FaRMlTraa nwMalwoowaa• (lncrudr
<br />F~rdlry Nand dl/JarnrJ
<br />llAtls_I'.C q~.~D1I•S~ ~'r~')S~lIL---
<br />--- F L A :~S..AF~_--_ _ _ ~~ ~3b~DL-
<br />-ACIUTV -~ - ----
<br />ATTN: DE!+NI•S~_L. SS °Y ENSDN PR1?ST6EMT
<br />Hwn DHA VOLwrenr DncH Awee ulMrNw noN rraTaM lNPDESI
<br />D19CHA MONITORING REPORT lDMRI
<br />17~1fl
<br />f) ~
<br />•CRMIT NUMaaR oIF<Hnwcr NVHwEw
<br />_ _ MONITORING PERIOD
<br />YEAp MO DAY Y[AR MO DAY
<br />.FROM ~ TO ] -_
<br />RD-211 /1b3)1 RL3L. 136 / qR-J / / 0. ll
<br />MInON Form Ap~
<br />(SU11R NI:J PONB?No. 'lEdO.0004
<br />F ~.~- FI N A ~ Explrea 9.30.91 '
<br />ACUTE wl:;~ r>±STING._ FOF. OO4A
<br />- I - '
<br />46t NO D~ISC4ARG£ ~ ~^~'~
<br />NOTE: Raad instruetfom before e'omaletinY this form.
<br /> (! Card Only) gUANTITY OR LOADING _• (1 Card Only) qU ALITY OR CONGENTR ATION
<br />~
<br />~ -
<br />~ FR[DU ENCr
<br />PARAMlt[R (I61)) (Jrfil) ~ (lBIJ) ~ (16J)) (71fi!)
<br />_
<br />~ NO.
<br />x .DF 6AMPL
<br />TYPE
<br />i~
<br />()1'17 E ANwLrslw
<br /> AVlRAOE: "MA%IMUM' UNITe MINIMUM AVlRAOE MA%IMUM - UN1T8
<br />P/F STATzE _48NR ACO SAMPLE aar~~Aa#
<br />
<br />1 Y,E#Cc4,il#
<br />'
<br />~ (` ~~ E ~ - :I
<br />- ~_ aaaaaa
<br />- : ~ ~_ ~ =~A~: .~ ; ,~/9D ~
<br />r~
<br />
<br />CERIODAPHk~A~ MlABURlMFNT .. -~ ~ A ~_
<br />~i n
<br />TGH 38 1 o- ='~
<br />
<br />~ ~e~P6NN"(T§~~'~ pA.p:~k
<br />„rJ,[?~~~,t
<br />k
<br />~ x'~~i'eN~~.`f*r~~s
<br />~
<br />,y
<br />~ Rtad ~ ~ ppip ~~
<br />«sin.EY ",~4
<br />~ ~u¢°.aA10{C±2L''ih~.",°.:
<br />T
<br />T.,'i
<br />a ~.Ha.l (~ b«
<br />~iri.~
<br />~~- a
<br />-.
<br />.~5~ ~~
<br />cy
<br />
<br />~ a. n
<br />~AIY
<br />EPFLIIENT CROSS YALO ~„>?
<br />~ ~~q
<br />~
<br />'~
<br />~
<br />$ g~y ~
<br />y
<br />'
<br />;
<br />am' ' aar ~ `~ ~
<br />m
<br />:« ~' $ ` ' ~,~
<br /> .; •
<br />/. .LCS
<br />a
<br />F g
<br />..J~" ~5 .:a ~, ~ e~
<br />P/P, STATkE ~96NR ACU~ =.AMPL! = loaaaaa~,
<br />m ~= a ;aa~a.aa
<br />.
<br />t
<br />• {:.; _) . ,~-~ ° ~
<br />? ~uL~aaa
<br />v ; ~
<br />r -{ ` `
<br />v
<br />:
<br />9~~: ~ ? ,(9v
<br />~ 6rCr{
<br />PIMEPHALES=P~OHELA~ M[AlURlMlNT: . ; r
<br />.
<br />-. G ~ -. r
<br />~
<br />^ ~ .
<br />, /
<br />r c 1 ~ ._ D .-
<br />- .g= reRM.kfe`stt
<br />~ Po~g~ ~. ~
<br />:~
<br />o-'&
<br />a'
<br />'X ,~s s~#~t ~;
<br />~ ~„
<br />
<br />~ raoa °
<br />.; ~~T e~'>e~
<br />~
<br />
<br />,~ :~ °>~
<br />ik.~~'w'
<br />{'~'
<br />~C~1'"
<br />°«
<br />~
<br />~~ s=0
<br />
<br />
<br />"1 $
<br />
<br />
<br />~" ~:.~
<br />'~''.,
<br />
<br />I..„ .
<br />.~~.~.
<br />EFFLUEkT GHO 5 VALf1 1[N:.
<br />a i72)lR
<br />~''
<br />ra ' ...,
<br />z: p
<br />a
<br />~
<br />:';~°. II,v~.
<br />~ I
<br />t
<br />~':~ ~ as a ~ - .w,~«.c
<br />~ ~ ~",.d. ..
<br />;~;F«,
<br />~•~ °' ~ a 1.
<br />a~ .~
<br />"`~=
<br />~
<br />
<br />a
<br />-~;:.
<br />^
<br />,e ~
<br />~~ '
<br />~ ~H
<br />~~ '.
<br />~~,w
<br />~
<br />~~
<br />''
<br />'' V ,
<br />` .]eAM PL! i a • ~
<br />~ ~
<br />~
<br />` ~ _
<br />w
<br />F O
<br />r L` y ~ ~ j
<br />O ' 3 =
<br />~' '`Z ~ J ~ ~ ~~
<br />_ i
<br />~M ~
<br />'
<br />• MfJ1eUR[M lNT O t. ~
<br />v
<br />~ - 7 I _
<br />. ~. I 3: -
<br />a _
<br />i
<br />.~, .,
<br />. .
<br />~
<br />~ - ' _'
<br />O_ O . Yrw i P~'e AB's ;~~°
<br />~
<br />` ~ ~ .;wB„ q; ; x'#r ~., ..
<br />&p .y ~. ~ _
<br />~
<br />' y
<br />~ `
<br />
<br />... .. ~ - ~-
<br />~I
<br />
<br />HIA ~~f• aa
<br />v"m' ~ti" a ~
<br />~e~t°" ~ ., _
<br />x
<br />:." '
<br />«a'¢
<br />a ~' G
<br />
<br />_ q ~
<br />'# 'Er~,o- a
<br />r » ~
<br />S.
<br />~~ c T ,:;
<br />~
<br />t 'S
<br />a,.: b .
<br />~ eta` p
<br />-
<br />S -
<br />`
<br />a y
<br />T. <
<br />
<br />•::
<br />~""-
<br />3
<br /> b ~
<br />' C -' N `, ~
<br />.
<br />^T .).AMPL! ~ -
<br />C: [j' = = r ~~ ti ~ Oc :. ~e N C G
<br />= `, _ ,~ ` I Z ~ ~ i t ? ~r
<br />.
<br />'
<br />. .+ '^
<br />~ MlAIUREM ENY ~- t? ~~ 'C` = I` ~ _. c .~ t: C c. ~ 1 .
<br />C M1 .- ...
<br />- 4 :v ~' `
<br />_ n. ~
<br />V
<br />.~ e: w
<br />~~»t;~PlRMI'f'. ..~
<br />
<br />.
<br />' ..,+
<br />z.•.`, a:~ xq~
<br />
<br />'
<br />'c'^' -
<br />~Ak:
<br />~'.~'.;'.~. •.n
<br />:.>:%.~rn,.q.,."6'=~ - •~
<br />
<br />~
<br />^
<br />~b,~
<br />~ .x?fia
<br />"
<br />-~
<br />~
<br />
<br />L ,. ... ..
<br />- :-~
<br />
<br />11[AUIR~M GIT ,
<br />'A, 'k
<br />":''S.
<br />t: .~
<br />'
<br />ms
<br />s,
<br />' :,~~ :ro
<br />^
<br />~
<br />'.S*: qr~«'"b
<br />,{,, ~'~''
<br />.
<br />;e.ze;~ga°~...
<br />~t•a_
<br />"~
<br />
<br />' {''"
<br />Ssa~~aml'o,
<br />~'a.,` '~s~r
<br />` _
<br />-
<br />
<br />II
<br />
<br />~[^J"
<br />=
<br />h ,
<br />"'FF..
<br />"'>"3 .. •
<br />'
<br />`
<br />
<br />.
<br />:
<br />~~
<br /> p
<br />
<br />a'ai .,. ., e= 'd`
<br />
<br />~c «
<br />:3,
<br />„ e gII e; .
<br />. Y+Vb m d+x ~
<br />Y. /'dfP. nl
<br />~ .{/e
<br />' .
<br />h
<br />Y y.: . .
<br />!°.2v3:. D
<br />• . '. "
<br />:
<br />:r
<br />~ L~ T: aav(
<br />'.AMPLE
<br />'P t
<br />y
<br />~~ _
<br />_.
<br />c `
<br />F ~
<br />I
<br />L i'
<br />- ra
<br />.-
<br />~
<br />~
<br /> MiA.U REM ENT - ` u. ~ `
<br />~~ v ," =
<br />C ti
<br /> `
<br />
<br />
<br />
<br />.
<br />'~
<br />= x i
<br />nt+EHFi iT "a+.
<br />Ii ' wa,'3gm8S: ~ i"a nk5;
<br />n: eP. "q;w.~~
<br />`° 'd
<br />~°k`ta?'~
<br />n~"a
<br />'~i" 's'
<br />n
<br />`:~d
<br />° aL
<br />'
<br />~
<br />_
<br />.%''y ~i. '`"
<br />uav S.`a~r e
<br />~>+ n ~
<br />, -•,p
<br />.~'
<br />• ~e $a Yv.'r es
<br />GK«..~. a'>F~#:
<br />• ` x
<br />mss
<br />~' ,. ~.S,bar
<br />'i.~'.'o;"~S`'xd
<br />
<br />"
<br />' .
<br />.
<br />LL
<br />
<br />
<br />"
<br />lr ~
<br />",.~.:A.
<br />.<Ni
<br />y, i~
<br />
<br />':.
<br />..I•:
<br />Y
<br />' ~~
<br />~ [OUI itlNT;
<br />A~ db .g
<br />~ ^ :
<br />,
<br />#'
<br />e
<br />a za
<br />'r
<br />~s .. S
<br />* .
<br />;
<br />g~
<br />~,
<br />s.~
<br />ga, e.= a
<br />;
<br />a>Y. a3
<br />~~t.
<br />u >t~~.¢~.
<br />$aA fl
<br />i ^d~s? N ~,
<br />'Y ~
<br />&
<br />:
<br />'
<br /> .
<br />~
<br />~
<br />
<br />c
<br />y<« Ara
<br />II
<br />Y. Mrp„ ,j..
<br />
<br />q,,
<br />, n.a,
<br />
<br />ka. .a~ . ~.
<br />
<br />,r
<br />
<br />~
<br />.
<br />t.
<br />.,
<br />,:
<br />_' =
<br />- LeAMPLE ~ _
<br />- - .] r ..L L `> a C -
<br />" V'.p L_
<br />~ ~
<br />- ~ ~~ - ~ -
<br />-. ~
<br />.
<br />• - MEABUREM ENT ~ _~ _,
<br />...
<br />~ _ - I
<br />,
<br />C `-
<br />- - ~
<br />3"ieeM i7: s ~F, au''ds 5.
<br />':
<br /><;g..
<br />'°
<br />'~
<br />gq~>.:. ,q~
<br />r ika ~h
<br />.a 'x
<br />:
<br />~
<br />
<br />-
<br />~ $!{Ih,'m.#'$?'..xy~c
<br />a s
<br />x.
<br />4
<br />w` as "~` x'?Lx S$Fn'"kn P&y:
<br />ri .~.a.
<br />~ro~
<br />~ a
<br />"~'
<br />=
<br />n..,'> ~ `III
<br />.& 's ,cFX 8.i
<br />k
<br />z ..d..;#a~,
<br />:
<br />` ~
<br />_
<br />]
<br />_ ~§. i@
<br />
<br />.t.
<br />" ". :a lF..
<br />
<br />.:
<br />.>`~ ,.e° •21
<br />I'
<br />.;'•'
<br />
<br />. ~ .. -
<br />~HE4U)R!M[NTi
<br />RyS:
<br />~
<br />"a aa°""e
<br />g
<br />~
<br />~ ~
<br />.
<br />~
<br />~
<br />~ _ .
<br />.
<br />y ~~ xn.g~~ ,
<br />R
<br />e~ ~a.«~~ng ai
<br />sm:
<br />R`
<br />^
<br />~ ,
<br />s yy g4
<br />a °re3
<br />.'+
<br />R
<br />° _
<br />..
<br /><I ,
<br />
<br />~"~':.
<br />.`$~.$~ a.a
<br />:.
<br />'
<br />x
<br />. .
<br />n
<br />.~en:k Y . V
<br />~
<br />:k a.
<br />a I x ai sgu~,8. ,
<br />@a
<br />ma. ,
<br />.B.
<br />A$~,ek'...
<br />mm~8.: <, C.
<br />.
<br />P. '.
<br />;c ] .
<br />~ BAM PLE ~ ~ u C _
<br />..~_ .. ~ .1 ^ _ S Ib e,
<br />~ I
<br />~ ~
<br />. _
<br />_
<br />,~ ~
<br />- MEABU REM ENT ._ .. - 7 C+ .
<br />IL ... -
<br />= ~ ..
<br />V ~+ ~.M ..u$/
<br />•ka (•NN(A. .°,Y:'
<br />v.~
<br />ya
<br />~[ II, ~%&e $`"$ q II«
<br />~c
<br />ttd~
<br />V;~'
<br />"~ ~a$s~$~ `e'B
<br />
<br />.
<br />a° Y.~"P':w qq~~ he S: -
<br />I
<br />r 8F' 8 _@~a ~
<br /><a~ a^~l
<br />
<br />~~p;r
<br />~,f. ~~
<br />p~
<br />" e'~n:'z &~»
<br />" 8 T`.+'.a.
<br />i Ca's''T
<br />x«d® bSID¢,~Y;&..'a3 ~q
<br />.ii S~i y°~.Y,'~p %'s
<br />W ~ t3'. ~
<br />
<br />_
<br />~ „;
<br />
<br />x~
<br />' :.m(-'~.vF~~. ~:
<br />l tr;.
<br />'R:p3 FTII'i4"
<br />'~~ .lr't"~. ~3'6 s.'.
<br />y,
<br />
<br />.
<br />'
<br />.- -
<br />_ .R! u(
<br />LN
<br />Q R~SS. V „
<br />'r+
<br />:' _
<br />ne
<br />9w ,
<br />~mys„
<br />"e
<br />f ~ „
<br />.
<br />.
<br />r
<br />~'" i~0 •sT'
<br />s O
<br />4
<br />~i'/ro Vqe
<br />s A'a -~ w `S ..y
<br />.
<br />^s
<br />c
<br />, d RI ~b
<br />' 5
<br />6'xy { &'
<br />.
<br />~
<br />u-3n i g:Yi
<br />kr
<br />~
<br />.. '. frxw .
<br />a
<br />- .
<br />ne
<br />y «
<br />~
<br />J~k
<br />are ~>8^ ~
<br />IIc ~br.. ~
<br />)
<br />sic
<br />..: me.
<br />. d" a
<br />NAMlRITL[ PRINCIPAL [%[CUTIV! OFFICER 'I C[RrIFr UNDER
<br />w[NALTr
<br />OF LAw
<br />THAT I HAVE F[RSONALIr [IAYIN[D - _ -
<br />AHD AY FAMILIAR wITH TH[ MF011MATON SUBMITTCD N[REM AND MSCD ~ ~ ~~' -:
<br />` TILRNON! D A i E
<br />1/~ ~ C- ~-
<br />(A/f N~ ... .,^ ` ~- _
<br />~.~~ ON YY INDUIRY Oi TMOSE INdVIp1AL5 IMMfpATELr RCSPONSIBLE fOR. ~~_
<br />OBi AININL THE INFORMATIO.'r. I BEi1EVE THE $UBMITT[O INFORMATION
<br />~ ~. - ~.
<br />;. ~:
<br />,
<br />
<br />
<br />~
<br />':
<br />'
<br />lf~
<br />IS TRUE. ACCUPATE AHD COMPLETE I AM NWAR! THAT iHCR[ AR[ 51G
<br />NIFICANT PENALTES FOR SubdITTML FALSE INFg1YAig11. INCLUpHL `
<br />
<br />
<br />G
<br />
<br />
<br />~
<br />rl
<br />SI, ervlsCr
<br />.~n~• r
<br />~ THE PO551&LHY.OF FINE AND MPRrSpHMCNT SC[ IB u5C 11001 AND 61gNATU E OF PRINCIPAL E%ECVTIVE
<br />D u5C f 1019 rP
<br />M•r rnrr uarvrr. n
<br />In l14IXwr
<br />~sr
<br />lr
<br />ld
<br />/
<br />n c'Z 97Y 51 ~ f
<br />-
<br />
<br />.L TYPED OR PRINTED r
<br />rm
<br />RS u
<br />nr
<br />r
<br />m
<br />VO
<br />a.d ~.rrn.r~mun rn~Pn.,nrn~.rU ~~/A.~ruwnAmunrA. and .{.r.F.r OFFICER OR AUTHORIZED AGENT
<br />NUMaER
<br />YlAR
<br />MO
<br />OA
<br />GOM MENT,ANO EXPLANATION OF ANT VIOLATIONO (Rrlornn all mmanmrnu nrrrl
<br />SEE PAP.T -I.F3~DF PERMIT FOR CF.'IAIl.S OF TEST PI20CSDUHF. R5F'ORT 4E'SULTS OF IBC TEST .4S YnIN[ryIIMN AND 5!)';
<br />lIORTALIT7 TEST (ANY CC'NCF.NTNATION) q:, ">14%IKllit'r AIID AT?Arn A('pTF TnCICITI'TCST R°FnRT FC4'+ T7 DEF.
<br />E i°or 20-1 (R 8)' ~ /. ua Ad Dha a bB u5 ' . IRaF LACaa eFli ~o 'T- 0 w kn MAY Nor •a usE D.I Fwca of
<br />DJi'';4/o~gF,l'i-1.:41 1
<br />
|