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PewMITTa[ NAM [Iwoow[n (/ndudt NwnoNU yo LLUrwnr DucnARCt to Mlnw non •rsrEM INYDEJI FiAlly Ntmr/Loa dl/Jern!/ DIBCNA MONITORING REPORT IDMR/ tlnlns-3.P n,L r n A [. ;~ 1SF11~C~ 111-~--- / x.19 n l u n R ZooR[n13 _5~.1SN.-1'91.f:---------- 0 ~ 0 ~ (; U d R N V J _--PLA,;51'AF~---_---~~~~1- •CRMITNUMB[R oncw.RCtnoY.tR F _ FIt7A1.. wY Form Ap~ P. 04B TNo. ~IQO-0004 Elplres 9-30.91 ----- -- ------------ ~ MONITORING PERIOD ` hCUT6 YE'C TESTS NC. FOR OD[3A -wclurT ~ ---- YEAR MO DAY Y[AR MO DAY LOCATIOY _ .- ------------- FwOM TO i. ' , __ I Cr K'!h (+r)R N[~ Dl'SC°4RG F: I A TT N : DE'[ N I'S ~ ~ L. S T ~ V T• N 5 D N P P. E 5I C° N T ~ ~ l70~71/ 17773/ /71-7s/ ~ ~ 17 - / 1787 / l a 1/ ~~ NOTE: Reed instTUCtiolu before mmpletinp this form. ' (3 Card Only) DUANTITY OR LOADING ~, (. Card Only) QUALITY OR CONCENTRATION PARAY[T[R _ (16J3) ~ (Jlfii) (3sIJ) (16.13) (Jldl) ~ NO. FREautncr or [AMPL TYPE (37.17) W' - -~ EI ANAL rsI! - AV[RADE J MA2IM UM ' UNIT[ ' MINIMUM AVERAGE MA%IMUNI UNIT[ 6743) (61fi6) (69.TD7 P/F STAT;tE:.4f~RR ACU BAMPL[ Oar>,aaa -' ac113aK[v ~ (~. :) - _ _ #a~a+ka ' - _ ~ 9A) !/ T / "'~ CERIODAPaNz.A= _ M[AiuREMENr .. ~ c [ Z (_/ TGn38 1 (T ..0 ~ r~,,:P ,~.,. EAMIT .. .. mow..yr ,.gql. abd< •m'..4.. '4p .. np fF.: ,°; ~, ra.~.~'f~)li~?iF ~ Va C: _'~~,~ .s ~#' .,~~E.Z~~+.~, [},Y:~ ~me~~ ;r > SS=O _ I ~ ~ a:R~~.. ~yn EFFLUENT GRO55 VALU w[QU~ • •.~,1 ; s'.p:r..b< a; M~y...a r ° - . Kfr ,a s~ ~'~f ,b:: ~e~°:~. ' .,• ... ~ ~ ,~ ~ ~ r d.. . 4 ; n.e r, y a .: N• Fy .,~ . f p; d C.{ r _ _ ;~v Ka..F ZT „ '1e P/F STATiE_;96HR ACU. BAMPL[ si0a-71~?>7l „luscaas (: -) - '.' aaaaaa '~ :( 9A) / G7R~ PItlEP9ALc5= PRD[1ELAS' McweuREYENr - - - - . : .. ry ~k~ . ~ . TGN6C 1 0 :0 ..,... •'.9 ~~~ rsaw)~'- .. ( ' M ~ '-bj71a~14~vr xe W'¢:. .w+~#;~i~:~#,S, r ' ~ 'aaa - ~ ~>~. 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' =1:,:,' NAY[/TITLE PRINCIPAL [[[CUTIV[ OFFICER rl CEMTIFr UNDER PfnAlTr oF LAW THAT I NAVE PERTONALLr [RAMIN[D -AND AM FAMILIAR WITN THE INFORMATION SUBMITTED N[R[IN AND sASED• - T[LlPNON! D A T E G ~ ~' ° ~ ON Mr INDl11RY OF TNOSf INDIVIDUALS IMMEDIATELY RESPONSIBL[ F011 _. ~~ ' •~ - • 7. ` = ~"~ •~ . ~ - ~~ OHTAMING THE MrORMATq:1 I B[LICVE TNC SUBMTTED INFORMATION ,LE_ I ~ ~ ~_ ' I- '~: > -~ - ~ '~ ~~ ' 1 , ' . ~ i - [ .R TINE. ACCURATE AND COMPLETE I AM AWAR[ TNA1 TN[R[ AMC SIG . ~ _ /' ' ' NIrICANT PENALTIES FOR $UBAITTING fAL$C INrpRYIITgM WCLUdNG ~~v ~V I ' hV ~~}(\ 11/ ~ 1NE POSSI&UTY OF FIN[ AND IMPRISONMCM 5[C Ie USC t 1001 ANO I 77 ~'S2 ~ ~ 1 / ~~' (~ , ` t ' '»u5C! IT9 IM1.MNir. uMr. Ib~ Marvin sr mrldr /mr • .P n, EIUMn SIONATU E OF PRINCIPAL E%ECUTIVE Yt ~- J - - TTPED OR PRINTED n•d •.•m. l.mum,myn..wwl.nt ~./Ml..rrnt+•~nlA. rwd.S .rE,., OFFICER OR AUTMORIIEO AGENT A NUMSER YlAR MO OA COMM CNT.AND lIPLANATION OF ANY VIOLATIONS IRr/rrrnrr RII wwrhmrnH Arrr) L. SEE PART 'I.~R IDP PERM77 FAR DF.TAIL5 OF TEST °RDC?DUZE. P.~PO°,T RF'SU[,'PS D~ IuC TcST AS "'fiNIMU'1" AND ~/T'; [fORTALITr TEST (At1Y cnuCF.NTRATiD[+) AS "M IIY.f9Ur" AttD ATTACN ACUTr' 1'ORICiTV TF,ST RF.[ORT F•ngtT T'1 DyR. Orly 1 (R . Y$B)~ A u1 Ildh! ey u eJ. RaPLAtE a-w C•o 'r-.0 Ev 1cn Mwr Nor Pa ua[o.l Pwaa of