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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 />