Laserfiche WebLink
r[RMITTIC RAM[/A R[!! Onrfud[ <br />FrrJlry NamrlLanbn' rnq <br />~~-L'f~, ;.OAI.~~f~_°.'71:9-L)---- <br />- - -1=1.IL.: s TL£f---- - - - -E Z- Q 5 n~ L- <br />PACT LITY <br />LocwrloN _____________- <br />i~.T.^}7. f14'~1:T f_ CTCOFI rl4 DU CC Thp MT <br />nw Honor orwNr oc turn rrvw nDH SV ;rLM pYPUG 51 <br />DISGHARG LNITORING REPORT IDfIRI <br />7./b Hw/~ <br />PERMIT NUMBCR cr Nuu[Lw <br />MONITORING PERIOD <br />YEAH MO DAY YEAH MO DAV <br />FflOM L ( TO ~I 1 <br />nn.lll /]L7)I /767L R6.lh U8. _'91 /30.311 <br />gi~;(1R Form Approv <br />(S ^ 7 I? ~ i) ° ~'oMB fllo. 2oao-aooa <br />P - FI li n L E%plr DS 9-JO-91 <br />DI~C!Ip ~ ;ii Tf) p3?;i/FI_;)1 CR5?R <br />:.... }uJ DIS~NP?G~ ~__~ :.:... <br />,NOTE: Read instructions belore completing this form. <br /> (J Card Only) OUA NTITY OR LOADING (1 Card Only) OU ALITY OR CONCENTRATION ERLOU ENC• <br />PARAMETER (Ib-SJ) 13161) (Ja-13) 116-SJ) (316)) NO' <br />EX or STYPEE <br />(JI~J7) <br />AVERAGE <br />MA%IM UM <br />UNITfi <br />MINIMUM <br />AVERAGE <br />MA%IMUM <br />UNITS <br />67611 •NAL r515 <br />(616N1 <br />IbU-7U1 <br />I it SAMPLE <br />MEASUREMENT ~=i i'F i°'+ .. i"~ ( ) <br />~ <br />5' ... '" t;.:. <br />7 <br />95 ( 7) <br />1 ~ <br />O <br />)I ~ / <br />~ <br /> . 1 1.:7 <br />L .~(I ['~V I Qr. ~'PERMIT'•;' ~vx=~T )i~i:Y:. v~riFi-~=r° v` <br />"r ~• <br />'6}e': <br />': ~' ~ :=F i'v~:t it U <br />..1) ' <br />£^cRLY <br />BQB <br />Fr'DLU't:7 ~P^,S VpL(1, REpU1REM ENT- t# - <br />}"T t7 . <br />•: '!I cr <br /> 6AMPLE <br /> MEA6UREMENT <br /> <br />' ~~ PERMIT."' a .. <br />~' "'~ <br /> <br />... <br />~ <br /> RHOUIREM HNT '~~ "' ~ " ~•' <br />" <br /> <br /> SAMPLE <br /> MEASUREMENT . <br /> <br />PERMIT'.. <br />~ ...:.`;."'..:, '. ... <br />::. <br />~ ~~~ <br />.. . <br /> REOUIREM ENT ~ ~': ~. '" ~ <br /> 6AMPLE <br /> MEASUREMENT <br /> PLRMIT ~ ~~ ~ ~ - <br /> REGUIRCMENT ,. ,, ~ ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> RHgU1REM flNT ~. ~ ~ ~ ' <br /> SAMPLE <br /> MEA6UREMENT <br /> ' PCRM IT ~ ' <br /> REOUIREM ENT ~ : ^ <br /> 6AMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REgUIREM LNT ~ ' <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CCRr1Ir urvOCR P[HALrr or uw rNwr r NAV[ P[wSOHAUV uAMm[D <br />•HO AM EAMILIIIR MTN THE INEOPMATION SUBW TT[D M[RErM 1NO BASED TELEPHONE D A T E <br />` <br />~ <br />~~ ON MY rNOUIRV OF THOSE INOIV IOIIAL$ IMMLOIITELY R[$POH$IBLE rOR <br />~~ <br />IAJr OBiAIHING iHC IMrORMATIO.`I I B[LIL V[ 1H[ $UBMITTCO INrORM/.IION <br />IS iRllC 1000RATE AND CCMPL FTC I AM wW1RE THAT THC R[ 1RC SIG I~/ / // <br />~ ~i <br />[/j <br />r NIIrCAHT P[NALII[5 !OR $VBMITTIN4 F/rL5[ INr ORMwrIOM MCLIIbNG VV <br />VVVV <br />(.vl or G VIrD <br /> <br />. Irs <br />Y~Y \ TN[ POSSIBrLrTr Or rINE wHD IMPRISOHM[Ni SLE IB VSC 11001 ANO <br /> <br />}]USC 11]19 rYrnalne• uMn rArr Ham1.r nu. mlludr pnn uP r.. IP1 uH <br /> <br />61GNATUR OF PRINCIPAL E%ECUTIVE ~~J <br />Cr ~C'j ~"~ <br />.J a-v nf~ <br />1 D~ ~2 <br />J <br />T PED OR PRINTED vN... ma rr.r.n rmyrr.nnnr.nl../A. 1...n6m..nrA. and :..a... OFFICER OR AUTHORIZED A4ENT AREA NUMBER YEAR _ <br />MO DAY <br />COMMENT AMD E%PLANATIOH OF ANY VIOLATIONS (Ir!/III nCf r/ll urlua llTln/1 nrrrl <br />OCL E GP..ASE--SF.F, f'ODTNOTF. F/, PACE 3. ;?RTBLY SAi1PLING IT;S'IA!iCTI~;;~--fr~J°'1nTs n/[ <br />EPA Form 7720~1(R~v.Y-BB~Prevlous EMitions may be used. 1flePLACE. [Pw FORM T~.o wRICH MAV ROr .E OS[D.I FA4[ of <br />