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PERMITTEE NAMEII' CRESS pInU4 FurGryN.wlncula dD15.r..p <br />NAME ._.. i. .. .. ,- ..:~~..c.. .•'i i... . <br />ADDRESS ~.._ ~:. ,%,. ~1 ~ ~ , .. <br />.;... ~. .:I~..„ :J <br />FACILITY <br />LOCATION <br /> <br />NATIONAL POLLUTM' 'CHMOE ELIMINATION BY6TEM /NPOES/ <br />DISCHARe )NITORINO REPORT 1OMRl <br />17-15, 17-191 <br />. ., ,. I'~ i f /I 6 1 <br />PERMIT NUMBER D19CHMOE NUMBFA <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM 1 -/ 1;7 1 ~ TO i 7 C'+ . C <br />1167/1 l72-231 111-151 13627/ l78-191 !363/1 <br />Form AF 'red. <br />- :, .t ( I .. OMB NI 40-0004 <br />-Approval expires 05-31-98 <br />T - c FC! <br />,~ NOTE.' Read InetructlanL~bafori'comlplatlnp this lorm. <br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING <br />' !1 Grd Onlyl QUANTITY OR CONCENTRATION <br />' ND FREQUENCY SAMPLE <br /> 106531 154-6 <br />1 /38-151 !1653 154-6 <br />// <br />EX DF <br />137-371 MALY519 TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !s1-s3/ 15q-5g) 158.10) <br />:'. :~;.. ... .. SAMPLE :::;~:;: : : .:. ~. ( :i~i~ 1 ri C, i,,ti:) ~ ~~/ <br /> MEASUREMENT <br />... ,. _ . . ~ PERM17 ~ :a:: I!.... <br />~ ~ ~ ~ 1 7.:i=1 I%° r:; {v7'i'-. y 7', :i'~ °: .. .. .... !. ., ~. I <br />:. :.:~: ~..' .. :~.c.:'~ ~ a I :1: REQUIREMENT: ~ ~ <br />. <br />~ ' : <br />.,. <br />.r .. <br />.. .. .. <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 />.:~ : <br />~ <br />~ ~ <br />~~ <br /> <br />REQUIREMENT . <br />. . <br />~ <br />~ ~ ~~~~ ~ <br />~ ~ <br />~ <br />~ <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PfHAITY OF <br />AM FAMILIM WITH THE INFO lAW TNAT I HAVE PERSONALLY EXAMINED MD <br />RMATION 6UBMITTED HEREIN; MD BA6FD ON / TELEPHONE DATE <br /> <br />MY INQUIRY OF TH06E INDIVIDUALS IMMEDIATELY RE6PON918LE FOR j_-,- <br /> <br />' <br />! <br />/ <br />' <br />'~ <br /> OeTAININO 7HF INFORMATION, I BELIEVE THE SUBMITTED INFOMIATION 19 ~ <br />~ <br />,~ r <br />. ~~ I,F/.(.~ ~ <br />~` <br />1 TRUE. ACCURATE MD COMRETE. I AM AWME THAT THfRE ME <br />INCLUDING <br />T PFNALTIE9 FOR SUBMITTING FALSE INFORMATION <br />9GNIFICA ~ - I I <br />' <br />1 <br />~' ' , <br />N ( ~ _ <br />, / <br />I <br />! ~ <br />i I , <br />(~ , , i THE PO651BIUTY OF RNE MD IMPNSONMENT. 6EE 18 U.9.C. F 1001 MD ]3 IONATURE OF P111NdPAL EXECUTNE <br /> U.9.C. 1 1318. IANWdr. uMU dru mrvrnr nNF irA.tl~ l.Nr w ro t /a,000 1. B AREA <br />TYPED OR PRINTED rq ormuinun inelmrwnt orbrw~FnemanNa idle Yeral OFFICER OR AUTHOR{ZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS 1Re/erence ell ertschmenrs here/ <br />....--r.n.~t_ :~):.: .: _. 1.. I:1 [~ ... .'LL[:. yn!.t ii' <= l;l-Y b:F ,4-Hi' i'i•. FiIF tV `c57 1°_ LLh:'~.^. ~ .. .. .. ~'f ~~~.. ! <br />,. ~ Li ~.L:. ..•:)'. .,:'i'L:..~ :. ., .:i'i.:.,dp .:!~.4°Uh=NEPT_--_E!: <br />EPA Form 3320-1 108-951 Previous editions may be used. (REPLACES EPA FORM T~0 WHICH MAV NOT BE USED.1 PAGE OF <br />