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<br /> IHRMIT NUMBER BIFCNwwc[ xuMBEw
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<br />I7INDR Form Approveo•-
<br />(SUBR Nfi) M061RTNo. 2040.0004
<br />F - FINAL E:plrea 9.30.91
<br />_~_nF ixrN ~______ c-u Nlnul MONITORING PERIOD PROSPECT SED PD~GOOD SPRING CA
<br />-AC/YTT!
<br />YEwq MO Dwr rEwR MO DAY
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<br />(70711 lzzlti 11e-7s/ 76~ 1 l7s~79/ / )/ NOTE: Rod inttruetioro bafor mplstinp this form.
<br /> (1.Cprd ONy) DUANTITY O LOADING (1 Card Only) QUALITY OR CONCENTRATION FR EOU ENCv
<br />BAMPLE
<br />PARAMETER (IbJ3) (J161) (ieaJl (1631) (J161J NO. OF TYP!
<br />(J737) AV ERAOE MAEIM UM UNITE MINIMUM AVERAGE MA3IMUM UNITE EX
<br />6761) Arv wlrals
<br />(6160) (69~7U)
<br />l~!I BAMPLE aoaaaa aoaaaa ( ) aoaaaa ( 12)
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<br /> MlABURHMENT
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<br />SOLIDS, ;ETTLEARLE BAMPLE aaacaa aoaaaa ( ) aoaaaa aoaaaa ~ ( 25)
<br />~ MGBUREM ENT ,
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<br />DIL AND GREASP..s BAMPLE aoaaaa ,aoaaaa ( ) aoaaaa ,aoaaaa ( I91
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<br />NAM [/TITLE PRINCIPAL BII[CUTIVH OFFICER 1 CEwTFY uMDEII PENALrv OF LAw THAT I NAVE FERrANALLr EAAMINED
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<br />CN MY INDUIRV OF TNOFiE INdVIWKS IMMEdATELY 11ESPDNSIBLE FOR
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<br />e~ld l,rmi+ImAm lmpnrnmrnru/A•IP.rnem.InIA.AM.i l.wml OFFfCER OR AUTNORITED AOENi A NUMBER YEAR MO DAY
<br />ANO EAPLANATION OF ANY VIOLATIONS (NeJFFeneF pl/ RI/YCnAIenN RfFSI
<br />SETTLEABLE SOLIDS LIMIT APPLIES ONLY IF <= 10-YR, 24-HR PRECIP EVENY IS CLAICfED. "IP CLAIM APP90YED 9Y
<br />YQCD, f55 G IRON LIMITS PILL NOT 8E APPLIED TO REPONTED lfEASURENENSS--SBE I.D.lA, PG 4 AND I.B.1D, PG 6.
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