Laserfiche WebLink
PERMITTEE NAME/ADDRESS /Ircbb Fartl.ry Nwr/[oranm JD,g..enp <br />NAME C.n:: ~.U.i 1• Li; :'E'f. ~.1 <br />ADDRESS C L e It h V• ~ ^: I N Y. <br />FACILITY <br />LOCATION FRf <br />, - t+;,nL <br />i :•U 1'. <br />Form Approved. <br />OMB No. 3040-0004 , <br />APProvel izpl~~r9e OS-31-98 <br />NOTE: Re>rilctions bdon col~Ietinp thie form. <br />PARAMETER l3 Cerd Onlyl CUANTITY OR LOAD( !4 Grd Onlyl QUANTITY OR CONCENTRA ~ NO, FREQUENCY SAMPLE <br /> !46531 154-61/ 138.45/ /4653 !5461) <br />E'Y GF <br />TYPE <br />l31-371 ANALrss <br /> AVERAGE MAXIMUM S MINIMUM AVERAGE MAXIMUM UNITS a=.sai l54-6'81 /53701 <br />i. L, .`,•,. :i-1 ~t 4:, i1: ., <br />~ SAMPLE .::4:, >.;i ..:, (,'. .:; ,}:}:r :: .. .:; :y F; ( Z~ <br />L., t. i (. .. ~ r ;. i; i n MEASUREMENT v, li / )~ <br />, nG~v 4 ~ PERMIT 4%}X~yA :F IC< ~'~: ~7Q~/4i, >r ..: .,.:.. !~ <br />~ :?re.:}.^s ~ F:+:F'::•:7 i~'%3 , ~. <br />•~~~- t","`~: <br />~: : <br />N~I.~Y.~ ~'l ii ti~ <br />E. <br /> :REQUIREMENT ~ r' <br />~ ~ <br />.. ~.5~ Oinaii F: 3L~... ~~ SAMPLE .:: ;~~. - 4710: ~~:~ 1'. ~~. ty.. {r ,r ;. ;1: ( ~[3 1 <br />i +Y~Lr r,,;iC:. MEASUREMENT ~~~ a /( .! ~/~ <br />i h:.:.. i G C PERMIT KtU:r+i•):: ~:'0>tOF7tiit+. :'si:+! y.::: ~ .... ~-~Ytv'ra +::.=1=AS's- ~ r.~.- <br />~'~~; T::iIL..Y. <br />~i;~. .4itH4. <br /> <br />..Fi•LULt.'L ..n ~.,- vl~L~l <br />REQUIREMENT <br />~ <br />>.: A, .. <br />-ti 'r; ..$' <br />~ ~i . <br /> SAMPLE <br /> MEASUREMENT <br />~ <br /> PERMIT ~ ~~ ~ ~ ~ ~~ <br />~~~ ~~ <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~ ~~ ~ ~ ~~'~ " ~~~ <br />.: <br />. <br /> REQUIREMENT -' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT : ;~~ ~~ <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENAITV OF L <br />AM FAMI <br />IAR WITH THE iNFO AW THAT I HAVE PERSONALLY E%AMINEO AND <br />RMATION SUBMITTED HEREIN <br />AND BASED ON ~ j' TELEPHONE DATE <br />~ . <br />~ l ; <br />L <br />MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY flESPONABLE FOR /~)' <br />~.- ~flr, <br />{`tfl I <br />/ OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS ~ / ~:' <br />~ TRUE. ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE <br />SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING ~, / <br />' " <br /> <br />~ , _ _ <br />G ~ <br />F 1'. I ~ ~ / ! , ~. / <br />(, 1 <br />t' THE POSSIBILITY OF FINE AND IMPRISONMENT. SEE 18 U.S.C. f 1001 AND as / ~' ~ ~ / ~ ' <br />. <br />TYPED OR PRINTED u.s.c. f rata. lP.n.hY. ww.. ,n.s m,vr.. nvr Ncxe. ~ • vP ro slo,ooo <br />AMwmvenu+r impd.pmrrnr of Mew..n empr,hr Arn>6YAN.1 BION ATURE OF PRINCIPAL EXECUTR/E <br />OFFICER OR AUTHORRED AGENT AR A NUMBER <br />CODE YEAR MQ DAY <br />COMMENTS AND EXPLANATION Of ANY VIOLATIONS (Reference e// ettechments here/ , <br />.rCr. l.nr_r Ir! `.-~. t'l.~.t LLidiL~ Of i.:il PAOCBDhY.B. ec:'L'+tl :' Lam.. li ~ J1.1i1 JTIL;hL Ct.lal G..Ti`. il'i t. 4;:1Li: :_ <br />Lt1.1nL LU +U'.e Jf' iL:.i ..;wdbL:,CSs AAU nT:ACr. ACU1'i ..:eSi,;_:Y a~.:+. n..r~/ai FGiih TU ;. i•. :.. Cl;rIcS vt nLi <br />NCB Ana ~A .. r:'- n: .t~. Ft LY+4' <br />EPA Form 3320-1 106-951 Previous editions mey be used. (REPLACES EPA FORM T-0O WHICH MAY NOT BE USED.1 J (J V .j ~ ~ 7 bU L U 1' G y <br />. <br />' PAGE OF <br /> ' ;,. <br />i <br /> i ... •rr <br />