Laserfiche WebLink
PERMII-EEE NAME/ADDRESS NM.bfrWryNewbGoeanm rJD~irewq <br />NAME UrI~~JS tNr'[kt ~, LSKYU:<y[[',.1 it <br />ADDRESS•`~ U 6(; X O J <br />i.xAio lU F316L6 <br />FACILITY i,YPKUS cnPIItE CckVUKAT i(1N ~ .' <br />LocAnor>(KAi.. ~Li tllal5 <br />e I IK M71 NA41 111:11 r!.,_ -~ rJLQAI bGY <br />Forrn NApproved. <br />O`MB 1p L2040-9004_ , <br />~;'L j L .; ~ r .. 1 ~~ I, ..-. t IApprovl e><Q7es OS-31=9B <br />'~IJuK f7d 1~~~~~~: <br />F- - -lyaL- <br />n ! N:1K <br />!.*a NL, Li1SGhtAFC~c '}+`+` <br />NOTE: Reed IrntruetltNa bet«s eompletlnp this form. <br />PARAMETER ~ !3 Grd Or7/pl QUANTITY OR L rd On(YI QUANTITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br />13?-377 M~531 15e-61f~ - 738x51 M~53 /5a-611 <br />EX of <br />ANALrsls <br />TYPE <br /> - ~ AVERAGE MAXIMUM ~>. NIT~~ MINIMUM AVERAGE MAXIMUM UNITS lea-e.Tl (se-88( ls8-7o1 <br />JIL AhL1 l,htA~~' SAMPLE <br />R <br />T ~.q}fry<;< (!i FrtiFill4 1`##ek# ~`:`;'+'Yi <br />• N <br />S <br />[ <br />J <br />1~UAL MEASU <br />EMEN - - ,: <br />~-- I <br />UA <br />- <br />4;JOt 1 U 1: ?§¢~! ?M#+lR!(y Y i #IIN-?IRI~ '~`##~ <br />N ?faNP## <br />#,.,; . ; <br /> - <br />REQUIE[ EN~ '~` ; <br />r , <br />- SAMPLE <br /> <br />'. MEASUREMENT ~ "~ - <br />m .. <br />. ,.. <br />:~::;I P~RN117.: '. r:. <br />[~EQULgEryFEN'F~' <br /> <br />- <br /> <br />'s <br />::a <br />~ <br /> <br />^ <br /> <br />BAs;? <br /> <br />`~?~: <br /> :: : <br />.. :. a, <br /> SAMPLE <br /> MEASUREMENT <br /> •~::.:yE ~~ .. .. ., <br />~ <br />., :REQUIREME(Jf' .~ ~~. .~ ,~ ~~~.~ <br />~%~::' <br /> <br /> SAMPLE <br />. '~ MEASUREMENT ~ ~ . <br /> ".: PERMIT .: <br />" :pEQUIREMEN7~ <br />'~* <br /> SAMPLE! <br /> MEASUREMENT <br /> ,,a ..,.:!..: :i. ::: i.. . <br /> <br /> SAMPLE <br />- MEASUREMENT <br /> ::.PERMIT,.:..: <br />: <br />: .. <" <br /> _... . <br />• .. <br />... <br />,. <br />- ~~ SA' PL <br /> MEASUREMENT <br /> .. <br />-. , <br /> 6 <br /> ~ <br />NAMEtTITLE PRINCIPAL EXECUTIVE.OFFICER I c gTI <br />AM FA Fr UNDER P.ENALTr OF LAW i!{Ar 1 NAVE PEnso <br />MILI NRTN THE INFORMAT~O SUBMITTED H NULY ExAMINED AND <br />EREIN <br />AND BASED ON ~ TE~EPHONE DATE <br /> ; <br />Mr INQUIRY OF THOSE : NQNIDUAIS~ IMMEDIATELY gESPON518LE FOX <br />OBTNNING THE I <br />EVE THE SUBMITTED INFORMATON IS <br />F <br />fOeATI~N 1 SE <br />~ <br />7 <br />~ 5 ~ <br />ichard ~,IIIIS <br />F• B <br />O <br />U <br />T THERE <br />T <br />ME' T <br />R J <br />. AND COM EErfE. AM AW <br />HA <br />TXUE• ACCCURA <br />E <br />A <br />INCLUDING <br />NALTIES FOIE e~R711TIN~EALSE INFORMATION <br />SI <br />NIRCANT P <br />/ <br />9]Q Q][]-~7~2 <br />~~ <br />~'~ <br />QO <br />En VIYOIl7!1 f'ITtBI hi3!l3(Pf , <br />D <br />E <br />THE POSSIBILITr OF HRNE AQD IMPRISONMENT. SEE 18 U.S.C. 1 1001 AND 33 T <br />R <br />PF <br />N <br />EXE • <br /> <br />U.S.G.. f 131-. /ArrWaiF wW tAFw mwn. P.FY icAMr r.1.. w ro J 10,000 SIGNA <br />U <br />E OF <br />II <br />CIPAL <br />CUTIVE <br />AREA <br />TYPED OR PRINTED ~or.ru. iro+iw.nw~t orbnrwn 6mmrAa rw6rwnl OFFICER OR AIfTNORI2ED AOENi CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION Oh ANY VIDLAI IONJ ~I170/Bre00e~-/I -rreODments nei~) <br />~-L..~ l-11h1T. APPLILy Tu LUMdI+lEO F,LOM.FROM 003e OC2 z. G24, AIL !: bK~ASE uIZAd SAi,lt'Lt ANALYS[~ ~•c~UiKCL, IF <br />vl~,i.,~. ~a'~cN IS L18SEKVtU. NKTRLY SAMi~LINU 1NSFRUGTIuNS-I.C._`t PG X. <br />EPA F«m 3320-1 108.951 Previous editions mey be u-ed. (REPLACES EPA ORM T40 WHICH MAY NOT BE USED.) PAGE OF <br />L1USjb/yol~ul-1311 1 <br />