|
YERMITTEE NAM EIADDRIE! (JIICIYdI
<br />Facility Name/Loaf' '•diJJoLnf/
<br />BAM.6_L:Ol~ :~L:03L.~LLbPANY-------
<br />woowssELpypy-yam A1II1£__-_-__-_--
<br />-~-5.231~T~..i E~1_GC1Si1Y~~------
<br />PwauTv
<br />LOCATION ______!
<br />dPT\• NTf'M\DIl C \TE 7D GllU
<br />nwnoH wL rover AHr oI[cH wwc[ ELIM IHAnoN Er[TEM (NPDESI
<br />DISCHARG' '10NITORING REPOR7'IDMRI
<br />2-I~ l~
<br />PERMIT NUM EER oILCHARC[nVM,[n
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAV
<br />FROM TO ']CT
<br />/10~1lI /11~1J1 116171 l16~ I 1I8~191 130 1I
<br />MINDR
<br />(SUBR NY)
<br />F - PINAL
<br />Form Appro•
<br />p~TNo. 2oao•oooa
<br />Expires 9.30-97
<br />LOADODT SEDI POND TO YILSON CR
<br />#$# AO DISCHARGE ~ ~ ###
<br />NOTE: Reid instruction[ before~mpletinp this form.
<br /> (J Card Only) QUANTITY OR LOADING (I Card Only) QUALITY OR CONCENTRATION FR EOU LNCv
<br />SAMPLE
<br />PARAMETER (16-7J) (7161) (J&IJ) 116.73) (7161) NO.
<br />Ex OF TYPE
<br />(J1-J)) AVERAGE MA%IM UM UNITE MINIMUM AVERAGE MA%1M UM UNITS
<br />616!1 wNAL V515
<br />(61681
<br />IAY.ID)
<br />Prl SAMPLE
<br />MEABUREMEHT ###### ##v~•#v ( ) .y
<br />######
<br />~ ( 12)
<br />Q I ^
<br />/l
<br />~JB~
<br />LJ4C0 1 D D ~> `;~:
<br />' PERFICT' ;,
<br />
<br />„~
<br />~y "
<br />d
<br />,~.~`*
<br />~
<br />~#` ~ 5S.
<br />~$hF=#~~~~~
<br />
<br />e is## K Y,$° w'SgC'a
<br />~~~' :~~
<br />.
<br />R. ,a ~
<br />~~
<br />"~~" b ~,y i° '61st
<br />~';~7~#~'K#,
<br />
<br />a a. A4 AZ;
<br />;9~~
<br />~
<br />%:
<br />>~
<br />°
<br />~
<br />-
<br />~
<br />E$KLY ..
<br />RAH'.::
<br />
<br />
<br />
<br />.FF D hr .A Dss D REQJJ/i~EM EN7a
<br />
<br />
<br />e~>~-.. ~~.tt ~
<br />ems
<br />.
<br />•
<br />a ..~ ~ tv«f
<br />a - x
<br />, .~~.~~~a~~~ ~~ «
<br />.;
<br />~ ...,moo
<br />.:~~;~:~.~'~~x"~ .>
<br />
<br />
<br />
<br />x
<br />#.. «
<br />,
<br />,
<br />n~... ^.-. .~
<br />nr
<br />xg max. 0
<br />~
<br />.
<br />,.
<br />i~'° ~m
<br />~.:~~~~~~.~~<~~>. ,
<br />.
<br />« .
<br />t
<br />;x
<br />«
<br />;
<br />~~.
<br />
<br />
<br />__,.;
<br />SI)LIDS, ^OTAL ewMPLe ###### ###### )
<br />( #####~ ( 19) Iy
<br />/ / 1
<br />
<br />SUSPENDEu
<br />MEABUREMEHT 1
<br />J~
<br />~
<br />770 1
<br />GyiLtl
<br />tiD530 1 D D g'g~AC RMiT~N a,~t~C~~~~ ri±~
<br />:a
<br />'~ Y.~t ?Y. ~f.
<br />$
<br />~ .'t # M ~
<br />~
<br />~ ~~cb',a'r°°~ Sg
<br />~
<br />~~ a°'~°p w~qa.
<br />~'
<br />~ ~
<br />~~ :A.~a
<br />~'S'
<br />~ .. sx
<br />
<br />F:FFLUBNT GROSS VALD $~,~~VIREN q$~
<br />?
<br />
<br />~p .~~
<br />:~ ~
<br />~.X
<br />,l~rux~-at~-Q ' >~~'~' .:
<br />'$'gS
<br />'BkM
<br />s~~
<br />a
<br />~
<br />#### ~
<br />'~~~',„ a..
<br />a .
<br />:p
<br />`~ ~~
<br />~ ; ,
<br />~
<br />':
<br />y~ ;
<br />:;
<br />SOLIDS, iETTLEABL° BAMPLE
<br />ENT ####~.# #####~ ( ) #####~ ~r#a## ~ ( 25) Q ~~3a G
<br />~
<br /> MEASUREM D. Iq
<br />~l (J S 4 1 S D D ~y: ;x .~61+d iT" ~ a. .pa.~q~~~~l~¢i~ : ~~~.1I(~~w" ## # ~ ~ m 1(7C~#
<br />#,~ a «
<br />~ ' M' +jlt(f ~i" ~~
<br />a
<br />~f
<br />~
<br />: ~~ :: ~ :
<br />aQr~„
<br />NGE/:°
<br />RAH.':
<br />(' ,REQUIRf;M I(~Mwl':
<br />:. '$' .i~"x
<br />n.. .... `"b;,,~.«
<br />:'. a'8v x$:~a'~w
<br />., c. a.w.• >...
<br />ay;~b
<br />.., ?xr~ aA ~
<br />>~
<br />#ttp w.,
<br />a~j'~a ~.~•
<br />ttrc.. a ~.,
<br />~
<br />.z e~x
<br />.;
<br />A
<br />0°P ed A'dRn
<br />a.a e « £^
<br />UIL AND ,;RF.AS F. SAMPLE ###### ##~:### ( ) #~r#### ###### ( )
<br />19
<br />F'itEON EY 1'R-C RAY MET MEASUREMENT A
<br />JAI I[ 0 u 4 N
<br />(.;JSSIi 1 0 D a:~P'e°RL(IT°'4"t
<br />' :aw#+~ik>Q~$?(t~°" ~y~OI>k?N~~
<br />e~X#+Q~
<br />F ### :..~
<br />;!4'~#l~ $°'e_
<br />$a
<br />~ gr~~l,....~ ~~,yy~~
<br />~1
<br />~^ •
<br />'~' ., .,...e .'r:
<br />e
<br />~O
<br />~ 3;:r,•" ONTTII ~RA9:
<br /> R[L141R1<M fHT
<br />e d~
<br />~~e ^.wa. ~ ~, •,
<br />e nmh.e ~''w;°.•},. x
<br />~ .a
<br />J .
<br />c~.a~,.
<br />~ .,m
<br />X tr .. esi h'q&
<br />~
<br />• .
<br />Q.,
<br />Y
<br />'`~, $"w '
<br />y
<br />b.&°
<br />^ T'#bx do
<br />;
<br />i g
<br />e~ a
<br />IRON, TOPAL BAMPLB ###### ###~:## (
<br />) #~#### ( )
<br />19
<br />~
<br />I /3D
<br />~
<br />
<br />(A5 FP
<br />) MEABU REM ENT D ~ D ~ (Jy~
<br />. x.
<br />'
<br />G1J45 1 0 D ;~: p~liMiT>°.,
<br />~gE
<br />y~Y' .y^ ~; ~.
<br />g~b~~~~ ~
<br />d~
<br />¢¢ ,~~ a
<br />~~ #•',:;• ~A ~ $
<br />al~.~~ +~~
<br />~ ~°' ~ ~-°~
<br />~a ,-9. ~:p
<br />~
<br />G
<br />~
<br />F~
<br /><
<br />~
<br />7,~fl n'~~'=u: `_
<br />3~
<br />sc~%=
<br />aAa` ;
<br />S q
<br />~QM(~(9M.1'.t.i;R bb
<br />~~f
<br />f,,
<br />~~D`.;6'f PtiR...`$4 pp
<br />5.
<br />~aA~'#wlA ~.y..'~~R' p
<br />`
<br />_..F.~~.~.^A~`~~°§'YHR• ~e
<br />'
<br />.~A'
<br />#'
<br />~~
<br />we~
<br />~ ,~
<br />~
<br />
<br />1•'LOY, IN CONDUIT OR SAMPLE ( 03) ###### ###### ###### ( )
<br />ITMENI' PLAN
<br />1'!1P
<br />U TRE MEABUREMEHT D ~ N
<br />.
<br />r
<br />(
<br />~JO50 1 0 0 sy .r.~:.. ,. ~ .re
<br />~PRa\IfT«-'~
<br />4/H4!
<br />P
<br />F ;~..
<br />~~~,~~A~~
<br />' :•;AYa`v #,w
<br />~;~~~'Ct'R?
<br />~„
<br />~ „Q P ~ '~. ~.q
<br />~~z~~~¢~Y~,.
<br />` ~m-e : ~ ~°,+
<br />~~##~a~~~~i$
<br />~
<br />` ~: z.II s x ~
<br />•~. Q.
<br />a
<br />'
<br />1 ~"
<br />1~
<br />F.~FLOFF 0 :S!
<br />,
<br />~~~~" ~ ~
<br />~r ~;~
<br />,~ ~~a~a~.n~~
<br />'~~~zr'r,a ~SA
<br />.~'° .~~~
<br />~ .aA,~o
<br />x«~
<br />„
<br />:
<br />~~<
<br />SOLIDS, YOTAL SAMPLE ###### ###### ( ) ###### ###### 6q (19) D I~qQ G~46
<br />
<br />DLSSOLVEU MEABUREMEHT o
<br />
<br />
<br />
<br />
<br />
<br />D2S5 1 0 0
<br />
<br />n.:<
<br />
<br />ee`A
<br />~
<br />~ Mir° _
<br />
<br />
<br />
<br />ii: ~ ~'-
<br />;~>~
<br />'~
<br />a
<br />
<br />~ ~~
<br />
<br />#~,.
<br />i~iR
<br />~~~
<br />'~~`
<br />
<br />
<br />
<br />#
<br />"
<br />
<br />
<br />y,~A.
<br />-'.~ ~~ n~i~s:~?;d
<br />'~
<br />~ ~_
<br />
<br />
<br />
<br />:.~~.##'~`~!
<br />~
<br />~m
<br />ffi ,
<br />
<br />
<br />
<br />°Po OS1'~t':
<br />=
<br />~$.AI
<br />`~
<br />~.
<br />
<br />
<br />'t LY'.
<br />A
<br />
<br />
<br />
<br />AB
<br />I: ( P (. S .
<br />[
<br />pR~S)~ILlEM.f~~9n g
<br />,.e
<br />•~
<br />~~~`.'~" «,wg'~, ~
<br />o-~.~ ~ aaa`~x$.. .
<br />;
<br />~twe~,"ash,.,"'~s ~',•
<br />v.~- 3 e~
<br />.# ~
<br />~
<br />'°s2:k as :A:: °a~s;~~~y
<br />a.x ~
<br />,.a.
<br />,~
<br />'a ~,p ..~m~:m,«'.z.: •~
<br />S
<br />,
<br />' w: ,3 ~x
<br />NAME/TITLE PRINCIPAL [X[CUTIVE OFFICER I CERTIFY uH0[R fSNALTY Of LAW THAT I HAVE P[RSONALLY LxAMWLD TELEPHONE D A T E
<br /> AND AM FAMLLIM WITH TH[ INFORMATION SUBMITTCD HEREIN. ANO EASED
<br />OH MY IIgUIRY OF THOSE IHONIDULLS IMMEOIAT[LY RESPONSIBLE iCW
<br />IEVE T
<br />C S
<br />BMITTED INFORMATION
<br />S
<br />/
<br />
<br />/ H
<br />U
<br />OBTAINWG iH[ INFORMATION. I BEL
<br />IS TRUE. wCCURATL AhD COMRRE I AM AWARE THAT THERE ARC SIG
<br />IBMITTWG NLSE wfORYATION WCWOING
<br />5
<br />O
<br />S ~
<br />//
<br />~ ~`
<br />J 1t J\ I
<br />HIFICANT PEHALT(
<br />F
<br />R
<br />TH[ POSSIBILRr OF fw[ An0 IMPRISOHM[HT SCE IB u5C 4 1001 AND
<br />6LGNATURE OF PRINCIPAL E%ECUTIYE
<br />~D ~r /( !,
<br />O~•T'~5~ 1
<br />91
<br />a~
<br />Z.3
<br />r 7J USG 11319 IPrnrilr. uMr. Ibv uamb. nlRr mrlWr Anr. uy o. l141AU
<br />AR 'A
<br />TYPED OR PRINTED •Id;um•.inl Wn lwlFn...Inlrnl,d Mlurrn(mnnlA. snd.i .ra..l OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO OAY
<br />COMMENT ANO EXPLANATION OF ANY VIOLATIONS (XrJr/rncr u(I Nllurnm[HI[ nrrr)
<br />SEYTLEABLE SOLIDS LIMIT APPLIES ONLY IF <= 10-YR, 24-NR PRECIP EVENT IS CLAIMED. IP CLAIM APPROVED B1
<br />M~~CI, TSS E IRON LIMITS YILL NOT BE APPLIED TD REPORTED tlEASOREMENTS--SEE I.B.lA, PG 4 AND I.8.1D, PG 6.
<br />E ( T • . ) illo y Bd. • IREPLwces ePw FORM TJO WHICH YAY MOT EE Ui[D.) Fwce of
<br />00999/9209DB-191(1 1
<br />
|