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PERMITTEE NAME/ lES5 R+r4 FsmryN.wLer./lo,yDld.mq <br />NAME .: •. _. .. ., ~,. ;. ~.. '. :. 7 !... . <br />ADDRESS :' / j, , ., r , , <br />FACILITY <br />LOCATION <br />C. .~. ..'i' ~i ;, I. <br />NATIOXAI POLLUTM 'HMO/ ELIMINATON BYBTEM /NPDESI Form AF •ed. <br />DISCHARG )NITORINO REPORT IDMRI OM9 NI 40.0004 <br />1-l6/ f7-791 'J l: i, f 1~ C l ` r '. !: ` ~ i <br />.' ` :1 ."' v f n - F .- ~ Approval"expires 06-31'-98 <br />PERMIT NUMBER DIBCHMOE NUMBER <br />MONITORING PERIOD ~ T. ~~ ~~• =~ <br />YEAR MO DAY YEAR MO DAY <br />FROM 97 ';1 :;l TO 97 (ri .C I)ri~ .,l~ r, ~;~,..; - I _'- :.. <br />(76111 (11-131 l1/-75J 126.271 (29-291 /36311 NOTE: Rasd InttrucUone 6etora eom~platln0 this form. <br />PARAMETER ~ !3 GFd Ontyl QUANTTY OR LOADING 11 GFd Ontyl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE <br /> (1653 (546/1 138.451 /4653 !546/1 of <br />132-371 EX Muvsis TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !e2 <br />IJ <br /> - <br />! !64681 /89-70/ <br />.!. .. .. .. .. ~.. ,- SAMPLE :i:: :;::;: . ~: ~ :N) ;i :::)>; f: :: r: il:i+ `: ~: ..... . I i I <br />- .. ,. ,_ MEASUREMENT ~ . <br />i i . <br />J ~ Vii, -. .., <br />... .. .. PERMIT ~ C.oj;)'. ;:+:; I 1 . ..t~ .~^. '3 tY t:1 f.: :tie: t,i,;:' <br />. r • .. L. , r . ,. F~ REQUIREMENT .. ~ .. ... ., ~... <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~~. .~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT :~ ~ ~ ~ ~ ~ ~ ~ ~ .. <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> .PERMIT . <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~~ .. <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENKTY OF LAW THAT I HAVE PERSONALLY F%AMINED MD <br />ALI FAMIUM WITH THE INFORMATON SUBMITTED HEREIN <br />MD eABFD ON <br />'~ TELEPHONE DATE <br /> : <br />MY INQUIRY OF THOBF IMDIVIOUN.9 IMMEDIATELY REBPONSIBLE FOR <br />OBTNNING THE INFORMATION <br />1 eEDEVE THE BUBMITTED INFORMATION IS . <br /> <br />'- <br />~ / <br />~ f / <br /> , <br />TRUE <br />ACCUMTE MD COMPLErE <br />1 AM AWME THAT THERE ME _~-.. ~. <br />. <br />~ <br />' - ! "(. ~' ~' - <br />7 <br />_ , <br />. <br />SIONIRCMT PFNN <br />TIE9 FOR BUBMITTINO FN <br />BE INFORMATION <br />INLLUOINO ~ ~ <br />~ <br />I , I I'I ( 1 '~! ~ . <br />. <br />, <br />THE POBSIBWTY OF RNE MD IMPNBONMFNT. BEE to U.B.C. 1 1001 MD 77 <br /> <br />eIONATURE OF <br />PRINdPAL E%ECUTNE ~ <br />~ ) <br />~, / <br />i ~ <br />. ; , <br /> U.B.C. 1 1711. l/1.rNYa uMr dNr enema /ryY 4uAd. hw. w m F 10,000 , AREA <br />TYPED OR PRINTED .ns or nsvim.n Nwlan.nr s/anrw emrrew.es6 F.va/ '.OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV <br />l• VMMCn r a Xrvu CArLIrnlr r r Vn ur nnr YIULM 1 was IROIeleIIC/ en elOCn/FIIn rJ OOlB/ <br />. ..,i.;~ .... .. .. .. ..: I~~ L;."~(~. isrF LC.-.~ :'ILY :i' <= iu-':"`:, tl•-iit. ~}:CIP •c LV `E~'! 7= (:Lnr1~I:C is .: I_: :' ., ;4: ., ,. <br />• I - . •. 1 . ~ I. .. 1 • .. ~. ~ i. L l l'.J rJ i .. r. /I !' I• Y .../ l J !t . 11 1.... 7 .. L~ ~ 1~ n ~~ U i •.'. 1 ` 1. •I ~ ~ I'. i ! . I ~ • i ^'I t ~ . i . • 1 • <br />EPA Korin 3320=1 108-961' Prevlous~editi6ne'meiy b'e used."~ (REPLACES EPA FORM Ta30 WHICH MAY NOT BE USED.) PAGE OF <br />