br />~ ' <br /> MEASUREMENT ~ <br /> a.?.:..PERMIT:. , :.>... ; .... <br /> ;h~T1UIRf:`INENT : .;. ::.:... . <br /> ~ <br /> . sAMPLE <br /> MEASUREMENT I <br />- .::~•: P MIT";..,: .... .:::.::;e.. ..,.... <br /> <br />,. . <br />:, <br /> <br />,. <br />...::. .. . <br />:o:..... <br /> <br />~~ <br />NAME/TfTLE PRINCIPAL'EXECUTNE OFFICER ICFRTIw UNDER PENaTY Of LAW°TNATI MAVEPERSO <br />AA~MA fM11VAR NAtH YNE INFI1RMAilON' SUBMITTED H NaIr EMAMIN <br />EREIN; MD BA ED MD <br />SED ON ~ TELEPHONE DATE <br /> Mr <br />'INOUII{~ OF TNOBE ~ D <br />VIOIIALB IMMEDIATELY <br />REBPON9BLE TOR <br />k <br />:III <br />- <br />i 1 . <br />. <br />~ <br />OBTNNINO'7NE INFOIIMATI011 <br />BEUEVE`T/IE SUBMITTED INFORMATION IS <br />[I : /~ <br />II:h7E <br />1 <br />S <br />l <br />Ag ~ <br />~ <br />TRVE. ACCtMATF MD COAJpT,QE. - AM AWME THAT THERE ME <br />INCLUDING <br />SIGNIFIOANTPENALTIESFOR'SIIDtl116B66RRMM//ITNMOfALSEINFORMATON ~ <br />9IO 870-Z71 <br />IO O <br />anatT@h <br />Fnvironrrlental <br />J . <br />H <br /> E PO551BIUTY OF FINE AND IMPWBONMENT. SEE 18 U.S.C. 1 1001 MD 34 <br />T <br />' <br />SIGNATURE OF PRINCIPAL E7EECUiNE t <br /> u.s.c. s /ale. /nn.ro <br />..I.dr dr... mrun, Is.r Pch.a. r..,.o ro F1D,psa AREA <br />TYPED OR PRINTED rld or mailxnr:nP'I..mwrlrwMr...n ameaN.rMaywsl OFFICER OR AUiHOQRED AGENT CODE "NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rrfsrencs el/sttechments hers/ <br />JLTTLLADLr_ 5(IL1J5 L11•111 nAIVkU FUk l0YKr24riR PntCIP "tVktJ7":itc 1.A.jr PU IVr FI,~ :.,.l.Ili~MthTS. i,l~ v <br />uhL.ASt G+<Ab SAMPLE ANALYSIS kt~UIkEU [F vlSieLk SNE!`N 15 L~StI~VEO. u~tT~LY ~;,:^.F~:LU [N;TRUCTIJ'~5-i.(,.,, <br />EP Farm 3320-T 108-95) Pravioua editions may b'e uead. IREPLACEB EPA FORM T-40 WHICH MAY NOT BE USED.) J04 U 3 / 96 L UG i' 1311 PAGE 1 OF <br />