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PERYITTEE NAYEIADDRESS!/nrlude <br />fardiry Nrms/Cannon Udi//ercnr/ <br />NAME _`.Sl l.>+;1'_C9 CL .-r1t: F~(LL_ - - - - - - <br />ADDRESS i";'1.11 ~'tL n~~-- -- _ --_ -- - <br />FACILITY--_ '~_-------_---- <br />LOCATION-_______ __------- <br />6r •IARIT C ATR TR"( <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM INPDES/ <br />DISCHARGE MONITORING REPORT (DMR) <br />11-16/ (17-19/ <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM / y Uy TO y I, ~ <br />- ~ !1/F711 /11-131 !1f•1J1 /16171 118-19/ /30.3!/ <br />Conn App[ovua. <br />}' - h' 1 ! I h i . ~~ No. 2010-0OOA <br />proral er<plre>t t1-30-Q1 <br />I!hLLi, I: ~l ll 111111!:1. 7l: wl .~,1", Sri f. <br />' ~ <br />h I <br />- t- I <br />NOTE: Read Instroctlons belore complstinglhla form. <br /> (3 Card Only/ ~ QUANTITY OR LOADING _ (~Carti Only/ pUALITY OR CONCENTRATION NO. FPEOUENCV SAMPLE <br />PARAMETER' (I6J3/ (JI-61/ (38IJ1 1~6JJ/ ~ (Jr-6l/ <br /> <br />E <br />OF <br /> <br />TYPE <br />/31-J7/ AVERAGE MAXIMUM ~ UNITS' MINIMUM AVERAGE MAXIMUM UNITS . <br />x <br />16143 ,ANALYSIS <br />(61-bBl I <br />(69-70/ <br />I .. ~ SAMPLE Yl ~ ::::: ::1 i% rA ~ ~ ~:[;[ :': % - <br /> <br />r MEASUREMENT . ~ 1, - e I - <br /> <br /> <br />./ 11111 1 Q [ U <br />~' PERMIf. ..~ <br />10~F #fj rA r, C, <br />-ii~a.'~['J~ ~ r <br />+i 4, c <br />bti_5r 'I <br />1-.Y[rJl~`Q.fi?# <br />9AU <br />~ <br />'^ <br />~}~4LLY <br />}I A <br />• ~ AEOUIREMF~NTw n .< ~ ~ ~. <br />. <br />,. R - w [+ <br />~ 7 :i [~ <br />I <br />~ Q [ <br />.. <br />:;, ~ 4. <br />):.11/Or T'U~PAL SAMPLE Q:':: .;: C: : :._ ::: it %.:, : <br />' -: %AL<{=~::"• I _ . . 1 <br />I ' I F' ., it 0 ~ O <br />~' l.r MEASUREMENT' _ <br /> <br />1 ~ . - <br />I, <br />•_ - '' i. ~ I .~ G. <br />1'•Jl/ S O `~n _ A PlSM1i r <br />R <br />EN <br />r ~[Y C[ID <br />~ <br />~ ~ L',4`~'il~it <br />~ [ -` <br />- <br />%i-; C, :~', i1fA~ <br />'• ' na ~ ~~~pp g ~[ <br />3" 5 <br />+ Uu:~ ~ <br />. 1= r <br />_ <br />s <br />~C.~•If <br />R B <br /> 11E0U1 <br />T <br />E TR ~, <br />~' <br />11.16 ;i <br />:iCT~'I:EAi/L., ,. SAMPLE L••a: :;:: [ <br /> <br />•~ tj:;1 y':;::::3 ~ n;:::[1:${::[ ;ry: ,/:.: ~::::. <br />. • <br />! <br />} <br />r MEASUREMENT.: a f u L:~ ~1 - <br />- [. q~ U I <br />I ; <br />~ <br />`. <br />`I <br />P .n _ ~ ' <br /> <br />.. <br />I./'J47 }. `Q, ~U !d <br /> <br />~• PERMtL' S <br /> <br />~ /} r)I~L+g' S <br /> <br />~' ~ <br />is <br />::,~i;: J <br />u. <br />'T~~ ~/ <br />.~ <br />}V <br />wa [ <br />_ <br />~~ ~ _ <br />lIQ~~ <br />R <br />B <br /> <br />- <br />• <br />pEOUIRE~fENT <br />~ <br />~ <br />© ' . ~ <br />, <br />a-: <br />~ S 7 <br />' • - <br />• 4• <br />, <br />_ I. A i~ U ~ R EA r~i,f [ SAMPLE <br />' CA %: ;:+Fb~: i[ :[irJ r F.. ,. i•. .e G'?[ u: :A <br />~ ;:;u`:?:;:: ~ ~ ~ i <br />n <br />1L•JI, t:xT~-~~r•AV nl:r~, YEASUREMEN7• -/ <br />t- <br />'.; ;= :, '~ <br />r ;~ - <br />., - ~ <br />I <br />-• - <br />I'fr, 1 tr : 0 ~ ' `- $' PEmAIr ~ <br />EMENT <br />EOUI ~'AI~OYAy7l <br />I fi~4 lktT. •x+ia a0~ ~ At ~ <br />© ia+oilk/aurt }b"°' ~ ~ _ ~'!(~'I R B <br />.. ~. I .P <br />~ r <br />P D.. , h G C ,[ ~.y...,. C V ~ r `I <br />~~I11\r <br />'f ll 1'11 L'. <br />}~ ~ '. SAMPLE <br />~ _ [yr,:{.:}:f:::, <br />+ <br />' ~:ay #M: <br />: I - J /j[~[::f, <br />~~ <br />O •J <br />~ <br />[ ,. - <br />.j i ~ `. <br />~ <br />_ <br />(AS'F}:)- i c IyIEASUREMENT 6i <br />~ , <br />, - a <br />` ~ <br />i c n -_ •r ~ '• rv , <br />i I ~ N o ~7 ., C .+ . <br /> <br />1114 ti 1 ~ Q, ~ ~ ' <br />~ EME ~ ~ <br />~ ~ r 1 <br />1 0 ~ <br />' a <br />.X+Y?(: [o <br />~ <br />.0 <br />r <br />C. 'u n, <br />~ <br />~ <br />B <br /> . . <br />[a1Nr ~tl 61)11 DPI T'i• Of+- .. SAMPLfi _~ u ~+'::?i::dti/.. ] ~r u <br />[ 1 ~4~(n;: ~ {{{' rr' ~ °.•:::[.j4. :: t'i ~ ~ p~ ' <br />1 •I U T H t A ~' <br />C ~T P L A t(~' <br />[ MEASUREIIENT~ •~ , 4 m L' . <br />, to <br />+ 7 _ m _ j ! •• ~ j. C_i _~ L' •~ <br />~ <br />,1050 1 'rQe .n ... t ~ <br />o sM*: asr '%R'~ ~ l9 lAN.• <br />r? <br />~ _ ,r <br />. 11.1 USr i0'CAL .; r 6AMPLE I ~ ~rrr<j~/l ~~ ~:: SA[: tC[7 L .D t ,,Nr'A4 ~;[is[0 •- :}~1~~: r;u;: l li 'i •a ~` <br /> <br />L»~LVE113 c~ <br />l' RIEASUREMSNT J •+ <br /> <br />• L O .q ~ <br />~ ' a `~ W ? i n '' i `' <br />.~'- ~ M O~*' <br />. <br />mi <br />) 2115 1 n CI' c0.-°.1 <br />~ P MI ~ pa OGId r3 ~ ~ .j~•,[ •, Y '4~. REPO 1[ ~- ' ~ - <br />W <br />i Y R B <br />, <br />'n ~OUIRE~ENTb -r <br />Allt <br />' 3'~ , <br />p.. <br />.'.'7<' <br />~ r.~ <br />~ F <br />~ ;~' F <br />a q ..ri" y: . IM <br />Q <br /> : , , r <br />rt ~ <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER <br />' ~I CERTI FY UNDER PENALTY OF LAW THAT I HAVE~P ERSONALLY E %AMINED z <br />n <br />~ ~ a :'• TELEPHONE ~- DATE, <br />' <br />ATKINSON ~ = <br />1` <br />ls AND AM <br />ON MY <br />7 FAMILIAR WITH THE INFORMATION SUBMITTE <br />INQUIRY OF TNOBE INDIVIDUALS IMMEDIATE <br />RMATION <br />I <br />F <br />t B <br />EVE T <br />SUB D HEREIN; AND BASED <br />LY RESPONSIBLE FOR <br />MITTED INFORMATION ~ <br />l~~ __ ~ <br />~ - '" <br />^ = <br />`' ~ f` ~ <br />i ' <br />. <br />• OB <br />AINI . <br />ELI <br />HE <br />NC THE <br />N <br />O I <br />~ <br />/ <br />~ <br />" _.+ <br />'' I <br />' <br />$ TpUE , ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIG • <br />i <br />~ <br />--! <br />~ 4 <br />3 • ' <br />VP IAND/ENyIR(1NMENi <br />/~yFAI <br />A IFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING 0 824- <br />45 . 04 14I L <br />9 <br />_ .. =THE POSSU3ILITY OF FINE AND IMPRISONMENT. SEE 1S U.S.C. t .1001 AND <br />e <br />~ SIGNATURE OFPRIHCIPAL EXECUTIVE <br /> <br />TYPED OR PRINTED up ro !10,000 <br />1 1J10. IPenalde under !her •rrmre day Inrlude firr <br />0.7 U.S.C. <br />ondormarlmum/mpraonmrnrd6rrwrndmae[Mand Jyan.l <br />OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Rprrenn all a/rxhmrnts Arrr) <br />1:1 uIL 'r' GRE715t,--•;FF.rUi)ThUTt E'/ P7 fMh: FhhM1T._ikTTLF-AHL~' SULfUS T6'S'f hLI~UTh6D ONLY 7}' <br />,'(r:i~1P EVaT CLAIMi•:t:. IF CLAIM RPPHi)Vrf, iiY N~Ci)r Tit: 1C11N LTNI'f5 u11.L 1iY)'1• oF. AiIPLIGU TG <br />MAT NOTBE <br />1 <br />HEP~1'EU <br />l~u'••11 !'U. I )fl ll-1 it li• <br />OF <br />