Laserfiche WebLink
DISCHARGE 'ITORING REPORTlDAJN/ ~~~ • <br />NAME__~g!! Ca)~'. ~.1 /r.:l ('~L ~~~~-_ l1-Ibl (17-141 P - P1NAL <br />ADDRESS I 1,"•~•~ VA1.~ k-' - - _ _ _ ~ S'f O.tRY-T P,R DISCH.\flG': <br />__-~~.=fir i~~__-_---~~~1n~ - PERMITNUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />AGILIrr <br />- ----------------- VEAR MO DAY YEAR MO DAY <br />UCAEION_-_--_____-____-_ FROM TO iSINOH rNTll.i <br />L lid • ' I' - • -(1 L I/a:IJ n?~'J/ l=4asl /a6~v/ lab-zVl L+0-Jq NOTE: Read instructions belore completing this loan. <br /> IJ Card Only/ DDANTITr OR LOADING l+C-rd Only) DDALITY OR CONCENTRATION NO FREOUENCr SAMPLE <br />pA R4MEIER (4671/ IS{~6/l IJBSJI (+6~1JI IJ{.bl/ Ex OF TYPE <br />/+' J'J AVERAGE MAXIIAUM UIJITS MINIMUM AVERAGE MAXIMUM UNITS <br />l6a-bJl Ar1ALr51$ <br />/6463/ <br />/bY-70/ <br />'•1 $LI.IPIE YY:F'vTY Y!i%i~Xr .'~ Y~V eY <br /> r.1C L5UREMENi <br />'l <br />)JVLJ 1 J U <br />PERMIT <br />r;k###;k <br />~+~~•#;:i w <br />v~ C C <br />6.5 <br />~##vik%.~ <br />9.D <br />NCb/ <br />L{4R <br />r„' ,,,,t, .I _ r ~ i REQUIREMENT ~1 <br />.rJI T[J~ <br />7(1: ,1L $LIApLE v:'3 :+'Y# *i Yr`~`r{~v #^.v:i#: tiY~~iv~"• <br />~ <br />.:1: r. L: ~ IAE L$DREI.IE IJ, <br />•,J3~ 1 t~ J PERNIT ~y"•yY.+-i•# #+'-'~F##'T Y~ i"%k vi v'-k '.Xrw#'•.E:• R£ITQf1T ~I~E/ RAD <br /> REOUIREIAENT <br />_,~Lt, T -, <br /> <br />,OLIU~ <br />PL'C'."L£i,BLE <br />SLIAPIE M~v 4 <br />34i3Y# y <br />TYYYYY ..FF <br />'l~YYYY AA <br />~~vY+ <br />, MEASIIRf MENi <br />,J.,4~ I D O PfMMI, Y#T#C# ##0### Y. YT4### #YY##3 0.5 NCe/ RAB <br /> HEDWREMEN, <br />• ^ C ~ <br />1[L AKD GFf:d~c' $AL.IPLE ~yY Y1Y:= YY.YY •.YTYY '3.'•##: <br /> rAE a$UREMEU, <br />' <br />:tON h2TH-GPAY 11F <br />TiL <br />. <br />. <br />;~SS6 1 0 G PERMI, #~:,### #G##3t ;:~# ##aa#~ #$#aaa iD NCE/ RA8 <br /> <br />Lv LI1FI:T C: It._lrr <br />- FE OUIREMENI <br />f:#:# <br />t <br />t{O [I <br />TO'f 6L <br />$AIAPlE <br />YTYYY# <br />#t Y ~y <br />~YJ+Tf <br />JC L"dv,k+f <br />~ rAE A$UREMENT <br />(dS Pi:) <br /> <br />.1:;4; 1 ~ U PERMIT #tQ:~# ##;s+#» YY ####~# #iilC`4•#'~ ReeosT tlCk/ R8R <br />£ REOUIRCMENi <br />- <br />L,,F, I1. co.+LUtT os $LIAPLE ND FLON Y.T~~a <:z=#Y;:a TYYTro <br />l/~ •1 TIIEST83~T PLSH '''EL$uRf MENT <br /> <br />.. ~U 1 0 0 PERMI, gEPORT REPORT L#x;;c~ ;rc#C#~r t#'i 4; # a#a L'E:KLY NSTAJ <br /> REQUIRE MEN, <br />_ L~Lll t tL <br /> <br />OL1ULe fO:AL <br />$Pr..CIE <br />#y###~ y ~y y <br />#'~'YYYY <br />Y~Y~`F# <br />rY~~~--# <br /> <br />1) <br />IJJL7G11 <br />. <br />• <br />IL;295 ] ~ ~ fER°'i1 ##$### ###:X:# aa:k #rYtt# oY::aYs REPORT THLi RAB <br /> PL O'JIRCN.L rJf <br />i L ('' -`• tlALll•~ <br />t t'LLL'. ~' <br />L <br />. <br />-L•.IL.111,!r.L.It'=L E'LOUiI.E Uf lICEP ICD ATMf M`ILDIAR WITH THEOINFORIA4,ION $UtlMEi P ED HDERELrv YUJD B46ED TELEPHONE DATE <br /> ON rer ,NOUIRY OF tM05E ^:DWIDUAE$ uA ME OIA,EIV RE $PGN$I BLE FOR <br />Drian P. Dunfeer MVfld el' <br />9 GB, 41Ya NG iME INFORMATION I BELIEVE THE SUBl.111TED BJFORr.IAiIDN • <br />r <br /> IS ,RUE ACCURATE AND COM PL EIE I AM AWARE IMAI h~ERE ARE $IG <br />CLNT PE <br />f <br />4 <br />T <br />E5 FOR <br />TU <br />FP <br />B <br />E C <br />Environmental Studies Iu <br />I <br />N <br />MIT <br />JG <br />l <br />I <br />SU <br />l$ <br />^JFORMATIOrJ, INCLUDING <br />InE POSb BgIiY OF FINE AND ,MPRISONMENi SEE t0 U$G 9 1001 AND <br />it U $ L f J, 19 /Prn/hin unGer ,Ar• <br />r smm <br />m <br />W <br />l <br />I/0 <br />[W <br />P <br />SIGNATURE OF PRINCIPAL ECUTIVE p~2 774-5253 90 04 26 <br /> . <br />in <br />uy m~ <br />t <br />r <br />nn y~ ro <br />, CER OR AUTHORIZED AGENT <br />OFF HEA <br />1 rrE.'~+n h, LiL ++l+rma.~•num~mDrmnmrwJOJbunnEmumAwnd +yruru I C NUMBER YEAR MO DAY <br />., I, IAMLLI GNU L/YL L!.L LCl. i,i A:r / . ~ I L III,L~IN~/.rrn.r Dll /IJD['hmeNf hrrr/ <br />It' hU UISCIIdLG nCC~u.Ls Hci•DdT °NO DISCHARGE°. OIL AND GREASE; SEE POOTNOTIi P/. <br />[f'A FOJm 332(}11Hbv.Bbo/P/bnLUS UJJLON$mtly DB USed. IREPLAOEB EPAFORM T~eO WHICN MAY NOT BE USED) _ PAGE OF <br />002o1A/1Gu599-]7({4 1 Z- <br />