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PERMITTEE NAME/ADORE55 R,.dil.fxWryN~dlorana.VD,)Jir•n) NAME PLIYDERH^:t,y CUAL CJii'.li.Y ADDRESS ROADSIDr H,i C'., N ~. ~ FJN.i 4:,. P.V. 80:( 1'.30 PALi~RDe: ~., ::I ,lu FACILITY LOCATION .:L7N: JG.1- A. ..~_?..4V- F,:r.~tnFST .NATIONAL POLLUTANT DISCHNiOE ELIMINATION BYSTEIA (NPDESI DISCHARGE MONITORING REPORT lOMR1 /Z-181 I7-19 ;.170017146 8 PERMIT NUMBER DISCHMGE NUMBER MONITORING PERIOD YEAR MO DAY YEAR MO DAY FROM U TO U tlM10I1 07J21 04]51 !]6]71 l18-291 !36311 - - .. _~.-J:orrti APProved. - poxp a tv cgia~ag'~"1~-e42°-oos3,>~~- (SUER YC) i~~~7 e - Ft!IAL ; "'INGR NOTE: Reed In•ttvctlon• b•lor• eompl•tlnp thi• form. PARAMETER !3 Grd On/yl QUANTITY OR LOADING l~ Grd Onlyl QUANTITY OR CONCENTRATION NO. FREQUENCY - SAMPLE 146-531 15b811 /3Bd51 46531 151-5/1 EX GF TYPE l32-371 ANAyYe3 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !F1-FJ! 15I-5B1 r59-701 :'f1 SAMPLE rC>Y:^.4 #3##Y-~ 0'J#aya' { j2) . MEASUREMENT .iUvliU 1 U 0 ~~. PERMIT Ut~'+i#i4`~- ~ ~#;tLI*O# =t =7: •~J ~~~`~~~ ~~0 ~ ~~~. .E~(•'.j.Y ~S~ITU r.r F'LUEN'C L;HOSS YALU ':REQUIREMENT ..: , . .: :;, .:~ ...~. .... 0#G# .IlY 14I tlUI4 ~ . .iyj i,I DS, COTAL SAMPLE.:' O4~#3# ~ #41ilOL. •O#+R## ( 19) .U~Pdt/Dcu MEASUREMENT ~. .: ~UjJ I: 1 U U >,=s~;;PERMIT::.?3:~ :+s .::.~: :. ~:~$L>K~S~>Oc 4+OW1 .~.3:.?.0:!M7F~?d ..~" ~~ ~~~.. :~~~i' ~ '7~~ ~ ~ ~:~~ ~'~~.~~~ :~ i~~ FrLL'Eh'C GROSS YALU [~REQyIHEMENT . .,. ... - #Y~~ . . ;~~pj ~~ .. . 'h . : iOLI :i, SETTLEABLE SAMPLE '~S#;:;:.' .-:;:#;:Y O#'Q?#0 { ZS) MEASUREMENT ~ ' ~U:f45 i ~` "b ~ PERMIT v#;%.`.'~:: '::ta~:~+# ;::rY "~ #$##:~L- REPORT ~HBF03T _t 11CE/ ~ : { T t EFLUENT GAIO$,S YILUc REQUIREMENT #L`S~ 30E.A AYG ilA.I Y C!Y !4L/L 1 M H . :. 1. I MU , TOTAL SAMPLE ,. • . - ;=#OOfiO >r=}~J :'s'„' { jg) (AS P$) MEASUREMENT J1J4S 1 O 0 PERMIT ~:tc~$>Yt; x#ICrllr~!>a A## 3###%2# 3•S 7,•Q i i7G'EJ ARAB ,Fr'LUEBT GCIUSS YALUE REQUIREMENT •oaE 3001? AV6 1f.AIjY t}I nG/L KOHTH ;IL RAID •.;BEASE SAMPLE yr#,`•,=;= #G##9 IG#=:+74; { jq) MEASUREMENT )3Sb1 1 U D PERMIT S=v##>$YF ".~-Bp¢%F.O O: a:irl~Ycx# NEFD$t 2Q.. ONTIN 'aAa FYLUEN: GROSS YALUE REQUIREMENT ##,^•0 30DA s46 RS..`.1tAY G G 6 'LUrr, I. CONDUIT OH SAMPLE ( ^3) ~#6#*>~=^ #:#t+r-: #t###;: -~Y.U TRc.ATt1EST PLA ST MEASUREMENT ,uJ~J 1 U 0 PERMIT ;i::E'.):i'1' HE;PU&T ¢L'#'~`+'•+ ##4##tY i`.rtb+A## #~'!' EEKLY :gSTAq rrLJ6NT GROSS Yr. l.~:c REQUIREMENT 304A AYG DAjLY PIY rGU ##r# .UL , COTAL SAMPLE ~t{=:%-'•:~ %k~:ri.~~~vk b0#1>'kL ( j9) „35JLVtu MEASUREMENT '_:.'y~ L O PERMIT ~=##~#x~ "##t:zu #4=} aae#>k# BEfOA3 REFCRT TRLY :RAH .FP'LUEhT GRC'i`.~ Y!Ii.Ut' REQUIREMENT CGF ..QRTF AYG .¢R'fA I7.AY KG/L NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTI AM FA FY UNDER PENALTY OF MILIAR WITH THE INFO LAW THAT I HAVE PERSONALLY E%AMINm AND TELEPHONE RMATON SUBMITTED HEREIN; AND BASED ON DATE Ir~~ T ~ V ~ ' MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTNNING THE INFOIMATION, I BELIEVE THE SUBMITTED INFORMATION IS T T E ME I- ~ HER TRUE. ACCUMTE AND COMPLETE. I AM AWARE THA SE INFORMATION INCLUDING TT FN ' l ~~ ~ C , SIGNIFICANT PENALTIES FOR SUBMI ING . THE POSSIBILITY OF NNE AND IMPRISONMENT. SEE to U.S.C. ! 1001 AND 77 T E ~ Io ~ ~ ~ 1/1 Q / E• 1 L ~ / ~ r. l u.s.e. !tats. rAN,rs. l+w o+r mron, m.r heA.ar lx., w ro s ro,oaD SIGNATURE OF PRINCIPAL EXECU R/ AR A TYPED OR PRINTED +rM •' nl++im+n LeWl+ar+,N•eWMnrr+n emvnN+rM F yrs/ OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY COMMENTS AND EXPLANATION Vh ANT VwLAI IOND I/rerersnce en ertecnmenre nerel ,cC'fLtAbL:. SOLIDS LIY.IL' APPLI$S UALY I? <1~Y8,27H8 PRECIYITATICN £VEF'[ IS CLAIMED. PEkT.I'C'L~E HAS J:.Jdtl JP' E'30oF Y9}ih Hb.~bE.°rI'IiV6 HtLIcF FtfJh 3E.TCL°,AoLE SOLIDS PFIMAEiY LI"ITATIObS. EPA Form 3320-T 108-951 Previous editlone mey ba used. (REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.1 n U 5 3 1 / 9 ~ C 2 Z 3 - 1 9