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PERMITTEE NAME/ADDRESS (Include <br />Feeiliry Neme/Locnlion if di(lerenll <br />NAME ~~ <br />ADDRESS..,, ____________ _ <br />- -3't.'~'r)- tt-iT~~ . <br />- - - ~fi~-9-ki -~:dirci -*1 T.J-~--i ~-j ~+S ~+=r:~-: 7 <br />FACILITY <br />LOCATION <br /> <br />NATIONAL VOLLVT4NT 015CMA RGE ELIMINATION SY STEm I LJ. <br />V <br />DISCHARGE MONITORING REPORT r UlIRI <br /> <br /> <br /> <br /> RERMIT NUMBER olsc..•RCC mo.+e[w <br /> MONITORING PERIOD <br /> YEAR MO DAY YEAR MO L`AY <br />FROM ~~ ) V 3 l' L TO '.1 J 0 3 3 1 <br />(?0-?I1 (??- it (N-?51 !lu-?7) (13-?9) L:r7 .31! <br />Form.Approved. <br />1;( <br />OMB No. 2040-0004 <br />- c I ~I ~~~ ~ . A roYalr afi a$ 10.31-94 <br />SUicr'n:::~. '..J:I:Ri f Q. YIJ: _4n <br />:~~::~ NU DI'i.'ii:l3~L ~.::: <br />NOTE: Read instructions before tbThpleting~this form. <br /> (7 Cn r.' ihdf'J CUANTITY OR LOADING (4 Card Only) CUALrtY OR CONCENTRATION <br />PARAMETER I]n-SJ) 15461) (IS-4±J (an-iJ) (54-61J NO. <br />EX FREOOUF NCr SAMPLE <br />TYPE <br />(7?JI) 4NALV51s <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS fG °6.1) lM14691 (69)01 <br />P ll SAMPLE <br /> <br />MEASUREMENT <br />.-.. <br />. +: vl'::r -. . ~ I l ~ I / <br /> ~ <br />QO4UU 1 ~ .~ PEP.MIT -'.[[i X4:,3+;i ~,i'J :: $:t . . ~ <br />~ • .':: Y,: s ::;: <br />, ~ 'J <br />~ ~ ~ ~ ~ Y 'A 1 <br />~ ~ A 3 <br /> RECUIREMENT <br /> <br />JULIDJ <br />T <br />~I:dL .,~-i` <br />r <br />- MEASUREMENT GS Ir <br />3USNLtiUEu J <br /> <br />UUJ~V I U J PERMIT s}:}s}#:~3 Yn:u3:pY,[:;; { Y::f::.: r~:3 C:V:.`•v ]~: ~'~ -!:r `./ rttAn <br /> RECUIREMENT ' <br />L' - 4 I' I I ` T ' ~ I <br />JJ:.IDJr ,iLT.: LEA :ILL SAMPLE ~.-, ... ; !LIB <br /> MEASUREMENT O / O 1/ <br />~•, <br />VGJJJ I ~ V PERMIT :: (: {:$it f}:{J': ~`~:: I; ~ ~ :}:: L: s3:iv <br />d;:E'0it. <br />REYUF'P <br />.NCt:/ ~ <br />'RAR <br /> REQUIREMENT - <br /> <br />JIL ANU L'KEA:iE SAMPLE ::: ;p:::.'n1'o ..... ..~~;~t <br />~ .,.-....... tY :;: <br />Y :{: :: ::[:;::) ` lr(~ <br /> MEASUREMENT N <br />FdP.ON BXTh-GRAN 19~':d N <br /> <br />OUySt) I J V PERMIT - ::Y,r41(tf,- f}'.:r{:5`-13 ri::::::: ~;t.'XY,::~:3 ;i,tis:3,A-: ju ONTIN rRA:~ <br /> RECUIREMENT ' <br /> <br />IRUtI SAMPLE :f~:~~{::.: }i:1,:Y}:,`. :;:([;:::}.,: L'i <br />~ <br /> MEASUREMENT O ~/ <br />TOTAL R~COVc:RA[:Lr' O / <br /> <br />~J`)t5U 1 V ~~ PERMIT .;;: e~:;: •'.":,`. r[{: :: ... ~ L :~ i}i~$[}:~:: 1.7 jL POirf ifiiLY r}iA:~ <br /> RECUIREMENT <br /> <br />E'LU6, IH C'J'7JU I'1 .%:~ (l j~ <br />::: •: r::'. <br />•~ <br />~~ <br />{: ': r:: <br />~, •~ <br /> MEASUREMENT <br />'idhU TB'c A'I':1 ~~T ?L;:.1 <br />5vU'SD I PERMIT 1•hi. SEtsnrSi ~:3t:3:: •: .:::;,;::: ~:: ,. F.'.~:~,Y "9SinN <br /> RECVIREMENT I <br />vP c.•~r r Tr <br />SJLID:i, TC'T.9L 54MPLE ..+. . <br />~- ` ~, ~- ::';t:,:{:U:3 :F::d}:::'.: ! <br />1 ~~ <br /> MEASUREMENT s i/ <br />iJiJJOLVEU <br /> <br />702')5 1 'J Q PERMIT .:: r,Y-v :.} .. +: .::;:Qsi. fl (,F:11 + i~: 't~ <br /> RECUIREMENT <br />I. U Y::::::: ` 1 u .~..., r r <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERnrv UNDER RENALn' OF Low THAT r H4vE aEa50Nn[L• EkAMINED <br />4ND 4M F4n11UAR W <br />iN THE INFO <br />MATIO <br />B <br />TTEG <br />ERE <br />4ND 045E <br />S TELEPHONE D A T E <br /> I <br />R <br />N <br />MI <br />H <br />U <br />IN. <br />O <br /> ON MY INQUIRY OF THOSE INDIVIOVALS IMMEDIATELY RESFONSIELE FOR <br />DBTA~NING THE INFORM4TION I BELIEVE THE SDBMITI EO INFORM1I4TION IS ~) <br />~ <br />~ <br />1 _ <br />~ <br />~ <br />G <br />N PCCUR4TE LND COMPLETE I 4M 4WARE THAT THERE 4RE <br />TFUE ~ <br />-~ <br />Y i' <br />/ <br />~ <br />' <br />W . <br />GNIFIC4NT 1'EN4LTIE5 FOR S <br />BMITTING F4L^ <br />E INF <br />RMPTION IN~' <br />S <br />DIN _ <br />ic <br />~ <br />P~ I <br />U <br />v <br />O <br />LU <br />G <br />THE RD59RIUTY OF FINE 4ND IMRR150NMENT sEE 1B USC 4 1001 4ND <br />] USC f 1619 (Pevluv under dlae srumrrs InrluJC Gnes 11 <br />a <br />m SIGNATURE OF PRINCIPAL XECUTIVE <br />TYPED OR PRINTED . <br />/ <br />II0.000 ~nJ nr mvvmum imrRSnnmenr n! nctrrrn 6 momhs end f Kars 1 OFFICER OR AUTHORIZED AGENT CO YEAR O DAY <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Relertntt all allachmenls here) <br />ONE-TIISE AnALY315 n::1UiNcu 4'f FihJT DIJCNt13J ::ikT.41411[; i.1tJi: ~I:::,I:i;,:} of `P. ., -... lCl°. , <br />TOTAL IRON LI;tI':S ,;ILL L, :: uI:IV6u, A::D ~i.TTLc'A".Lc: ~OLiJ:, Li'!i'e ArPLit.S r'~1c C=10Yar 343: k'kF.CTb' :'V~:!'L'-;;g~' <br />A Ror 932 - 1R ~Bf3) blevioQ;=ed ons~may b~ A(I v~ .! ~IREPLAG'E ifA~FO NY T~ WNICH NIAM ~N6T=BEVIS 1 ~ L ~~ - PAGE OF <br />