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<br />LOCATION
<br />N wTIOM wL FOLLU1w MT OIICMARG[ CLIM IMATION CrST[M /NPDESI
<br />D 19CHARGE MONITORING REPORT IDMRI
<br />1•l6 1~
<br />•[RMIT NVMB[R 01.cHw1lat NUYrtw
<br />MONITORING PERIOD
<br />YCAR MO DAY YEAR MO OAY
<br />FROM TO
<br />110.1// 111.13/ 111. 3/ 116- / /78~ l I l
<br />Y I t. 0 R Form Approved.
<br />(S U c' R tl w QMB plp{QQ90-0004.
<br />F - F I ti A {PPIOVaI expires 6-30.91.
<br />SURFACE RUNOFF OAK CkEEK
<br />### N(: DISCHARGE ##4
<br />NOTE: Reed inltruttioro before ~mp~etinp thi! form.
<br /> (J Card OIUT) QUANTITY OR LOADING (t Card OnfT) QUALITY OR CONCENTRATION FREOU[NCY
<br />BAMPLE
<br />PARAM[T!R (/6-JJ) (!Id!) (Jd.IJ) (1637) (J{dl) NO. DF TYPE
<br />(31.!71 ~ ANwLrsls
<br /> AVERAGE MAXIMUM UNITS MINIMUM AV ERAOE MAXIMUM UNITB 676!1 (616d) (69-70)
<br />2!H BAMPLE ##### t}0### ##### ( I2)
<br /> MEASUREMENT
<br />W4G u 1 0 0
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<br />SOLIDS, TOTAL 6AMPL[ ##### ##### ##rr#~ ( 19)
<br />SUSEENDED MEIIBUREMENT
<br />O053U 1 0 0 ~~~>rrenx~<`~n ~.~a~
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<br />SOLIDS[ SETTLEA5LE BAMPLE ###y#4 ##### ##### ( Z5)
<br /> MEABUR[M ENT
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<br />CIL ANG GREASE BAMPLE ###### #6#~## ##### ####YrF ( I9)
<br />FAEGN EXTR-GAAY iIET EABUREMENT
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<br />OOS56 1 0 0 ~ 7[RMS'1'3 "wal
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<br />lAOh, TOTAL BAMPL[ ###### O##### ##### ( 19)
<br />(AS FE) MEASUREMENT
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<br />FLON, IN_ CONDUIT OP. BAMPLE
<br />EABUREMENT NQ DISC ARGE (G3) ##### ##### #><###
<br />TRHU TREATtlEMT PLAN ~
<br />50050 1 0 0 -~~ . -_~
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<br />SOLIDS, TOTAL SAMPLE ###oa# #9##O# ##a## ( i9)
<br />UIS~OLVED MEASUREMENT
<br />77295 1 0 0 > ~+~eeeeSTa~°
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<br />NAM [)TITL[ PRINCIPAL EX[C UTIVE OFFICER 1 C[IrtIFr UNOER PENALTY OF LAw THAT I NAVE PERSONALLr EXAMINED
<br />AND AM FAMILIAR wITM THE INFORYATON SUBMITT[O N[REIN
<br />AND BASFD TELCPNONE D A T E
<br />.
<br />ON MY INWIRY OF THOSE INdVIdIALS IYYEdwTCLY RESP01151BLE FOR
<br />O ~ L - `.Q IV G. ORrAIMING THC INFORM1Tp;l I e[L2V[ TMF SUBMITT[O IryryFOPYATIOH
<br />RAT[ AND CCYRCTE I AM wwARE THAT THFRC
<br />IS TmJC
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<br />M1 E SUPT. N1r1<wryr PENwLTI(5 FOR SUBMITTING PALS[ INFdIMATgN IryCLUpNG
<br />Tl iH[ POSSIBILITr Or FINE AND 1YM150NM[NT SEE IB uSC 1 1001 wnD OF PRINCIP
<br />SIGNATUR
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<br />TYPED OR pRINTEp •~d..•nr.rwrwn rn.n~+rmnU../Mlurrn6munlA. rod .~.w..r OFFICER OR AUTHORIZED AGENT t` A NUMBER YEAR MO DAY
<br />COMMCNT AND EXPLANATION OF ANY VIOLATIONS (Rrlrrrn[r ull ullurhmrnll here)
<br />TSS E, TOTAL IRGN LIMITS GILL BE MANED, ANU SETTLEA6LF. SOLIDS LI(9IT APPLInD FCF. <=lOYR,i4RP EH:iCI6 EVENT-
<br />SEE I.A..l, PG ZY, FOR RE~~UIREHENTS. 1;kTALY SAtlPLItIG INSTRUCTIONS-I.C.9, krG XIlI.
<br />EPA Form 3320.1 (Rw. 488) P/svbud editions maybe used. IREPLwccE [Pw FORM r-ro wNIDN MAY Nor R[ uE[D.1 Pwoe o•
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