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Facility Name/Lxarlon If dlRerrnll DISCHARGE MONITORING REPORT (DMR) NAME =7~7~~7~i~ ('y~~~.' ~ t••P`---__r (1-16) (17-19) YIN;1R ~ ~ • ADDRESS~D~~~7_jt[0(~-;--__-----ti- CD~AF~Di17~ ~ r D R ($09R NB) rj',D(gT'ApPfoved. --_ S~3L~A~~~F11)~L ~_------- PERMIT NUMBER olac~Aaoa NU.laaa P '- FTN11L OMB No. 2040.0004 ~ , .. ---~~`~~--'----'-'`~~~~-T :` I, ,~ ~ MONITORING PERIOD' C..• TAT LUR YI'T.TJ'-]Jr"ClT'la)lr~C!IG";K ~ ~ .. . FACILITY ' : -----------------=------ YEAR MO DAY '~ YEAR MO DAY '' ' - ~ , ' ~ ' ~' ' LOCATION __'_.' ~ ,.'FROM 'TO• Qlaa :-___ . • __ _ _ l m _ o plsting this form. R f T R :. R .' D . U > T L Y D N . P R R 5 [ D P. R C' ? •+~ ... '.' (zo-zl) (u-zn (z4-u) I . (ze-z7) (za-zsl (aJU E . NOTE; Read Inttructlona befor (J Card Only) OUANTIT7 OR LOADING ' ~ , CUALITY OR CONCENTRATION (4 C1rd ONy),', PARAMETER ti (%-SJ) (J4- ' I~ ?' , (38-45 (%-SJ) (54-6U 1 ~ ~ ..i '~ - NO: FREaENCr tAMPLE (7137) • I~ ~ EX AK4Y56 TYPE i - AVERAGE ;~ MAXIMUM UNIT6 MINIMUM AVERAGE :MAXIMUM 4 ~ UN1T6: 16711) :~. (61ba) (6810) 7CL AND ~f?P.AS$ '% sAMP~E R6R4C'S 94) ( kOR~IGb. 3ttr:lOt C3GCp~' .. V C i U ~ L :I MEASUREMENT .~ .' I'l; I ~ ' ~ ( . t. ~ ' 1 ,. ' 3; . •- i ' • tt 1 HxU66 t 'D :~ 0 . ;;,...,..:_.,, PERMIT:: ~ -asaa~+x:;' - ~»,. ~~~ s'° .,• t os ~ 1 e~~s;zd~oa ., ~;~=~"a~aaa, ~dt aa~a~aa aax~• , ^`~ RP; K4'q IApA;t~ ;:PF1 !IF N1 ;ROSS fALUF ~REOUIREMENt ~ ~~ ' $`I!} 71i71AI`' t =0 ~ '"' t ~„i '4. i ~ Y ': 'Nfi ''r:r• ~°? ~' a. 7" }r` ' p L t~ ~ ~ .y,xxr. :, ~q . . . , .• .. n _ NU ro4 . . „ ~ .5 i' 4J RCCR ~_.. x, r,, SAMPLE MEASUREMENT , r- 1 ~ ' 1 ,' ..i `_ ~ .T I', ' ° '~ .~ „ ~ 'y - .' ; .I. ~ r c T S 'p (.~''::1'.'xr"`.^ ~ z l F j. ~i'+ 'e ~ e ~p ~ 1 ,,.y.~..e r;«:; :vY' 1 .~ .:+A_. ,YVS...,.. :.-~.<. a . , 2"4 ~ y.. .,aYnx ~ w. 7 ~ ,'.i Fi :] r ~. c ~ ~ ~ ,ate Y ~ $ y..,,.. '•' , uI RE M N 6 ~.. ~ r ~.ir' ` + ~' i~ ~" Q•'i ~' `) 4 < A .~ ti tf ) .S yypp. YY.. ' ~ r ~ 7 ..fi r ,} . :tl iS':'f.: ~i ` '. J ' SAMPLE MEASUREMENT n ').:I 'r ~• .. .' ~ 1 r: -.i„ . r, , - 'm s PERMIT _ r .. s F . r .I ~ ~ .v r 'rk: +n'~r a ~ Ev~yy y ~ r' ze' I"" _ :~; I;' ~ ~ ~' I: n ~. . ') J.I o RECUUiEMENT p ~ S f.. 3 # ~k - f > • x v ~ v ~ P ~' o -I ;c r ~ .._ " i f .~ , ..d ~. r k . ~, _~'1: ; y tt7. .,,5• . w .:1. •7 .. In SAMPLE MEASUREMENT ~ :'1;~ ..i}. i. 1 r. ~ . ~' i.: tom' ~ " : ' .. ~ j 1 ~. -i PERMIT.,, I T r se. ~ s .. .~ '. n 51-,. l - / rte. 1 •1 ~ .',C' r s. ' r ,t 'w Yy ' +. +~..~.. ~A„W '++Z : JX i. Y S~ ' " C. +-~y S ~ t w !i q nu -. .h _ REQU REMEN , a 4 1 'R ' , ~ _ ~ , , .., ~ ~ r~v .aw - 1 . : - ' ~ SAMPLE MEASUREMENT )I .,. .~ rF ' ~ `; ?.. , 'j : .~ ,,, .; ., ~ 1 ~ ' ~' 1 ,. . . , i r ^ - ! x 1, 1 r.Yy PERMITa s 4f ~ L Y 1'x d n ~ ~` ~'}~'{• S y1~,~~ l ?-, ~ rJ ~ l C' V ~4Y1; Ss I v .~a~~.~~ 1~L '~' :Y '~'~ F E `t ' ~ } "llC'. .!W-~i` mil` +$ ) F r . I~ J• iC Y ~ ,. e~' : MM.'ii sq1 . _ .. ~ QUI ENT ~ REF) K '~j']t x . Vh ~f 9k . it r r x t 7r+I `~' ~ 4 .., -r.S ~x i ~,. * y p P t' ' ' % ~ ~ , ; n R3+ ~ . •rtY M14 a •~, ~ t .: '.. ~ , . ; y ,y~ r ,• t t. . k._'. y ? I . SAMPLE _ ~ ; .i' ~t ' 1 MEASUREMENT ., rr ~ ~ i !e in ;~~~ ~ ' ' ~ ~ ~ ~ ~ ~~ I ,. ' .,_ ~ PERMIT'' Y ., .KRmx 1+ 7~ w ~' r'vtf ~ e«r '"r ~ .a ? ~r ~ 'j k ~ , } 9 T "7 ,f'S tp v' .~ 31, i' `°y'l~"+II ~.=u ~ s rf"` a. ar' ~_'1~SaM'~Ye r ' .1 m . • a „~„ .;,r, REQUI{IEMENT r z j ~ ~el ..y, c i r ~ ~~ ~' sy , y~. `~ 'Y' ~ y ~ ~,i~-r'r. ~ ~ ~s ~w~ y< t~ J M ~ '' "' ' ~ t ~~ ~ rl . . R~Zk .~ ~ ~ A .i -:L'# :. ~ ,r~.' . ,l+,.J' .. - .r y . tiN r.'~ .f ', . 1 C MEASUREMENT 'i ~ " i ~ ... '' ~ t~: f7 -l . +1 .. ~ ' $ ` ...~•F'ERMIT•. ' •. i4`~ xq~M1. :?~t~ `.., ~ 4 , 1 + ~ r tf ~ ~' '°~ P' ]~'' ~{ ! S{. p ~rF i~ k'+~~ !"'~ f "~` ~~~ '' ' . 'i y ~' ~' , 'r i. ,- i ° ~ REQUIREMENT ^~! i I '«. '- .~ ~ p i M M t ~ Y ~ 1 - ~ + y. ~ . : ' # ~ n ~h ! }Y ~y }S I ~} I ~S' ~~' r Y /'• : + r Lj. t'i.? t . rx. T' ' ¢. .? . ir 41 ~ x i. l , i .. , i5 , h t S e , K• .~ f - - 1 S. .N.a I. s NAME/TITLE PRINCIPAL EXECUTIVE OFFICER i CERTFr UNDER PENALTY CF LAW THAT.I NAVE PERSONALLY E%AMNED ' ' ~ TELEPHONE . ~ ' ` D A T E ~ ' AND AM FAMILNR WRN THE INFORMATON SU®AITTED FEREIN AND BASED I ,:j .• ~ ' ' , ' R.G. A7KINSON ~ .,;; F ' ~N MY INQUIRY W T4eOSE WDIVIIXIALS IMMF,DIATELY RESPONSIBLE FOR OBTAINWG THE WFORMATION I BELIEVE THE SUBMITTED MFORMATON IS TRUE ACCURATE AND COMPLETE I AM AWARE THAT T ERE ARE ~~ '' - -` ~ ~ . I• I- ..-~-~ ~. 1 ' q ' J ' ' 970 4' A S I . ~l.•1 ~... ti HSED . H E~~IFKANT PENALTIES FOR SUBMnTING FALSE INFORMATION. INQtJpND , ~ . ~ • ., ( -HL 4'4451" / OI{ 0; & LAND MANAGER • ~ THE POSSIBLRY' OF FINE AND IMPRISONMENT. SEE .IB US.C, 1 IOOI AND 33 USC / 13 lkn 8 ni M tl l i 4 ti SIGNATURE OF PRINCIPAL E%ECUTIVE TYPED OR PRINTED . 1 . ( a n ul aID lbNlu mq nc u M) uy to Fl ~ fIODIX/ end al mAVmum impnsomnenr of berwaen 6 aronNr end J ysan) OFFICER OR AUTHORIZED ACENi NUMBER YEAR MO DAT COMMENT ANO EXPLANATION OF ANT VIOLATIONS (KCICRBCC all aftaCBmCnti AC(C) :: 1: SE[Pf.EABC,f SOLCDS LI!tit;AP,PLfP.S aN6T LF C= In=lRr,' 21-ERR PP.ECIP FYENr "IS'°LRIt1P.D. `L P.,CLAId'.RPPRMPD qR l;' f1]CDa YSS E TRDN LIMLT:':4[`LL NDT 9R IIPPLIFD"TD ,R"F~POR?P.D`MFASURElT:5NTi-.-SEE I.fl.lAa PG~.;LL-AND-'I.P.1D~ PC.• 61. EPA FDIIn 332D-~. 9-88) RCI'ADI15 Adi(%0/IS m2y bE f6EO. (REPLACE6 EPA FORM HICH.MAY NOT BE USED! '~:,r ~ ' ,~ qe 1