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PERMITTEE NAME/ADDRESS p+iid. FsWryNawdLOrula VDfJJw,u) <br />NAME POYUEkBUaN CUAL COGPAKY <br />ADDRESS RUAU~ID, Ci ti ~', N ^; ~ pUR'YALS <br />p.J. l'.OA i41~` <br />PALL~Al1y: CU cl'i2o <br />FACILITY <br />LOCATON <br />a:lA: JJrn A. 'CHAS, phE3IUEVT <br />NATIONAL POLLUTMTDISCHMGF ELIMINATOM SYSTEM /NPDESI ~ FOIm APPfOVed. <br />DISCHARGE MONITQRByQREPQRT /OMRI <br />Tars/ _ _ f7-rsl POII.'~ ~ .TO _GOy.T___-MIGnA~.yor 2D4o-4QD6~ ~ <br />0000 7 4 (BURR iC)' - IYpPro e[e~p~itscD'S-' -98 <br />PERMIT NUMBER DISCHMGE NUMBER F- F I A A L <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM V V U TO U <br />170-711 l77-131 114761 /76-771 /79-791 !363/1 <br />MI1:CH <br />NOTE: Reed InetrYeUone belor' completlnQ this form. <br />PARAMETER l3 Grd Onryl QUANTITY OR LOADING 11 Grd Onlyl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE <br /> /16-531 154611 138-151 146-531 154611 EX GF <br />137-371 <br />MA1Y515 TV PE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS m7-e]1 /5s-551 1s.~701 <br />c1 SAMPLE ###:-? #r#,I#; R:>7#### ( 12) <br /> MEASUREMENT <br />' V4UU 1 O U PERMIT ~ ~ #3-i1c## s`.OFC->Sit~l ##F .5 ~~ ~t#S### 9.0 - ~ ~ EL-k4Y YSITU <br />eFFL'JENP GROSS YALU REQUIREMENT ~>x.;0 h:IRYlIUA ~ A <br />~ <br />~ULiUr, 'YGTAL SAMPLE ##p### ##II### #9##0# ~-i9) <br />J.i P E N U d G MEASUREMENT <br />., v ~ iU 1 0 0 .',':PE.RMIT. ; : ~~:~'C#'#auYCt :. .:~ /Ctt41k+RA O# ?'z13+01?il ~ ~ <br />~ ,33 ..:.. .' TQ ~ <br />.. ~ '~>;1 <br />~C~ . ~ ~A~~ <br />:;rF'LUe.NT GROSS YALU RECIUIREAAENT. ."._ ': 16X+~3 ~ <br />~ ~ ~~ 30DA 1!G 9A ~' G/L ~ . <br />, <br />CN . <br />~iJLiU5, ::BTTLEABL6 SAMPLE #;:##::: ####;+# ##30#3 ( ~5) <br /> MEASUREMENT <br />)U~45 1 0 0 PERMIT #~.##tF# ##: #t73 #;;: ¢##### RE EO RT R8 ~06T RCL/ ~ :tEA <br />FFLUhNT GROSS YALIIk; REQUIREMENT ##S: 30UA AYG GAILY rX RL/L K H'TR <br />L rtJ il, TUP SAMPLE =.#:;c :.~ .'.:##~+`.~ ##34'9: ( I9) <br />(Ag% ~H) MEASUREMENT <br />~1J4S 1 0 0 PERMIT +~#.-4'."•# #:SOC;## ##:: #40ytS# ~,5 ?..Q 1{CE/ iBAA <br />:FFLU7:N'Y 6ROSS YALUE REnuiREMENT Y#G7< 30DA AYG 1fAI: Y !fY RG L lIONTN <br />ALL ARU G 6'ASE SAMPLE s#a<:;r~ ;~##;;o ##3##X ( Ig) <br />' MEASUREMENT <br />~35'J2 L 0 0 PERMIT v=y'~#:=v ~?=f#RtrS~r ap fi.~:~3 t-1G~7pt,0 RC' FORT 1.U ( ONTI'~ iRAB <br />FFLUENT GROSS YALUE REQVIREMENT -;:# 3CDA. AVG IAS7 l:AX MG L G NT <br />' LJw, IN CONDUIT UF. SAMPLE ~ U3) ###4#:' #X#>C#:~ #X3:X~# <br />IO nU SREAYRENI' PLAN/ MEASUREMENT <br />~ilUSO 1 U U PERMIT N3PORT L?tPORT +'-'~#>+*.# #~X3ris -3tYX##>;< #*# i E~'KLY. 15TA\ <br />FFLUE:IT GROSS YALUE REnuIREMEN7. 3UJA AY8 DAILY t1Y NGD #### <br />;UL US, TOTAL SAMPLE :#u:;:r =x~##~# #o#~t; ( Ig) <br />1IS~uLYtiU MEASUREMENT <br />lJ1~5 I U U PERMIT ~~~~~+~ ?Xt3##4 al • rr r-3#X+#c R6iafiT REPORT TRLT :4AA <br />ik'FLUEN'f GHO55 YALUE REQUIREMENT a## QRTR AYG. 4RT~ NAY MG/L <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I cERnFV uNOeR PENALTr oP <br />AM FAMIIIM WITH TXE INFO uw THAT I HAVE PERSONALLY E%AMINED Mo <br />RMATION SUBMITTED HEREIN; MD BASFD ON TELEPHONE DATE <br /> <br />S+fl L E r <br />T <br />E MY INOUIRV OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br />OBTNNINO THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS <br />,~G_.` <br />. <br />. TRUE. ACCUMTE MD COMPLETE. I AM AWME THAT THERE ME <br />INCLUDING <br />SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION c.~~~ <br />i <br />~ <br />~ , <br />E POSSIBILITY Of <br />PRISO <br />MENT <br />S <br />1 1001 MD 77 <br />S ~ ~~ 'I <br />~ U/ <br />'~~ Ll l !. ~ 1 <br />~ <br />. <br />Q p n . <br />TH <br />RNE MO IM <br />N <br />EE 18 U. <br />.C. SIGNATURE OF PRINCIPAL EXECUTIVE 7 J <br /> U.S.O. L 1]10. //rNI,10i. urW Orr .eroroa rrry Ycpnd~ Arr. W ro S 10,000 AREA <br />~ <br />TYPED OR PRINTED uldnmuinrn M,vlewrwrf olWMwn emmN.IMe ywval OFFlCER OR AUTHORRED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Reference el/attachments here/ <br />.~t.T'iLEAtiLh SULID5 LIN,I:S APPLIES UNLY It t=1+JY H,24ilk pRECI PIT?+TIU'+ EV1•Y7 I.; CLAI:'i L. 2::HCITTEEtiAti <br />rIUHUi.N OF PHU.;^' w9F.N khuUcSTIHG Re.LIt'Fr'nUN dL'TI'LEAbLE' :iULICS 4fiICANY LICIT-ATICAS. <br />EPq Form 3320-1 103.951 Previous editions may be used. /REPLACES EPA FORM T40 WNICN MAY NOT BE USED.) 0 OU 5 )_ / 9 8 C 2 2 3-1 2 S Er PAGE ~ of <br />