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•ERMITTEE NAME/ADDRESS IIrII'IUJr ~... ~ .. .... .......... .... _, . ~. 9rulq nom{ u(q!1 In r) DISCHARGE MON 1AME +~~1~1~1 `~1AL ~.U 15); [1 G~.h Ii I `----~---- (5-161 ~ •DDREas 1300 __U1'N_YBL_E-_-_-_-___ _-_ U vu c~.d FLAGST9FF ~_AZ 86GU1 PERMIT NUMBER . ..............•...... v. ~ 1 ... ..: I ITORING REPORT r Dhl%1 PIitIUa rl]-rvl G A (SUfifi NH) olacRA•ca RuNea• E' - F I N A L nrcrua D!•c~ FoE161A~ved. OMB No. 2040.0004 B'eBrerrlpOreleha fRe11.OIIO P e v ----`~---`---"----'---`-- MONITORING PERIOD ua•+~.unaw c. -av'-a-nial-o nvv vl~warw -AgLIT-! T,~- YEAR- MO DAY YEAR MO DAY xaTlow tW~ owti ~oiYS01.~ _ _ FROM ro ., #~~ NO UISCHAAGE ~ ### --- -- - - ( AT'P N : i Filial i S L s T v ° ` `°N , E' R E S I D E R T (1aa11 (n-1J) (~+-1s) r16-1)l (18-19) (Ja31) NOTE: Read InelTUCtlone before ompleling thls form. ().Gerd Only) OUANTRY OR LOADING (1 Celd Only) QUALITY OR CONCENTRATION FRE NCY PARAMETER (16.37) (f161) (38-df) (16.53) (3161) NO. EX ~ ~ Yys SAMPLE TYPE (31-17) ~ - AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MA%IMUM UNITS (!]•71 (6168) (6A~]01 I, R ~ 'J - >x#Ks ( 12) SAMPLE ' MEASUREMENT U041,U 1 0 U ~ ... ' ( ~.~~ ;: .: ..,: . ~~~ ~:- !~ • aa:: _ ~ o. .~~:. ~ a# #>a .: - 9.0 ~ ~ ~ oEBRL 6HAB .PERMIT : ;, ,. ..a ..; .. : ,. ~ :: ~ . . EFFLUERT GROSS YALU °U"~~T ~~' '~ ~~ . ~ ~ ~:- #### ~ gINIBUM _, : ~ ~ ~ ~ = tlAYItlUtl SU T . ., . : . , . . , , 0 • 0 6AMPLE SUSPEtlUEO MEASUREMENT OU53U 1 0 0 :'.FlRMIT - , ~ +~#K: RC H EFFLUENT GROSS YALU uuo~~. '~ ; ;~ av#r- ~ " 30DA ~ AY '' DAILY ~ H% HG/L tlOHY ~ .; , ~ . , ~ r ; 0 S SE T EAHLE # # ~r' :###4 ##a#luz! ( 25) , SAMPLE MEASUREMENT UU545 1 0 O ~ #~~ A E G $ EFFLUENT GROSS YALU PERMIT aP!REMEN* t.e ~ `~!~' _ ##K:%~ '~ DAI~LY~~d tlL/L . ~ HONT ~ 1 SAMPLE 4 ~' Y; ~ FREON E1TR-GRAY HET EASUREMENT UUS56 1 U 0 nivr ~„- `P '. ##r C NTI GR B. EFFLUtibT GAO5S VALU , e CU!REMENT ~. • , `' :, #.+PK<# ~ IRST'l1A tlG/L GENT , B SAMPLE ~ v6r" ' (A~ FE) MEASUREMENT ULO4S Z U O .'•#'J;i • • G PERMIT ~ ~ EFFLUENT GROSS YALU ~?nME!+* ~° - ~ ~ - ~ ~ ##~:# ~ ~ ~ ~ '-:;30DA APG DAILY tl% tlG/L BOAT ': ~ " • SAMPLE U ~' v •Kr'-A K~ #~a"r # j TtlRU TREA TRENT FLAN 9UREMENT SOU50 1 0 0 #### y EFFLUENT GROSS YALU PERMK t;.. umtMaNT :`;,;30D6 ~AY.G ;r :DAILY,'a% tlGU _ #### _ ' B SAMPLE ~ UISSOLYED MEASUREMENT 70295 1 0 O ' ~"#^' ' U R OH ~.. 0 C GRAB PERMIT .. ~ ~ ' ~ ,. , .. . EFFLUENT GAOSS YALU EuulrtEMENr .:'._•,:.,>, ~ 2::,.; :._., ~ ,-~~ .? '. .. ., .:;.'.: ~...= ##~~# , :~ .. s°,......... 30f)A`: llAILY b HC/L .~' , .'BONY NAME/TITLE PRINCIPAL EXECUTIVE OFFICER 1 cEaTFY IADEa PENALTY OF LAw rluT I HAVE PEw5o1vAI-Lr ExAMINED TELEPHONE D A i E III... !p G Q_ K `` ~® ~ Al0 MA FAMIWR WITH THE BiDRMATx%1 SUBMnTED HEREVt AND BASED N eI E L F ' y V 1! \ L AMING THE NFpftMATR OBT NL BELIEVE TFIE SIIeM TTED R+FOaM iA qN IS lAl1E ACCURATE AID COMPLETE. I AM I~WARE TWT TFERE ME SICNFICANT PENALTIES FCR l1BMnTWG FAL E INFORMATg11 INCL IC IDR ' LI 1 ~/ ~ i / {, ( ~ ~ ~ O ~ S S ~ I P TH ~~~ T i ~~ I / 7 O 6 ` u W / V ( ~ ~ - Rl E I y IB R 11 M h N ~ ~ uE rn~ O1 ~° SIGNATURE OFP CIPAL E%ECUTIVE /~ ( . ( 10 u e I eR m rtuy e , u E ' TYP OR PRINTED f10,600 end or malimum im•rYl•nmenl o! benOn 6 monrhr eM S ye,nl OFFICER OR TNORIZED AGENT NUMBER YEAR MO DAY COMMENT AND E%PLANATION OR ANY VIOLATIONS /RCPorcnre ell •fferhmrnN hrrt) UIL E GREASE--FOOTNOTE F/, PG 3. SETTLEAtsLE SOLIUS LIfli'i APPLIES ONLY IF <= 1V-YR, 24-RR PAECIP dYtNP CLA1tlEU. IF CLAIM APPROVED BY HQCD, 'YSS E IRON LItlIT5 HILL NO'i tiE APPLIED TO RdPGHTED HEASUREtlEATS--SEc :I RPh FnrT 3.'O-1 IRpv 9-RR) PlPVlnll$ Pdilinn< may /w ucPrl .., (REPLACES EPn FORM T~aO WHICH MAY NOT RE USED( .1 ~ !!I n 7 ~ n _ I 1 .I ~ PAOE (OF