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t .~.. .~__~_ ,nrue <br />Fw'liry Alwrv/ omn-~ ImmU f •.-`-r +•+~ ....:...? ... J?_+._ _+.. Z1ti°;, ' <br />^ME-~C.E •'LSJES r2 C1{1.~I.9.~128t:1`-'_- a-I in:,sr <br />ADDRESS n n -~'-:_'~_~,_'_ T•n 00(i2 I u01 A <br />~._ ~2~ ~ ~L1Ir ~.... <br />J ~ N~= PERMIT NUMBER .. I} DISCHARGE NUMBER <br />------'---"'.=--.,---- -- ~~ MONITORING PERIOD <br />ceCIL ITV __ = - ~ :! - YEAR MO DAY YEAR MO DAY <br />LOCATION__-__ ^-__-~_~___-~v"'- - - ,. FROM YL U v ^ TO is :.-. <br />:. 'P'f T)VTLT SI' i.T lingtTTT1P 11T-__- /10.}II /}}_}il OA_>TI r)T_>}I naYm rr2tr, <br />F - FINAL <br />STOR"1WATEA~ SPOIL SPh~E :'"Ipc <br />~_ ; --- -- <br />r;pOR n,ATA; <br />NOTE. RABd Insfnmtlnns Anlnre romnlellnn IHIA Inrm <br />' <br />u (J CLMOnIyJ .j QUANTITY OR LOADING -; ~- <br />'[ <br />~ <br />' <br />~ (I CanJVnly/ ~ ~~~OUALiTY OR CvriCEiJi RATIO.: <br />•• <br />~ <br />~ <br />NO <br />P'n'eGUEt:CY <br /> <br />PARAMETER :: <br />•} <br />163! <br />!3461) .;i <br />1 <br />., <br />/38~U) <br />N6-531 /3l-6// <br />- <br />. <br />EX <br />aF SAMPLE <br /> <br />(JS-d7j C <br />:'; AVERAGE ~• ~~ <br />MAXIMUM <br />UNITS ~ <br /> <br />.MINIMUM <br /> <br />AVERAGE . <br /> <br />MAXIMUM <br /> <br />UNITS <br />ANALYSIS iYPE <br /> 6147 (61-GPl 169-701 <br />!':I - ~. " SAMPLE c I~(J#t`44Ati <br />~' <br />~ Q:yl YA44+X. .] ~. -= r tr' lY X:~4t3 S: <br />~ ~' <br />~ <br />- '! _ <br />G MEASUREMENTS '~. T3 . _ I <br />S' ., - ~• ~ 7` 63 - 9 <br />UT _ . _ ~ ~ 1 /7 GRr16 <br /> <br />+(i /i t; it 1 V v '- <br />~ PEP.un i.:_. <br /> <br />~ <br />*'~ # ~'~ <br />~^ <br />' <br />' ~W ~r <br />~~0.~.~it,A'J4•: <br />- <br />44+7 `, <br />Gtr Jrc. ~' <br />+ <br />`+T <br />~'4~4(s•' <br />-~ <br /> <br />~ O ~ _ <br /> <br /> <br />" <br />' <br />~ ~ <br /> <br />.$EP. L Y <br /> <br />RA B <br />+ <br />rr <br />I , c <br />•A ,T AEOUIREMENT <br />~° ,.,, <br />~ <br />~.~i•l, :.. <br />'~• <br />r- >. <br />-~: <br />~u ' <br />'1=+ 4#ra~ , <br />x . <br />.., <br />_ . <br />• - _ <br />. 5' ,; <br />r I <br />. _ .. _ . <br />. ~ <br />_ ; a <br />;b <br />11 •• <br />~pJ.jDSr TOTAL SAMPLE i+ <br />E <br />R <br />d• '~y~Idrartnh <br />> <br />T !.~-`YTL`Y+A4. <br />~ _ <br />" Qty.t{74•J l:~ _ I <br />~ r <br />. ` _. <br />< <br />d, M <br />ASU <br />EMENT . <br />¢I <br />t 't: ~ <br />i - - ~ ~ <br />UJO3O ]. O O <br />• <br />~~ ~.: PERMIT::~ <br />+ ..>+~' GVLI¢LL; <br />._ <br />K Y,~~II,AiY <br />',. i~:.'v :: +'c~~~A/C6 J 31C /o / ,.. <br />' ~On,T,- I t ' <br />^. - L' A- h CEI <br />• A'AB <br />S I <br />t REOUIREMENT '~._ <br />, <br />,_ .rY.~;..T~ V4Y:::t: '~,'~..y`•:m ;';), ji 4 <br />Ll { - <br />1^ T ~ <br />r 1 <br />~OLSOS, SETTLt:A:iLE.. SAMPLE ~. ;'4Ffi~4YF #;J #;J;;;k _' '.>,¢RIC4*_ 4tt~t4YAC ~ ` <br />1 <br /> MEASUREMENTr/ '%-,.: ~ .'. ~ .' 't: '~ - _ _~ O , <br />i ` ~ _ <br />~'JSUS 0 0 ~`0 :_ <br />' <br />r +: PFnMrr'~ <br />A <br />M <br />' >kp;td:" <br /> <br />'fir ~ >R <br /> <br />'x"' <br />: <br />~'> r•0+7 `'- ' ~ ~~~ <br /> <br />D -z <br />e~ duYSkOilp>Qe. OP'.L"LOAfIL~ - '~ <br />i. - <br />-UGEI <br />KAA <br />,Y t, ~ <br />„r R~ EOVIRE <br />ENT i+ <br />i5 ., <br />• *. <br />. <br />-. <br />I <br />,r f7 ~t4.. ~„E <br />L <br />'r1-;J2~'~~ ~ _ <br />y ~NT <br />-5. ti' A~ 1 <br />O <br />M <br />v^IL AAt; GREASE i. :. SAMPLE 7 <br />ME <br />U ~4>rrr.4fi: 4dG4rff4 <br />-~ '_ ~ .~04>QvSk : ~l'Fi}415>r ~ 1 <br />FREON E%TA-CsRAY'METt' AS <br />REMENi,f _ '- <br />' w _ is - - - I _ N <br />I <br />Oy556 1 0 ::0 +~• <br />- L` PERMIG .'J` <br />f1EGDIREMENTO.' ,r6.p">dI/JStt~,{Lt ,i <br />~P <br />~' <br />' <br />' "';)11"tt4L03~; <br />=.:e <br />~ C4Y: ~ t p~,Lt.O+7nPIyGF <br />~'' r <br />' -+%4010187}# <br />rG O~j' ( ~ <br />3-. <br />~1 <br />~~ ~' EE9CZ.Y pAB <br />t <br />Cc 1+C <br />- .L <br />~' Y," <br />.14 i ~;= <br />. <br />` <br />Y. <br />:f#l:'t' ~Q <br />C IP O~ `" <br />ti' ~ ,+ . <br />. <br />.s 1' <br />Y(' T ~ <br />- .T. _ <br />L' <br />I <br />L Y~'.:1 !:p TOTAL ,~ '~' ~ SAMPLE oc ~G,'itt#OitG'al~ <br />~ <br />° <br />~ ~ $~#O~O ~ - ii 4f`fFGhrT <br />u' t ( '' " <br />P <br />~ + ~ <br />... <br />- L <br />T• <br />F E)t k":.i <br />J <br />- MEASUREMENT_ .: .. <br />7 <br />% <br />^ ._ .'. ~, ~' . :: <br />:: _ <br />.: ~ ~ <br />, <br />, <br />.t 0 :=0 <br />C10U5 1 <br />~ <br />:: r c v 'ra PEIiMIi~' <br />' ~EOUIRENENT <br />000000 + <br />4 <br />tj.. ~~ <br />^ ,~5 4„~a~ <br />.,~ ti..t .6'.m aav ~ <br />Z ,~ <br />~ a~,o~ <br />~ ~j'.3s <br />fn ~ 3r v ~'y" ; <br />v CT .' u ~~ ' <br />w 1, '' <br />~'~ <br /> <br />~' ~ <br /> <br />r _YC~/` <br />~ <br /> <br />• I1. . <br />'.~~ . <br />FLO>+~ I4 .CONDUIT OR <br />' '.~ SAMPLE IC <br />MEASUREMENT -~-1{: .• •; • <br />. <br />"'0:064 - ~ <br />0 <br />110 ] 'y r7ttC{t0 <br />= <br />~ ,. pn+,T;714q <br />= Yt#r74O#. - <br />= <br />0 <br />N <br />TA <br />' <br />TttEATIS~ <br />ifT PLAN <br />y . _- - ; ! _; <br />: 1/7 S <br />~ <br />I <br />=~50 1 O <br />~O <br />" ~ •PERMIT.':s~ <br />'REOUIREMFM~ :i ~~PCfR~ ~' <br />- '~RpROA~.~ <br />. L -r '• iihs~til'viD~,~ '~av col' , <br />,tr <br />+ <br />~ <br />., > ~;I:o4~n~o-'.~ <br />7:1 <br />-` nit= ,- <br />.. - c '.s~rir f1$TAN <br />r ~. -. t T <br />~} _ .. <br />V ti. ~,i ~..,J, <br />:? . <br />.r?,. <br />,~, <br />. <br />113 .1 _ <br />t ~ <br />4L'ft f: <br />1 Cf <br />_ - I <br />SOLI JS/ TOTAL SAMPLE <br />MEASUREMENTII J~taL'444tQ ;t~#f,=L:~Ye <br />- ~: is ~baLer~ORt 4~IyfiiORtY _ pp <br />~ <br />I ISSOLYE -. ~ - _ ~ . 7 L c S 3414 - Q qq <br />~/JO pp~~ <br />r <br />GIV10 <br />_ _ <br />7027 S ~. O ..0 <br /> <br />: <br />' <br />,'ti PERMR: ' eC <br />REOUIREMENT``3 <br />~ <br />16tri4+01p4 '" <br />..g <br />~-'~ <br />: <br />' <br />~` ,~Ki'+i9iit4 <br /> <br />r+ •"'- <br />' <br />` ~-+• r,:~v .: <br /> <br />~ - <br />T ,/ <br />Itr~~:4$~" <br />+ C <br />~ <br />y~ ;yam, <br />.4 ~4 <br />L'''•+ -^1 <br />_ <br />•ja'REPOf~'C:' . <br />3': t: `. ? `° I <br /> <br />?RSr ~ <br /> <br />RAB <br />: ~ ,.~.~~. <br />eT nc <br />-nn , <br />.~I <br />; ~ <br />- <br />.I-a'TA....-~. rt~t,,.t +. <br />pl ~ ~ ~ .,,~ -;i w 1 <br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER. 1 CERTIFY UNDER PENALTY OF LAW TNAT I HAVE P ERSONALLY E%AMiNEO '' <br />~ <br />- ti . _ TELEPHONE DATE <br /> AND AM FAMILIAR WITH THE INFORMATION SUBMITTE D HEREIN; AND BASED _ <br />M ' <br /> ON MY Iry0U1RY OF THOSE INDIVIDUALS IMMEDIATELY RESP ~' :) <br />~ ~ ? <br />Brian P, Dunfee is '_ ONSIBLE FOR <br />OBTAINING THE INFORM <br />TION <br />1 B I "' <br /> A <br />. <br />ELIEVE THE SUBMITTED INFORMATION G <br />= i - <br />u <br />Mana CP <br />9 IS TRUE, ACCURATE AND COMPLETE. I AM AWARE TNAT THERE ARE 510. - _ <br />- <br />.. _ <br />p NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING <br />THE POSSIBILITY OF FINE AND IMPRISONMENT, SEE 16 U.S.C. { 7001 AND T <br />$IGNATUREOFPRINCIPALEXEC TIVE 02' 774-5253 ~ 91 04 29 <br /> OJ U.S.C. { 1]70. IPrndlb undo (Aar amn.le nMy Inrlude foe yp'lo J/O,OR) 1 <br />• TYPED OR PRINTED <br />rnl/llcuT Aun c aMwmMmwllmprlronmrnr o/brrwmemonrArand 3lY.n./ OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY <br />__..__._.__.~~..~..-.,.....v.....•rv,..~.rvnWnr'L/v.K UUYUWnmmuR% <br />OIL AAD GREASE; St:E FOOT!%OTE'F./. ,•jO--C.i1iT P.£PORT IF EI(EYPTIO!75 CLAIMED. SSS'MUST~I3E RE:rt7~,Te:U-AT RLL <br />Ttr,es. ' <br />,.. .. , _ <br />EPA FOrTI13,TZQT(RlV.a~~PTIYI0Ut1 BdIIIORO TlY Al UB~. ~ (REPLACES EPA FORM T•~,t/ ION MAY NOT BE USED) PAGE OF <br />• - ~ :II 00029/1005H9-17+14 1 2 <br />