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r.__...•.., ,. uRess N+rArdr .1;.' ': ~,'r., <br />~`,`.~~r~2~1..Q 9.Y 51+. {LIL1rI~~~iiY fAi^~ <br />ADDRESS `~N-~CC1 ~ 9.E G_.~.A - - ~ ...~.. - - <br />~~~~. <br />FACILITY __~------~ ~ ~ ~ O~ <br />LOCATION _-_----~---r r'~`'~--~ <br />ATYh: D'r,KN25.`:STEVENSQtI PREs'~'DEN. ~ ~-' <br />.~ PERMIT <br /> C ; <br />"' ~: <br /> YEAR <br />=FROM <br />0 <br />e <br />'' e. aD-:u r: <br />ELIMINATION SYSTEM (NPDES) F ApprOVad. <br />ING REPORT /DAfR1 <br />u7a9/ F I- P I N A L I ~a~00` <br />al eaplrea 6D0-91 <br />F STGRMYAtEA_DISCN,i3~E1 <br />l-i - DISCHARGE NUMBER U <br />- I <br />I1NG PQRIDD ~, - : : - ~ , .. <br />,YEAR MO DAY ~ ~ _ -; ~. ~ • :. '• <br />TO ,~ ~:. ri'r~oR ~ uoa `vc) -; t~>+:~s <br />-~ :17677) /78-79/ /JO-Jl/ NOTE: Read Instruetlons belore completing this lorm. <br />' <br />~ '' /J Card Only/ ~ QUANTITY OR LOADING _ <br />~ <br />~ r l~Ca Only/ ~. QUALITY OR CONCENTRATION <br />~ - <br />~ <br />• <br />NO. FREQUENCY <br />SAMPLE <br />PARAMETEN ~ <br />~ .O <br />r `.- %~ : !11611 ~ <br />{1613/ •~ <br />~ r (38~J1 <br />- ll6JJl /SI-61/ <br />I <br />- E% TYPE <br />(J1-J7/ = <br />,- ~ .< ' ~ - <br />;"AVERAGE'. ~ ~: MAXIMUM ~ ~. UNITS - $, MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS <br />F II _. <br />- ~ SAMPLE ~ <br />ME <br />R ~ /;.6 ~f1_ <br />.. <br />, <br />y1 <br />, :O a'•J.:' C: i7:r. <br />~ :~. <br />^ >•. r _. _ <br />-v~~ a a a C : O _ l ,J I <br />7 /~ . / J <br /> ASU <br />EMENT' a <br />~ <br />"' .. : <br />4 <br />U ~: P,1 .: ~ <br />U' CT Oa~ c .. .' "/, <br />0 r ~ I r'IC~ <br />'OuCO 1 0- ~I =- ~ PERMI't.• sVi q.oos,, i; <br />'IP K;•~Qopo4,; ai,o 0 6:5y;-;;~.,a-'.. ,~otr>ti4ua ~.0• ; _ <br />= ~:. ~ ,.. <; NCE/,c Fl:1e <br />cPFLJENT G975S VALOr AEOUIREAIENT =~ _~r ry:r, . %+„{~.':: `Si ,)~14~ ~~ - - 3:'C. i <br />IDs. 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F? <br />' <br />S <br />w -•: <br />~ a <br />° <br />. <br />' <br />01:, I4 COADUII•GR' SAMPLE' <br />4EASUREMENTM G <br />-,;.°;: .. <br />U <br />S /~" -= <br />- <br />U ~; A~4 <br />c ,r~•i: <br />•` , Oi: ~li+'A %: 4o00cav: - -' <br />~ ~ <br />~ <br />~80 IREA.t;tSAt PLAtiT .. . <br />.} <br />S =V}~D _ j, ~ <br />~ J .- ~. i C / - I~- <br />' <br />fr0oso 1 ~ o ~~ - _ C_ <br />t~• , tl PERMIT.'':. <br />~ p <br />OA :ti p A ~ <br />~ <br />~ _ +,~t a4 # - <br />.. <br />'~ '' 4ctiao <br />. ~ p~ono t <br />' <br />'7 rr~-:x• _. ;, <br />s ~ <br />PEKLI. v <br />NSTA. <br /> REDUBEMPxT . :, . <br />v .. <br />J . <br /> <br />'OL205 tOtAf.. [~ ~ <br />' <br />° '~ sAMPIE ~ <br />MEASUREMENT 'aonoaao~: <br />~6' <br />' <br />F ' Qaac~o: - a~ano~ <br />~ I2 - aon0o0 <br />' ~ la i <br />1 ~ _ - - 1 - <br />/ ' <br />•a - <br />^ <br />ZSSaLVED? .0 <br />. <br />_ <br />a - ~ _ _ <br />DL ~p~ ~ f~ D 6~Gn <br />0 <br />~ <br />70295 I .`, O_ ,-,aV - <br />- ": PEPMR ~ <br />y Y <br />~. ~+~wq <br />i~r <br />"A <br />' <br />' -4ngn4#~I'' <br />'~' <br />' ::'.Sv ~ -'~A~A1>~'t. - <br />~ <br />~ "°,fin?¢4AA <br />' - J~POR~Y• ~ <br />~ ~ ° s : TALY • AxI? <br /> ~EOUIPEMEM ' <br />7 <br />, <br />L. .,~.. <br />,7 : ~ TZ..:~ <br />. : :73##~ `0~ <br />4r <br />~: A ~- V ~ S`: _ <br />-%r <br />.. vf• - CT y i. ~ I <br /> <br />iL AND G <br />B~A58 = <br />-sAMP~¢'m <br />^ x +P 4_4110 <br />. <br />,v ~ <br />.O :.: ~. <br />.< ~. _ <br />ce <br />_ ~ +71 ~icvz:- <br />< ~- <br />~ 03ra0co - #anGn:7^ <br />, ~ ~ f <br /> <br />/ <br />~ <br />_ <br />UAL F" N ~, MEASUREMENT ,..E; n '.v ~ ~ i D ~U <br />' `~ ~~ <br />.,,GS 1 ~T~i r+l a' C `~~ <br />e ENi~ u ~ <br />..' <br />' ~.--r,'x~ ~.o : ESal^: •rrA1~ >~YA:.fr: `v4A1~'+rl`~1#. 4lyd4Lr ./:=k aC~/E i5UA1 <br /> R ? <br />, ~ <br />- _ <br /> <br />_ <br />- _- _ _ i I <br />a R M y~ <br />w <br />V <br />~' <br />' ~ ~ <br />' . <br />_ ~ <br />`r ^ <br />` ~ D + <br />' <br />I <br />- ~ <br />C MEASU <br />ENT G :. L <br />4. <br />• <br />. j p <br />• v : <br />7. <br />r <br />- - <br />m <br />~ - <br />..- '- ` <br />? <br />~. .. - <br />v ~ „ <br />NEOIPEI{HEMEN . ,-. y ~ <br />rC ~ <br />l ~t Gl :^: CIS <br />,,.."~` .": ~ y - .~ <br />_ M <br />' ~ ~: .. ~ <br />G ~'~ .:d <br />.•p^ L. •'. j .~ <br />L _ <br />__ .. ~ <br />L; J :e :. <br />~. <br />~. ~ f- _ • _ <br />NAME/TTTLE PRINCIPAL EXECUTIVE OFFICER ~: ^I CERTI FY I/NOER PENALTY OF LAW THAT 1 NAVE P ERSONALLY E XAMINED ~ :S >> TELEPHONE DAT E <br /> AND AM FAMILIAR WITH THE INFORMATION SUBMITT ED HEREIN; A ND BASED ~ ~~: <br />~ <br />f ~ <br />^ - , <br />` <br />~ •' <br />-, '-i~ :1 %4i YiJ ~ ~ _ <br />C <br />- ON NY INQUIRY OF TNOBE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br />AT <br />I <br />T ~ <br />O <br />v, ~. - <br />` <br />_ <br />T I G ~ <br />' <br />~ 6 SA <br />E <br />M <br />W <br />B <br />ET <br />I <br />E <br />5 -' <br />~ <br />~ <br />! ~ ~ <br />- <br />1 1 <br />_ 1 <br />y I` <br />~'1UC1 ~ <br />~'nV tl'-0-N <br />b~la 4 - Ifl r <br />~T • UE, ACCURATE AND <br />COMPLETE <br />A <br />A <br />ARE <br />TH <br />N <br />AT <br />ER <br />ARE <br />6 <br />NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING 1 <br />' y <br />~ <br />L : -_ - =~ i' .: <br />~ <br />` <br />- <br />, <br />~ <br />. <br />J - THE POSSIBILITY OF FINE AND IMPRISONMENT. SEE 1B U.S.C._I .1001 AND <br />•57 U9.C. F iJAI /PrreBie uMn rhor rnnrm nep LrfWe !'~ up-ro t10 <br />000 SIGNATURE OF PRINCIPq EXECUTIVE G~ 7 <br />=S:f S3 ~ <br />' f~ ~ <br />•~ TYPE~OR PRINTED , <br />WnAraWnnwlnrplwnmrdbrwn6maarluW lymrsl OFFICER OA AIRHORIZED AGENT NUMBER YEAR MO DAY <br />COMMENT ANO EXPLANATION OF ANY VIOLATIONS /ReJermaaammchmena hne/ •. ,- <br />IY '~OrDZ.iCNARGE OCCU?.5 :t_P09T'.".~IO DISCNAAGE°. OIL AND G4EASE~, 5Ez FCGTNGTE F/. 0~ =%U ST Rl;POFT If ~Ak:"P- <br />tZONS CLlIKED. TS5--i5115T UE ALrPORtED hT ALL LINES. ~ ' <br />EPA FORII.~'~~(Rer.9EB)P~~VIOUS BdifIOnS may be Used. r (REFUGES EPA FORM T~aO WHICH MAY NOT SE USED.) PACE OF <br />,;~a,~.'• 0012rs/900010-a 402 a I <br />I I <br />