|
<br />PERMITTEE NAME/ADDRESS pM~dr FaediryNawdfacane, dOr)J...,r9
<br />NAME PO~DERifOkN L:OAL CC: ;7e'ANY
<br />ADDRESSRGADSIJ:' ."C`~':, F ,. .~ FVi[TALJ
<br />P. U.dr,~ 1nJ.,
<br />PALISAft F; CD liiS2~~
<br />FACILITY
<br />LOCATION
<br />nTTN: JU.-IN A. ~'.~;NAb, ?;!E:~IGF.:aT
<br />NATIONK POLL$ANT DfS~C~NAADE ELIMINATION SYSTEM (NPDESl-
<br />DISCHARGE MONITORING REPORT (OMR/
<br />1-I6 I7-19
<br />~ Tn
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM O1 .1 :1 TD O1 03 J1
<br />/1611/ IlI-731 !14751 /I6-I7l l18-191 !363/1
<br />- Form Approved.
<br />POND 2 20 COL08AD~~~D~~,~oooa e
<br />p plre~05-31-98
<br />F - F'iDAL ,
<br />NI!:CF.
<br />"-'- 70 DISGIAkGP '-""
<br />NOTE: Read irefructlorr belor' pletinp fhls form.
<br />PARAMETER 13 Grd OnlYl QUANTRY OR LOADING !~ Grd Onlyl QUANTITY OR CONCENTRATION NO. FREQUENCY SAMPLE
<br /> !46531 154611 (38/51 14653 !546/1 EX DF
<br />I3I-371
<br />ANALrsS TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !s3-eJl !64681 169-701
<br />e n SAMPLE ?;: r^ ~ ~ := .. ,...
<br />#~^ ( I ~)
<br /> MEASUREMENT
<br />(.ODUU 1 0 0 PERMIT g.',<#g:,~g «,:;~V~^.- ; -::c: 6.5 >}z~##ao 4.0 R6%LY CN.STTO
<br />::r°LUENT GRfiSS YALUc REQUIREMENT ;:;-# K A Nn
<br />.iJL.LDS, TUTAL SAMPLE „g;: r~•;: ,,, ,-, ###gTP ( 19)
<br />SU-,tENUSD MEASUREMENT
<br />t:U~4U 1 0 0 PERMIT :~ ~. ...•. ...
<br />'r'A'v v:. -r ,,#t~=F# g=.`•Y (egg### ~~S ~ 7~ .~, f~[; 1./ ;RAE
<br />..FF'iJk:NT (,R03S YALD1 REQUIREMENT ,?g;:,~ Q V # Mnd
<br />~uL1US, SI;TTLBAHLE SAMPLE „:~:t:~: ~:;<::;:.-~ .##^#0 ( 2S)
<br /> MEASUREMENT
<br />'.10545 1 U 0 PERMIT ,;:rg1g ;:g«fir## «>;~• C##### A£FOAT RF:.EOFT t NC';/ :RAki
<br />aFtLJEKT GROSS YALU2 REQUIREMENT ;zgxg ~n P ~ 1
<br />ifGtl l TGTAj,.. SAMPLE , ~ C::Xe}::: : #g-^.:}-:-+` ( 1[))
<br />(AS >")•.) MEASUREMENT
<br />"IJ45 1 0 U PERMIT 4t::Y'r'{=: .',: Ct Y:;rr~ #=?~ :+g#~.`-7'.- 3.5, 7.0 jl ~:i / ;RAfi
<br />I:FFLUtNT GROSS VALU- REQUIREMENT 3nr,A Y; DA M t H
<br />JiL AND IiAEAST: SAMPLE .-..., .. .;}#:: :;: g,+~{~#'.: ( 19)
<br /> MEASUREMENT
<br />:J5b2 1 0 O PERMIT ;,##.~II+T:r`: :x«r#;-# #g; ##9rY## REFOAT L0 OItTi-+ .RAii
<br />r.FF'LULNT GROSS YnLU=' REQUIREMENT #g;=# 30 Y4 R RA 1G BEN
<br />LOi, IN CONUU lT 03 SAMPLE ( 03) '•`~3g;::3 ~'#t,,~'% -#A##''#
<br />Id1tU TRiiATMENT ~LAA MEASUREMENT
<br />Ii1U~U 1 U 0 PERMIT itF:PO$T YEPORT g0#g## #ga### :%#tC##g • '+tt:# £isiLY ;NSTAti
<br />FFLUtNT Gk'OSS YAL'JF REQUIREMENT 30DA AYG DAILY :1 :5 MCD ##;#
<br />;OLIDS, TOTAL SAMPLE #;t::.`.;:{; K:;.#fi## ##g~',yf' ( 1`F)
<br />-~I~SOLY ;;O MEASUREMENT
<br />JU1'IS 1 0 U PERMIT #wCL,nik# ##gC,'t# ., ;: #Q### REFnJRT R£FGRT TRLY •riAEt
<br />E'FLUE:NT OkOSS V.4LU REQUIREMENT g::r# QRTF AYG aRTF ltAX "fG/L
<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I cean Fr UNDER PENALTY OF Lww TNAT I RAVE PERSONALLY EXAMINED AND TELEPHONE DATE
<br /> AM FA MILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND BASED ON
<br />Tr ('
<br />; ~ e ~
<br />E '~ Mr INQUIRY OF THOSE INDINDUALS IMMEDIATELY flESPONSIBLE FOR
<br />I REDEYE THE SUBMITTED INFORMATION la
<br />OBTAINING THE INFORMATION
<br />(
<br />J
<br />a ,
<br />TIIUE. ACCUMTE ANp COMPLETE. I AM AWARE THAT THERE ARE
<br />SIGNIFCANT PENALTIES FOR SVBMITTING FALSE INFORMATION, INOWDING
<br />n'lu ~11~~. ~~QI
<br />_
<br />~~
<br />~, !/
<br />(~
<br />(~ a -''' THE PoSSIBILITY OF RNE AND IMPWSONMENT. SEE to U.S.C. 1 1001 AND ]] BIONATURE OF PRINCIPAL EXECUTNE , d
<br />J
<br /> U.S.C. f t ] te. BrWU, ~,sr eww mwe, m,y Y,cNd, Rr, w ro i IO,OOD AREA
<br />`1
<br />TYPED OR PRINTED w>nr,l+n.rl MFdovrl,nt olbrwwn emmeuW eTPNaI OFFICER OR AUTHORIZED AOENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANV VIOLATIONS !Reference s/l ettechmenb here!
<br />~i,P'fLr'ABLX SOLIUS LIdIT APPLIES ONLY IF ~=lUYR,24HR PRE:CIF'I7ATICN FVE:t=T I> CLAIP'rD. PFhMITT}:p %fP.S
<br />~U;tLEN UE' PROOF WHEN R~QOESTING kE.LIi•:F PIt0f7 SETTLEAFLE SOLI05 PRIr,ARY Li!!ITATTOFS.
<br />EPA Fwm 3320-1 108-951 Previous adifiona mey be used. (REPLACES EPA FORM T~0 WHICH MAY NOT 8E USED.1 D G C> I 1 / 9 8 C 1 Z J -1 .~. 5 O PAGE Of
<br />
|