PERMITTEE NAME/ADDRE591Include
<br />Fsdllly Name/LoceNan f! di((erenU
<br />NAME ^]1.'1YY;1 ,,^l~f. C~1MPfiYI~I:_V.
<br />NATIONAL POLLUTANT DIOCNAflGE ELIMINATION 9YETEM (NI'UtS')
<br />DISCHARGE MONITORING REPORT (OMR)
<br />!1-l6) 117-19) MTNfIR
<br />4DDRESS~D~OYL~ IL[.~_____________ C(1G9 ;0"17 009 4 (St1AR YY) ~ rj41pP9pgrovsd.' .' -
<br />
<br />PERMIT NUMBER oncyw.e. Nw..P
<br />S73L~gAre~~'i
<br />fl~{
<br />d L
<br />~
<br />~ .
<br />OMB N0.2040-0001 '
<br />'P .~ PIN~L
<br />___
<br />-
<br />.
<br />-
<br />---_---
<br />-,
<br />---~PaPi~~-__-_
<br />--,~.S:~~r11.-L-T I~
<br />ORING PERIOD
<br />'
<br />MON ,
<br />.S'C ~16 PDND~9YBt.4f?ID°3~le1aG'CRfi -
<br />_
<br />.
<br />,.
<br />IT
<br />~
<br />FACILRY' ~ ~ ~
<br />~ '~' YEAR MO DAY YEAR MO DAY
<br />-
<br />-
<br />-
<br />-
<br />--
<br />--
<br />-
<br />-
<br />•-.-
<br />-
<br />-
<br />^
<br />--
<br />-
<br />-
<br />^-• '" ~~. f r i '
<br />-
<br />:FFROM TO~ ~
<br />LOCATION
<br />_
<br />_
<br />_ I~~;aao' .. •
<br />aaO 1RD DISCHSRGei'.I
<br />_
<br />_
<br />_
<br />_
<br />_
<br />_
<br />_
<br />_
<br />_
<br />_
<br />_
<br />_
<br />A P T N: R. D. U S I L T 0 N P R e 5 L D P N T ~- .r,_ `'. (zo-zu (u-1)) (z4-13) "" (z6•n) (S8-I9) 3o-Jl) ~-' NOTE: Read Inetrlrefbne Clef ompleting thle'rorm:
<br /> (J Cab Only) QUANTITY OR'LOADING (4 GJd ONy) QUALITY OR CONCENTRATION
<br />'
<br />~
<br />F
<br />E?KY
<br />PARAMETER •• ~ (46-53) - (54-6x) ~!! (38-45) ~'' '~I' (46-S1) (54-6f) ~
<br />:~ I' " ~~ ~
<br />~ sAMPLE
<br />(Jl J~)
<br />- ~ AVERAGE
<br />r: ,~ MA%IMUM, UNITE MINIMUM : ;., AVERAGE. ~ . MA%IMUM
<br />1 . UNRe `
<br />1 '
<br />(6}671 L
<br />:'•(616!1
<br />(69-101
<br />oic -rlo ..seese BAAIPLE :,. aaaaa- -. ': _, ( 94) :•aaaaea'. .aaaaau aaaaaa -..
<br />H 15 O ~ L (~ MEASURE,ENT `I r}ji ~ _
<br />,_ i. .
<br />~ ~ fi `~ {. .' :4'_i L~• !S i1
<br />3JD65 1 0 0`:~ '~~•rERMrt r: aaoh+a~. ~~? '~ ~
<br />r°`. 65=1'; trObOa~~ _?a'aaa4#.
<br />, `;~~aq~aard~~ aea~~ -.;Ef.-t IS9~~-
<br />I
<br />LO
<br />o REQwRe14~ <.;
<br />~it ~ ,
<br />r-
<br />S'
<br />1~t"
<br />1~ NJ-b~i ~~;
<br />~L3
<br />~
<br />`~ `'
<br />~:i~' ''~>'
<br />•
<br />'~?/~ RGlba'`r; v ~~i~.'~`r
<br />1:PPLDeNT
<br />R055 :
<br />0.
<br />P. ~.. :1l
<br />1
<br />7S. .
<br />x
<br />~., .r
<br />. r,r ., t
<br />.- .
<br />~
<br />_
<br />~ .. SAMPLE
<br />MEASUREMENT. _ I. 1
<br />~ .Lp ~ .+ I.
<br />.'1 ,: ;.', l~ i {1 1. j '~' ,'
<br />I ,
<br />-•
<br />'
<br />~, -
<br />A .q... .,.. 1
<br />.'Y':.
<br />~. PERMIT' • ,, !1"
<br />~
<br />tk x ~
<br />~,. Y.T a
<br />..
<br />- :A
<br />.7 11 r+x Kr
<br />L ~f
<br />I C- 6 ~.-
<br />'.y 1'Tfi' Ix-
<br />< .t
<br />a
<br />!
<br />~
<br />~
<br />b Y xv P
<br />~
<br />d'
<br />~
<br />~ ~I Fi -
<br />W
<br />'
<br />~.
<br />.-. x~'
<br />~t^~ 'c tX;;
<br />I. RHgU1WEMENT.: q,
<br />S'~i ~.:
<br />s r
<br />'•
<br />;ti u
<br />1
<br />T
<br />,~ yt;~r 1 ~
<br />~ p
<br />#
<br />a
<br />~
<br />c ., ~
<br />~ # {
<br />o
<br />'"
<br />Y
<br />> ~
<br />"
<br />~ r 4 '~3' '~~ ~t x "i- •.
<br /> . Su .
<br />.,:>a'
<br />>`t l
<br />,
<br />7,-e -
<br />L ~ f .~ a w.. a ::-~a.
<br />k ~
<br />;
<br />F
<br />~ X ...
<br />'~ ~
<br />. .n t .
<br /> MEASUREMEN
<br />T -f
<br />s:
<br />'.
<br />i' ~',
<br />f `i ..
<br />? u a ~., i., .T: y.'t:,
<br />" tl' 'H l
<br />a u' C. ~~. ).D .-~G
<br />:J
<br />li
<br />-
<br />i .
<br />l . ;
<br />~ .F •%
<br />- •~ ,r. ca.
<br />~ ~~ i
<br />I: i ,,. ~ g
<br />i
<br />s
<br />3i •• o
<br />~
<br />, r r
<br />~
<br />}z ~
<br />•1u r 5
<br />k
<br />}
<br />~ C l:
<br />Y
<br />'~ --
<br />rµ ,
<br />J
<br />~ REQUIflE14E~{T
<br />~ w
<br />.~~
<br />T F?s
<br />'
<br />' 11, icykyy
<br />w1, G3
<br />i
<br />' i,
<br />*t~
<br />f~ ~x~~ .
<br />~.K+6
<br />~ f CV
<br />?
<br />. ~A y^
<br />4. \~;T a 'sl
<br />#~~m7zC
<br />~.
<br />, ,
<br />a . J
<br />C
<br />m-d ..
<br />e
<br />.l
<br />.~- ..v, ~A k
<br />.. t
<br />i+.. 1'Y
<br />e 6. -axTi. R'
<br />~
<br />4 .-. C ~
<br />+& .a.c ~
<br />;
<br />.:- t
<br />
<br />'I
<br />}.;. :.~ ~
<br />-'SAMPLE ~
<br />MEASUREMENT
<br />
<br />~ _
<br />.. !,r' T
<br />l~ v'
<br />
<br />i
<br />cJ• k.
<br />
<br />.J .o v
<br />.'c' ID i.
<br />
<br />j.l/
<br />-5• ~
<br />~
<br />~ i,.i~~~.; .`
<br />
<br />? 5
<br />7 S
<br />
<br />~' h.
<br />
<br />-~ v
<br />.
<br />.J
<br />~ +
<br />. I
<br />1 I, J w .. T
<br />~ ,.
<br />•
<br />_
<br />- " I ' ' PERWr~,
<br />T I;~e = -~
<br />t
<br />' ~ I^ ~. ni ~ic ~ 'r1'
<br />s ~ Z -~ ki+--
<br />
<br />rte ~'
<br />2*
<br />J'
<br />~ ~sX' - a,e,~`^5 -
<br />r
<br />`yi
<br />t
<br />t
<br />,
<br />-S
<br />~ :•)' ~:
<br />t'1 ~
<br />~ `/y~Y ld+lf. rt ~"'-'
<br />
<br />'
<br />•
<br />
<br />REQUIREMEN
<br />r
<br />" I
<br />.
<br />~ }
<br />7
<br />'I:
<br />~-
<br />j .J
<br />~
<br />s. q f
<br />t ~~
<br />
<br />,
<br />3 ..f~
<br />5
<br />-
<br />~
<br />{a'
<br />,
<br />y,,,;
<br />. T
<br />'
<br />rf
<br />~
<br />[,.
<br />
<br />x~ ac
<br />s
<br />' ,~
<br />7r
<br />~
<br />~ . , .1 ra !e•/r„ ~
<br />s
<br />_ ~ :
<br />n. .e _..
<br />E
<br />-s
<br />• . L,I (I. 6AMP.LE
<br />MEA6URBMENL
<br />h i
<br />. ~
<br />J~; .~ '. r
<br />~n ~, L;
<br />: i r I; .
<br />,~ - Fi .I~:
<br />4f ~j ~ ...• .. ~ .
<br />f~ •?~ ! 1 ...
<br />,~ `p; - . ~
<br />::Ix ~. j.
<br />`.,.~
<br /> . I _ ^
<br /> 1
<br />` .4YM> s '4 F'Y'Is i
<br />~ r~.
<br />~ !°`Fx.. '~h` ~. I .< '4 V "' ' t }I M a ~ ~~
<br />L ,x9' 17 .V
<br />
<br />., ' PERMIT i
<br />`
<br />~ z -t
<br />f,.
<br />~.' n
<br />~ „* $q
<br />' '-
<br />Gi .9 ~ (;
<br />Z
<br />~
<br />~ S2 ` x xf". C
<br />`~)~ . 1
<br />~ _
<br />~ D'
<br />l y * T.- s .
<br />*
<br />~
<br />:N 'IiEQUIREMC}NT , :~ Is.-[~c
<br />`7x45:
<br />`
<br />:- N
<br />' .
<br />~.
<br />TMV~>7~"
<br />'~
<br />I~ ¢e'~
<br />`
<br />r~;~
<br />" LL
<br />'
<br />''
<br />`''
<br />'
<br />1
<br />T
<br />'
<br />~~r I~1 f'° '4,~ +
<br />~
<br />J
<br /> J . -
<br />.. 4 ,
<br />Y
<br />..
<br />I .
<br />: ,
<br />..;a
<br />.,.
<br />s
<br />. .
<br />.
<br />.,33
<br />.
<br />•
<br />i. , N#.
<br />.-.
<br />:
<br />
<br />.
<br />~ i i
<br />MEA6UREMENY
<br />I ••
<br />~` ~
<br />'1
<br />.., _ I,. r..•
<br />I1
<br />, ~ ~
<br />c:.:. i N
<br />,
<br />:I
<br />~ ~ ~
<br />• 41
<br />~
<br />. I~
<br />1 x, r. .Y t .
<br />-RERMIT a<'
<br />~ < tla.S'r r,
<br />~ -
<br />`1 s. (' T> J"'E lr9 ,rL!
<br />m ~ / rr
<br />,: -. aPh P C'1
<br />~:~ ~c' J.
<br />o .Y`Fd ^n 4~ @
<br />`fi' 37,
<br />, _
<br />t "Gt F _,~+.
<br />#~ !
<br />~ .D.
<br />r =k
<br />+.... -,
<br />
<br />~
<br /> flE'CUIPEMENT ~;, r
<br />~'
<br />l ' <~
<br />I
<br />I
<br />~~~''~ ~ >•
<br />}~'t
<br />~
<br />~ F
<br />~'~ V ~~ ~
<br />~
<br />~ uy ~ : ":
<br />,J y .1
<br />'t',<~+vv
<br />y
<br />1 r
<br />t
<br />? "
<br />' .
<br />S.
<br />.Tr• '~h
<br />~ ;~ X .i
<br />4
<br />~u J
<br />1
<br />- .J'Q. R'
<br />
<br /><~
<br />SAMPLE'
<br />ASURE
<br />ENT
<br />•
<br />.:d
<br />r I:
<br />_ ~1. 'v .: )
<br />~~~ ,
<br />>
<br />.~
<br />~:
<br />x
<br />~• U ;1
<br />,.:
<br />~~~
<br />I
<br />-
<br />~f~~
<br />l
<br />. tr' Z n
<br />.O y
<br />3•~
<br />.'.. ~ .,,
<br />~
<br />I
<br />
<br />I ME
<br />M
<br />. i .. ' -,
<br />, IJ ' .
<br />."
<br />. P
<br />:~
<br />- .
<br />.
<br />? I.•I ~ • V U.
<br />I 7 . ..
<br />I
<br />y
<br />- J CL ~^' n A
<br />~ .. PERMIT 2
<br />a
<br />e ~ 2
<br />r r
<br />'•4 s JP" yT
<br />~ n y1 ~ ~;J
<br />~ : '~ ~" 4'1 x . ~~ ~
<br />T
<br />.IT ~ ~~ ~ ~ O f`° 06 ~ e c~~ .E ~.
<br />-~
<br />/
<br />r e
<br />QUU:a~}Ewr. .
<br />71 ?': ' E
<br />~ r: r
<br />S
<br />~
<br />'
<br />R
<br />`~+ : z ci
<br />~
<br />- z ' A
<br />'
<br />~
<br />'~' S
<br />$k
<br />^~h~' .rte ^I' ~}'
<br />a
<br />xt
<br />1 .~-: ,
<br />,
<br />,
<br />r ~
<br />r. ,
<br />, 'r
<br />n
<br />'
<br />.
<br />~u . *
<br />. ,.
<br />a ,
<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I cERFIFY UNDER PENALTY. DF LAw THAT I MAVE'PERSONAUY EXAMINED _ _ ~ TELEPNONE,
<br />'
<br />' D A T
<br /> AND AM FAMILY\R,WTi TFE MFORMATgN SUBMITTED HEREIN: AND BASED LI
<br />. ~.
<br />V
<br />N f~
<br />T
<br />YID
<br />E5
<br />9
<br />E
<br />~
<br />E
<br />0
<br />Y
<br />M .I
<br />•
<br />IJ
<br />' " '" INFOR
<br />OR
<br />1
<br />MITTED
<br />YVFOR
<br />MA
<br />T
<br />ON
<br />15.1
<br />OHTAWWG THE
<br />A
<br />BELIEVE THE
<br />TRUE ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE ~ p
<br />,.,J ~~ /p q~1 .1
<br />l
<br />,, ' ~ 9/P8G'f"WO~
<br />~
<br />95
<br />~'O
<br />HSEQ & LAND MANAGER .
<br />W
<br />,'SIGNIFK.tNT PENALTKS FCR SUBMRTNG FALSE T'FORMATIDN tNl1UDING I ~ 'O ~
<br />,
<br />' I
<br />' THE POSSIBLRY OF FINE AND IMPRISONMENT. SEEIB USG 1 1001 AND-
<br />i
<br />hd
<br />'
<br />' SIGNATURE OF PRINCIPAL EXECUTIVE I •- R" -}~ 1j "
<br />
<br />...I 33 US.C / 1318. (Rne1MS Ynder 16CIC !NNW N.y
<br />nc
<br />C
<br />-
<br />!uln YO. fo
<br />S
<br />THORIZlD AG[NT
<br />OFFICER~O
<br />•A
<br />~
<br />~
<br />A
<br />TYPED OR PRINTED ~
<br />~ yrua) I
<br />f10DW ~d ar wrtimum imO++lY/Yt¢YI N 6elrxn 6 monW uld R
<br />U NUM![R
<br />- YEAR MO D
<br />Y
<br />COMMENT AND E%PLANATION OF ANV VIOLATIONS (ReRrcnce tll InechmMN here) „ -'~ : - .. ; ~ r _ I / ` '.. .~ :i-;-~ T ~ I
<br />S~TTLeI1BLE $JI;I:DS LIf1f9~ '1'PPLfES' ~NLT IP C= '1:0'-TR. 2~-,tIR PRF.CLP °YP.NT. 74. ..LRIMHD. I!',~.':CL11I11 11PP.R,D>/QD'Bt !"+
<br />Y~CD, PSS 6`IR)q LfRifi~'iICtL .NDI RS BPPCIPD "*0 RP..P9R'LRD I!eASOR4!1°riTS~=SeP. L.ff.10.E,";p,'stl f1lVD-''Ir9.'LD~' P+ fi.',
<br />EPA FDFT 3320- .9.88) P7BVADI6 eUiUmS mey be U59d. (REPLACES EPA FORM NICN.MAY NOT OE U8ED.1 ~' I'~ 1
<br />-.. OC•199/9t47922-1`x`:7.
<br />OF :I
<br />
|