1 I[RMITT[[ NAM[/ADDR[ff ()RCIYdt
<br />' F~nQ(ry NaM/Loorrbn lfdl/firen)/
<br />~ys_rrlt.TUV,Ly,rnir rnM~~___
<br />woDR[f[ r-nt nu vb1L7~___~---
<br />___S,]it STf TF HT(:HYiy1i__
<br />R wrloq wL PD LLUrwwr DISCNAROi ELIY INwrION frsrEM /NPDEJI
<br />DISCHARGE MONITORING REPORT /DMRI '
<br />_` 1-16 )~ HINOR Form Approved .
<br />(SUER NY) h®MRTNo• 2040-0004
<br />-[RMIT NUMe[R RISCNAwct wVMRtw F - PINAL EXplraf 9.30-81
<br />___nr. r:X i'H ______-~~1f1h3L~
<br />MONITORING PERIOD LOADOUT LOOP SEDI/YILSON CP. F.ER
<br />_
<br />FACILITY ~~_~ YEAR MO DAY Y[AR MO DAY
<br />LOCATION _~_____________ FROM 9 0 ~TO 95 03 31 ##¢ NO DISCHARGE ( ~###
<br />T
<br />lzo.z!/ lzz~zil lz~-ztl ~' ~ ! d- I lzs~ I I ll NOTE: Rsd instruetioro bfor plBtinp thif form.
<br />R D R N
<br /> (! Card ONy) QUANTITY R LOADING (I Cab ONy) QUALITY OR CONCENTRATION FgEOUFNCY
<br />BAMP~
<br />PARAMR[R (16-J!) (7161) (!D-IJ) U~Ji) (7141) ~ NO.
<br />Ei OF TYP!
<br />(3137) wV ERAOE .MAXIMUM IINITB MINIMUM AV ERAOE MAXIMUM UNITe 636!) ANALrf16
<br />(616!) (69~7G
<br />OIL AND GREASE BAMPLE #aa### ( gq) ###a## ###### #####a ( )
<br />~
<br />VISUAL _ MEASUREMENT ~ •~ ~ ~
<br />
<br />e4066 1 0 0 ~ s„ m a ,«
<br />~+e +~~R~
<br />~
<br />~
<br />~~~g ~~
<br />~ ~ .,
<br />~~~q~,
<br />~
<br />ES=1 ~ ~ ~
<br />~~e''
<br />~`
<br />`~~~'® ~~ a ~ ,
<br />~"-g ~
<br />##a
<br />~- ~ ~
<br />1~ ,.
<br />~~
<br /> y
<br />~ , ,
<br />; ~
<br />
<br /> BAMPLE
<br />1 _
<br />t- _
<br /> MGBU REM ENT - h ,- •I
<br /> ' L~~E Md~~Y
<br />u
<br />~M~
<br />~
<br />~
<br />y ~~z ~ .., ~x (A
<br />~
<br />~ ~,~ ~`a ffi~- ~~
<br />~
<br />~
<br />~ / ~gxp~ ~~~R~: $
<br />~YF
<br />~ g ~~.$~
<br />~ ~` ~ ~ „~ d
<br />~P `~ ~
<br />8
<br />~ as ;r ~ ~ ~. a. ~ ~z
<br />ul
<br />' g~O~~
<br />S-~
<br />y
<br />~
<br />{
<br />!
<br />p¢ p~'$tt`~' b
<br />~fep~bn
<br />~
<br />aIR` ~~~~n lC~g K
<br />`
<br />®
<br />ft~n &~A
<br />~ 4x ~1,~ ~ffi n M~
<br />~ °h
<br />R ~+e ~Ba ~
<br />44w~Y ,
<br />ID
<br />~ ~„0,q.
<br />°'%a
<br />..
<br />' BAMPLE
<br />MEASUREMENT
<br />~ C'~ `~• ~ ~ ._
<br />•
<br />I ,
<br /> ~ .~PEl~Ft 4~'~a~ aa; xs
<br />a
<br />~
<br />~
<br />° ~
<br />(
<br />m
<br />5
<br />"~s •~
<br />s~
<br />~ ~~~ e
<br />~ ~
<br />~~
<br />~ a '$&~
<br />~ ~ -
<br />:
<br />iT
<br />. a. ~
<br />a a~
<br />. It~[c)Yltat;~~R ~q
<br />~«
<br />?
<br />~
<br />xe
<br />a
<br />~
<br />s ~
<br />*
<br />~
<br />A
<br />e
<br />~"~'
<br />"
<br />~' ' v
<br />s
<br />~~;
<br />T~~
<br />~~ ~
<br />~
<br />a
<br />:
<br />~~~
<br />~`
<br />~ e
<br />q~
<br />~ ~° .
<br />(
<br />I' ~ ~
<br />~~ ~
<br />o- ~ .
<br /> , q ~
<br />w
<br />~
<br />m~~,~
<br />= a
<br />g;
<br />~~m.~ _
<br />a~,
<br />r~ ,
<br />~~~»
<br />&
<br />~~ ~
<br />, . ~
<br />
<br />' BAMPLE _
<br />l' -
<br />(` -
<br />~ '
<br />
<br />. MEASUREMENT ~ _, -, •~ .I
<br />' ~ 1 ., r. ,
<br />. gr 6~.a°'w B'~.i»~
<br />' &8 B k .~'
<br />a
<br />~ ~ )q,. -~ CH' e
<br />~ , ~ m+,ok • ® ~
<br />c~
<br />°~ ~ 5 •.gq" A
<br />~ ce V
<br />~ _
<br />"
<br />: $(~CI~J)[YMICi7
<br />r, ,~,~
<br />aaa:~ ~~ . era wPo
<br />~ ~ r~ y
<br />4 m « ~ ;.~s
<br />~ k~ _. k ;~
<br />:
<br /> ~
<br /> BAMPLE
<br />MEABUREM ENT
<br />~ ° ~
<br />~ :;
<br />p
<br />; L ..
<br />~ "' 1
<br />(~ ~
<br />~ ~.
<br /> . u. ~
<br />y ,. _ ~ ~ `
<br />' ~~`° ~B-11~ ~ ~ ~
<br />U1
<br />~
<br />i
<br />~ ~~~. ~ m' ~ w.re,
<br />~
<br />~~
<br />a
<br />~
<br />~~ ,, k ~ .®'n PoW~e Po a
<br />~
<br />~ Z °e~ e ~ & y#~ X
<br />~ ~'w ~ ~s<A~ ~a~
<br />~
<br />a
<br />~ ~'pr,'w2a~ ~ 'yip
<br />~
<br />t
<br />~
<br />~~
<br />~ ~ ~~ ~ a
<br />~°'~~ ~ ~•~
<br />~~~.
<br /> 1
<br />A
<br />1iiM
<br />I~J ~~
<br />~
<br />;
<br />~v.;
<br />~b ~ .r ~ ~~
<br />~k~.° ~,~a Ps ~ a
<br />~
<br />~ '
<br />"' c~ x
<br />y
<br />~~g
<br />~o
<br />p ~ d
<br />~ kr~
<br />~ y _ ' ~.~a
<br /> ~~..88 8 xVF S ^v~ R 8' e
<br />' R ae
<br />'ai~ A
<br />e4 bRrOw
<br />ror
<br /> BAMPLE ,
<br />(
<br /> M EASU
<br />REM ENT ~ ~ ~
<br /> yy ,~
<br />
<br />
<br />' BAMPLE
<br />MEweU REM ENT
<br />~
<br />- ~ ~
<br />_. .. „ r
<br />.I
<br />~ '~ '~ ~
<br />~~ d
<br />•.
<br />pi I IA ~ - _ D
<br />L_.
<br />
<br />,
<br />~ _ ~ ' ,
<br />. I _. `~~~l117~1'f~a
<br />O
<br />T
<br />tl
<br />C f"k p a~;g~ec
<br />
<br />Affip
<br />' ~>
<br />~R~'.~~ n~a~q~
<br />Y . E e# a~'°~ ~~. ~
<br />
<br />' Y e*~a ~ l~T~'~~a~
<br />
<br />R
<br />s
<br />~~x~ ~~ - e, a~ga^w~ °`®~¢,~tt
<br />
<br />.
<br />- 4
<br />A Q 1
<br />IIf7~
<br />I
<br />w~Ap
<br />< 88.a
<br />~
<br />ry R` n ®
<br />~~• ra y.~d~ti
<br />%'~x~ p
<br />w ®w. •,6 ~ t[ fl ~ ffi
<br />bm °M'`ba p 8 .
<br />~a ~g R
<br />Ri&w.. .~'g,y «m sr ~ k ~
<br />' .bF @a& .,kg b~~ ~ R
<br />e Nv%a ~~,~ fl
<br />~<
<br />I CER16Y UNDER pENALTV Di LAw THAT I NAVE PERSONALLY EAAMIN[D
<br />NAM[/TITLE PRINCIPAL [i[CUTIV[ OFFICER
<br />TTED
<br />T
<br />S
<br />B
<br />ER
<br />[D ~ ~ T[LEPNDNE D A T E
<br />HE INFORMATION
<br />MI
<br />H
<br />EIN AMD BAS
<br />AND AM iAMILIAR MTN
<br />U A ~
<br />'
<br />ON MY RIDIIIRY Oi THOSE INdVIOUALS IMYEdAT[LY RESPOMSIBL[ FOR •.
<br />OBTUnInO THE MFORMATIO.Y I BELIEVE TN[ SuBMTTEO INFORMATION
<br />~~:"~«"«I`suB~RTIMC":LSE"":IF~M:T'b„"`P,~~D~~
<br />~ ~FITCNT
<br />HSEG&LANDMANAGER
<br />~ i
<br />. ' I 870-pr)A AAC~
<br />{!LY"P1i)
<br />6
<br />~l~ 0
<br />.
<br />.
<br />TN[ pOS51&urv OF nN[ AND IMPRISONMENT SEE IB u5C A 1001 AND
<br />MM
<br />SC 11318
<br />l
<br />ld
<br />/
<br />EII
<br />I
<br />M
<br />' -'
<br />A BIONATURfi OF PRINCIPAL EXECUTIVE
<br />~ '
<br />- e_ ' '
<br />'
<br />r- MElu
<br />r. nrnr mr
<br />r
<br />/
<br />IM
<br />tM. undrr
<br />mn W lu
<br />L
<br />33 U
<br />TYPED OR PRINTlD Pn/nr ms+rmv-IlnpnP.nmrrll n/MtArrn6m.~nlA. Ant.S ..•r..I OFFICER OR AUTHORIZED AOENT A NUMBER YEAR MO L
<br />COMM[NT AND EXPLANATION OF ANY VIOLATIONS (Rr/rrrnrr ull ullpcAlnenlF hrrr) )
<br />SBTTLBABLE SOLIDS LIMIT APPLIES ON LT IP <= 10-TR, 24-NR PRECIP EVENT IS CLAINED.I-~-IP CLAIM APPROYBD•BY
<br />Y1CD, T55'-G IP.ON LIMITS PILL NOT BE APPLIED TO REPO ED HFASOREMENTS--see I.B.lA, PG 4,AND I. D, PC 6
<br />! - - • (R[PLAC[f vw -ORM 3 wNICN Mwr NoT BE uffn.) I'r> [ oI
<br />t1Tt~~io~ngnA-14tu ?
<br />
|