|
ITT[[ NAM[/ADDR[[[ (Illl'IYda NATIONAL POLLUTANT DI.CHAIIO[ [LIMINATION 1T/T[M (NPDESJ
<br />y Name/LorarlYn 11 d1/14rrnr/ DISCHARGE MONITORING REPORT (DMR)
<br />i-COL01LY~1.OJ4L•-Ca~F•Al4Y---"'-----" (1.16) (17-191 NINOp ~p
<br />~ES1~OITOY-T-0~I~-IF&------------- (SUER NN) L7~tJ/7~p,~~$p1proved.
<br />q'J~~S.}I ~I~+ ~~.~~~~--------' PERMIT NUMBER ~ vI.cRAwe[R~Meew 'P - FINAL VMtlIV0. 2040-0004
<br />-- _e..~.N..,el ..ail... ~n~
<br />--~A-^X `mow ---------~-~~Z--S ~- ~ MONITORING PERIOD YCST ~P1T ~56Yi-"l''D--Tq T-AI-LUH GNK•
<br />`
<br />--------------- --_-~~ YEAR MO DAY YEAR MO DAY ~ ~'
<br />'
<br />~
<br />\T10N ` '. --_-----_~. FROM 95 0 1 TO: 95 09 30 ##a o ~ = ~ aoa
<br />-------=:=---- HO DISCHARG..
<br />- ~ (za-zr) (1z-zJ) (1+-u) ~ (zs-n) (1B-19) (JaJr) "NOTE: Read Instroctions be(OreZ18 plating this form.
<br />•' (J Card ONy) GUANTRY OR LOApING r (4 11rd Only) ~ ' c: GUALITY OR CONCENTRATION •i - '-
<br />PARAMETER s''•` x (46-SJ)(54fi1) (38-45) (46-SJ)(54fi1) NO:
<br />EX' FRED~NCY
<br />"ANALY35 SAMPLE
<br />TYPE
<br />(31-37)' i 7
<br />' - AVERAGE J
<br />~ MMAXIMUM ~; tUN1T8= C
<br />MINIMUM- ' AVERAGE ~ I
<br />MAXIMUM UNIT9 -
<br /> (676]) (6+68) f6470)
<br />AND GREASE=. ~ SAMPLE .######
<br />- ^~ _ ..e
<br />x ~ 94)~ ;>d~KK##e_ #####o, .######;
<br />" - ~ ~
<br />`- MEASUREMENT "4 .? 4 I Tl
<br />;DAL _ /
<br />
<br />X66 1 0 0
<br />, - -:,
<br />PERMIT
<br />~
<br />~ ~~a~a~a~# _ , ,a- r~Y
<br />: , ~ S=1 v
<br />ys
<br />aaa#~~ ~
<br />`
<br />~ #al~l~lp#
<br />~
<br />Ip~##o+P
<br />a#al EERLi ISUAL`
<br />,
<br />- ,
<br />- REGUSiEMENt
<br />
<br />`.
<br />' ~ .•'
<br />,...Y~:=w'z _ .-r-.
<br />is
<br />s =
<br />~a,-r,.
<br />. xvr :...._~.a w: r`
<br />..1, ::~
<br />
<br />- j.
<br />.'~`-i ~4.'-
<br />i
<br />~ ^ SAMPLE _ ~
<br />' - - - ;.
<br />` "
<br />Y .~ -
<br />t
<br /> MEASUREMENT ' ` ~
<br />' ~ ~
<br />/ '
<br />U ~
<br />. I-
<br />r PERMIT i -t 9~
<br />$ i ~ 4 c - '. >:, is
<br />~ r ~ ° - I -
<br />~
<br />-~ r ~ IIEQUIRO.tENT x.
<br />4" t 6 5
<br />;r ~r';`~ o-. ). is ` :
<br /> .~At ~.b.e. •..T c i
<br />.Y.d-}- i t"CN I.li`.. r.~ .~.s va'4.YVrL 1 .w{._wl ~t@lY u'r •1N -~Y. .'n f ~'. 1
<br />,i SAMPLE ~ ,. 7 ~
<br />_ '.i c: ! _ T ~ ," - - r ~ ^~ ' ~ t a
<br />-.
<br />_• MEASUREMENT ,
<br />-F .. -~~ - ` i
<br />_I
<br />- ~
<br />' `
<br />' ~ f '
<br />
<br />a. c CA
<br />PERMIT
<br />.Q
<br />:~.'
<br />t. $ w
<br />S
<br />r
<br />r ,.~ .x.
<br />r ~
<br />q
<br />'
<br />~, .i•txr i
<br />y. yr -
<br />_
<br />.~
<br />.u.
<br />.
<br />.. I ~ RECUIREMENT ~. <
<br />~ Ix
<br />- i, ~; ~ a of-
<br />~ _
<br />r ~.,.
<br /> :
<br />S :.. a.;. s~j..
<br />.id ,r». ,. e.^.
<br />~ ..-tom;--3.
<br />w tSF .i
<br />..
<br />V
<br />
<br />-..
<br />~ (i ~
<br />SAMPLE
<br />`', • ~]
<br />L v r
<br />_ ~ j.
<br />-
<br />.~ _
<br />-: v
<br />
<br />it
<br />'i .,;
<br />
<br />
<br />~
<br />~
<br />'.
<br />' °
<br />C1 MEASUREMENT ~ ~ ~ ' -' ~
<br />_ ~
<br /> ~ ~ ~ ~ a
<br /> PERMIT ~"
<br />i $
<br />.~.z
<br />~Ic I ate`°
<br />•V ~
<br />~ ~
<br />s 4
<br />~ '`;s at . 'k ~.
<br />` r' br"
<br />~
<br />~~ ~ {
<br />1
<br />~
<br /> RECUIREMEN7
<br />1
<br />~ ,
<br />``~~
<br />- t
<br />t t "E- ~ .
<br />"~
<br />( -
<br />_ ,,.. x .n.,.
<br />4 :..~+,-
<br />w.7+. :•
<br />,as br:°Gx t+F.. :tea.'
<br />3 .n,. .6.
<br />, •s ~
<br />= ~LJ SAMPLE Cr
<br />`n u - `~ ~. - ~ y S - ~~.
<br />~] _ `r }. " :. ..
<br />_L c• -~ L~ MEASUREMENT ~ - ,v ~ - _
<br />r - 1 ~
<br />~ ~
<br />u 'O M P
<br />RMI A t `u ~ .-^-~ , L
<br />'` /.+ } A^ _] k . .
<br />.. E
<br />T
<br />IR
<br />M
<br />T
<br />~ ' ~ N .
<br />/
<br />~•. ' ~ ~ ..
<br /> WEQU
<br />E
<br />EN
<br />' ° a t s y
<br />' ! -
<br />'
<br />
<br />~ .
<br />r.
<br />~~ ~ i-. X15..-.
<br />~ H3.a.:-._....
<br />•. n+
<br />T
<br />~
<br />.m>„
<br />r
<br />•" .w.-
<br />~
<br />~
<br />-
<br />~
<br />~ SAMPLE - ~
<br />u u y
<br />~'-' ~ . ;~ ~ ~ r. u
<br />^ L. ~
<br />-' nl
<br />~ MEASUREMENT 1-
<br />' .~ c - ,] ~- ~,
<br />t` .. .. ,
<br />
<br />e
<br />i•'
<br />^ ~~i'. w T
<br />s~
<br />y ~ r~
<br />
<br />~ V
<br />"'
<br />r "{ ~'~s~.. ~'~~'F
<br />_ YI.,. ,.Y)'""~R
<br />"
<br />t
<br />`X'
<br />~
<br /> REGUUiEMENT '
<br />.
<br />t r ~.w_ d- r'rrH ~+ ~_ -
<br />~ ,
<br />` .
<br />:
<br />~
<br /> :aet~-a`~,.- X.,~.#"u .+a .- ~;ac~~ :a:5a :aan..n. uY-.:
<br />~ .++ ... ..w ~~., .
<br />:Fk ~.4"e r w+,'.'.
<br /> ~
<br /> MEASUREMENT .. -.
<br />,
<br /> ~
<br />
<br />
<br />
<br />.
<br />,~
<br />'~ ,PERMIT . ~
<br />
<br />`"~
<br />
<br />
<br />_~
<br />.-.;; ; ~''
<br />7F _ - . ~;
<br />
<br />v _
<br />..
<br />a:
<br />1°; :--'~
<br />'u ~i~
<br />q , .~_
<br />
<br />, '+ ..
<br />
<br />~
<br />~. -s: ;
<br />
<br />J$~ ~
<br />-
<br />n
<br />..
<br />- ;REGUIREMENT v _ .
<br />_;
<br />-
<br />/
<br />~ ~
<br />'^" 'z
<br />~ x
<br /> ty .~' .~a. ks. cwla
<br />KssI- -ate es~ ' ,c
<br />475+: +kl.v vf. k;`
<br />ME/TITLE PRINCIPAL EXECUTIVE OFFICER. 'I CERTIFY UNDER PENALTY OF, LAW TgAT I HAVE PERSONALLY ExwMIrvED'
<br />' .- 'r
<br />= ` :
<br />~ TELEPHONE' ~ D A T E
<br /> AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN: AND BASED=
<br />~ ~
<br />~ -
<br />~~ CN MY INQUIRY OF TWSE INpVDUALS MMEDIATELY REEPCNBIBLE FOR
<br />T
<br />NI .e ~ c -~ I ~ " '
<br />R.G. ATKINSON ~' CH
<br />AI
<br />NG THE INFORMATION 1 BELIEVE THE SUBMITTED INFORMATON IS
<br />TRUE ACCURATE AND COMPLETE I qM AWARE THAT THERE ARE T _
<br />
<br />^ r
<br />70824-44~ o
<br />~r
<br />
<br />~ SIGNIFIGNT PENALTES FOR SUBM?TING FALSE INFORMATION INCWDNG- ~ {I 1/ -
<br />HSEQ & LAND MANAGER THE POBSIBSITY DF FINE AND IMPRISONMENT SEE IB uS.G 1. IOOI AND
<br />33
<br />se f
<br />n
<br />fk
<br />l
<br />k
<br />M
<br />i
<br />l
<br />d
<br />!
<br />'' sl NATURE O P
<br />CIPAL EXECUTIVE
<br />_
<br />TTPED OR PRINTED u
<br />r
<br />s u
<br />er
<br />ma
<br />t319 (
<br />na
<br />lae mroln meY
<br />nc
<br />u
<br />e
<br />uP:b.
<br />f/Y,dYY enJ ar nMTimum unO~Pmenr d bewan B mon0a e+M S yrue)
<br />~ OFFICER dR AUTHORIZED AGENT AREA
<br />NUMBER
<br />TEAR
<br />MO
<br />DAT
<br />MENi AND EXPLANATION OF ANY VIOLATroNS (Xeleronce a// erracamenU hero/ r
<br />i'TLEABLE SOLIDS LIt+IT APPLIES ONLY IP <~ 10-YA, 24-NR PRECIP EVENT IS CLAIMED.
<br />~D, TSS,~{~ IRON LIMITS MILL NOS BE APPLIED TO REPORT,CD MEASUREMENTS--S EP. I.B.lA,
<br />/nay
<br />(REPLACES EPA
<br />IP;CLAIM,APPROVED BYE
<br />PG 4 AND I.B.~D, PG 6ti
<br />MAY NOT BE USED)
<br />nnniF/Q~1.]na-1T7~
<br />OF ~
<br />
|