P[RMITT[[ NAM [IwDORLif (/n[ludl
<br />FErOify Norse/Lonfbn IJdiJfrrenr)
<br />wooRLnS:P1JiYrL1:7'~L----_--- -
<br />---'tF)'~c F--------yLit11JL-
<br />-waur+r
<br />LocwnoR _-_-_--__-_-_-_--`_-----
<br />NwTION wL rotLUTw NT OlfcNwwGt [uMINwTION fYSt[M IIVYUtd/
<br />DISCHARGE MONITORING REPORT /OMR!
<br />1/6 /7/9
<br />I.~ll~~. L. 111 I.IT 5
<br />•ERMIT NUMBLR Oltc Hwwc[ NuMt[w
<br />MONITORING PERIOD
<br />YCAR MO OAY YEAR MO OAY
<br />FROM ~ U V TO ..1 ~.. J 1:
<br />/10JI1 /11~LI /167L /16~ l /]A-00/ I 1
<br />:7 1 '~ (, is Form Approved
<br />(SL'.'i'+ fi d) MIOMBiNo. 2090-0004
<br />- f' T :1 A 1. EXplrei 9-30-91
<br />Sil:Yi;I. l'U4I. LL);:LUI!T/'I'aYL.11( ('!i
<br />NOTE: Read in[truelionE before eomDlstina thiE form.
<br /> (J Card Only) OU ANTITY OR LOADING 11 Card Only) QUALITY OR CONCENTRATION
<br />PARAMlT[R (Id-JJ) (lI~61) 1JB~7) Ilb,ff) 11161) NO.
<br />EX Fw EOOUF NCr SAMPLE
<br />TYPE
<br />(lZ-37) •NALY815
<br /> AVERAGE MAXIMUM UNITE MINIMUM AVERAGE MAXIMUM UNITE
<br />61b1
<br />) 161~A1
<br />16911/)
<br />I SAMPLE ': yt I ;.:r..: ::: r } / )
<br />1 ;I {.:. ( ~ ~I I
<br /> MEASUREMENT
<br />I //I( li [ 1~ r `PERMIT'... ..,r.'xlk:ky'E(':.: ~:4~:1T/AXFZL4` ` .rt:;:::: 6'A~
<br />~ •:iztr&~:?F.rF:~~: :.9~:0;:~:~;i
<br />~:
<br />' ';: BLit
<br />"LY ~RAE±
<br />
<br />
<br />L' l U c: tt 'P G R 0 5 ti V .4 L U
<br />ReOUIReM ENT
<br />
<br />{::r.;:.:
<br />
<br />M
<br />i~ e
<br />e . .
<br />'
<br />)1.[[I.`i, i7TAL• SAMPLE . r.::,: r.: .: ( ' :j:Y: ~:: ' :} ( ~lf)
<br />~~ I ~( t•'JUF. 1. MEASUREMENT
<br />r ~
<br />..U 1 0 L
<br />"'PERMIT::
<br />'
<br />piif~h"~`
<br />IRAt~(t {E~
<br />V
<br />{L is :7
<br />
<br />iSrFy3s
<br />7:r
<br />~*i
<br />
<br />i.°,.`
<br />.~s'
<br />'s1`
<br />~G'°j+: s."¢
<br />
<br />Y
<br />L.~~'
<br />
<br />R![6
<br /> REOVIREM[NT. ' , .. .:y:.. ,
<br />c
<br />.
<br />II [CJ, iEiTI, F'A iIL[ SAMPLE ...: ~!Y•~;1 ;I.;:.,Y t rE.~ ( ) ;::J {+:~:;: :;: + ;; ;;[.'I ~{I ( LJ)
<br /> MEASUREMENT
<br />1. ,'115 1 G G ::~cfy~iY:'~; ~~tiYi.~:~.rlt>ai t/':~. ' ~~44~?k~;.
<br />ii~. Yl ~l .',: ::jt~gi?u ;i~~i; .'~k,#t<pA~td~:; °
<br />~' `° :
<br />~~:: 5' :~iC ~
<br />~: B:`:=
<br />'R~A
<br />r'F t. (J t: t(T C.RDSS VA LU+ REqu~REM 6t1?
<br />.
<br />... '
<br />. .
<br />.. Q:1 Y:R r11: •"` ;^.i,'': .'f:"1 )~ -:° ~
<br />,
<br />. . .
<br />l II. 4t1[I :;RFA`iF SAMPLE ~L'l.
<br />.'J +i:ii:Y':A:;: ( ) {::y{::;:;: :T~~i:;::~;. ( ly)
<br />r.lc ('N ENl if-GRAY T'I F:TI MEASUREMENT
<br />
<br />I JS-F`6 1 n /1
<br />:PERMIT::~
<br />':fjtrYs yr,v11(r:
<br />".: r~±A1:+~~. ~F.. :~
<br />{`::F.
<br />:: ,ri Ik$yt Xj;y,..
<br />~, ;?I iltYr LY,yw~:~.
<br />X~:`;'~'~': ~::c('a;F,
<br />Y`p~ YS. e,,:
<br />.4~~'~1L
<br />,[~R'Fl ..,z
<br />r'F 11P:Y' GFOS!i VAl.llt :r`: s: ;,:,,: n~., .: -..:"•'•.:.:':.i-' #ui:: 'r
<br />1 :I.)i., TD['r11. SAMPLE ... L::,`.i.a4{: iiY%ii~:F•.= ( ) 4icY'r'~'%~ ( 19)
<br />(A., F'F) MEASUREMENT
<br />
<br />
<br />[ s r ( .. ... ...
<br />
<br />
<br />...
<br />:cnidt .. a .
<br />., `
<br />
<br />.,
<br />.-,x ~i~`
<br />`
<br />~~ "~z''
<br />
<br />a
<br />a
<br />a`°aaa:r;~
<br />
<br />~
<br />
<br />_
<br />
<br />,.
<br />'~: . ~ ..:
<br />
<br />
<br />
<br />;}~: ~~p~e
<br />
<br />
<br />
<br />k~C: .~:.
<br />. 1, t, r, V ~Rt4U1l1EM~8MT:. CCUCt .
<br />.<<
<br />1'l,~i,, ]II Ct,NDI1TT ()R BAMPLe ( G3) :t:;r,:t:Ac tL;n:a.zr r,:f:l,:r,:{tii ( 1
<br />111Pt1 TFL F:F'[tl l!NT PLAIT MEASUREMENT
<br />'i(I`~(1 ]
<br />C 0 PiRt11lT as
<br />~ tyP
<br />?IEl(1`A'L° '~;REP
<br />OR,T' arG4!k;E!d!¢I;rs ~`"~Lr.$ &~e>Cr:'
<br />~ °s?RC!lx!PlYklp;` tdl~ q:°~. $' ~'3Y '193~AN
<br />.
<br />rPF'LUt11T L'RDSS VA Il AEQU1REMSN7'~. .
<br />. , °°..
<br />~ p,
<br />:`._;<:
<br />"
<br />rY:r
<br />;:~: .
<br />e~a.:~,.
<br /><~,~'-:b.w. .
<br />~JI.IDS, TOTAL BwMPLe r:~r"'i: ::#[: e;u:s ( ) L=~kYr4.,,,t :;t{:Y::x:tC ( lyl
<br />1. ['iSOLVF
<br />V MEASUREMENT
<br />.
<br />7,i L!f 5 1 C ~ eeniile'< -s~~fcrd~ipi~s; 'i~oc~s~atisz~:. ,,,rc `:~a~+ks~u~ :~ :-:~t #~iz~~i~~;` 'a'= R~:`PQ{t7':
<br />X ~;` AST.
<br />"
<br />:° R~;~~..
<br />i.rt'I.UF.h'f t,pnSS VALI)t ~`~QUIREMENr° ,~
<br />~
<br />~
<br />~ r~~ .
<br />; r ~±e ,
<br />.
<br />~ :
<br />NAM!/TITLE PRINCIPAL [[[GUTTY! OFFICER OF
<br />LAw
<br />TNAT INAVE P[RSONAttr EXAMINED
<br />I CERTIFY UNDER RENALTr
<br />S[ 7ELEPNONE D A T E
<br />
<br />
<br />1:J (
<br />HARD G
<br />ATKINSUN ANO AM FAMILIAw PITH TN[ IMFORMAIIOM $UBMITT[D NCRCIM AND N
<br />D
<br />ON MY INDNRY OF TNOrE INpVIDWIS IMMEOOTCLr R[SPpISIBLC FOII
<br />BMITICD INFpRMATION
<br />N
<br />ATq
<br />I BE
<br />[VE TN
<br />(
<br />S ~~/)))
<br />// ~,hhyy /
<br />/ / /
<br />,
<br />.
<br />VP LAND/ENVIRONEMTNAL AFF'AIR [
<br />:.
<br />II
<br />OBT,VNIN
<br />THE I
<br />FORM
<br />U
<br />15 TRUE ACCURATE AND COM0.ETC I AM wWAwf THAT THERE AR[ Sq
<br />uwT F[NALn[s roR sueArlnlNC rwtsE MFORMAigN wnuanc
<br />'Nl ~
<br />.
<br />/ I
<br />
<br />30 824-445
<br />
<br />92
<br />
<br />10
<br />
<br />14
<br /> n
<br />THE PO$$IBILITr OF FINE AND IMPR15pNMENT SE[ IB u5C / 100/ AND
<br />w
<br />Em au
<br />I I
<br />ld
<br />9
<br />A
<br />R B16N ATURE OF PRINCIPAL EXECUTIVE
<br />--
<br />TYP[D OR PRINTED A mr
<br />r /mr. wy A.
<br />ilalwr. undrr r
<br />rr .mmbr
<br />)]usC
<br />T
<br />r
<br />r.d ~•r.M r~mw,nlm,nw.nww„r„/Ml.wn %wr~~nrA. and.i /.Ar.., OFFICER OR AUTMORI2ED AGENT A NUMBER YEAR MO DAY
<br />cDMMCnT wnD cXrEwnwncsn or wnr Tw~A l Inns tnr/rrrnrr ... ,•,.,...,~ ....... ......
<br />,: cl'7L::Ah1.(C SULI05 i,T.'1I1' APPI,I''S UNLY IF <= LG-Yri, ~4-TIN D},C;C[P F.Vr:!iT I:i CLAlt'EC. IF CLA['1 APP9UYFD UY
<br />.L I('[, 1:i`~ IBJN L[r [TS ,+I L1, }i 11T (• APl'L.F:G ;n at'PUi~,'f,.°:C 11 !~>1511R87}:irS 1'r-i--Sf't: I.Li.I A, L'C 7 AND I.F~TL,~PG 6~.
<br />. - .. _ _ _ )..~' .___. - ___ -n. ter.-u MIrM Mwv weT Rl u[fOJ JL OP
<br />
|