Laserfiche WebLink
,~I HM11gENAM&4' SS •b.:-I. <br />NAME_ (mod ~rn„Ci1 JI. liL. r~urr ~ ~' ~c.} ~-- <br />AUDRE5513i!1 ~y;Lj T'1 ~'i~.}.'__-~____-- <br />- _ _ f:I.Ai.ssa-z e_ _ - - - - -.~.~ a~J ^~- - <br />FAC_LITY __ _ __ __ __ ____,__ _~ __ <br />LOCAIION_________________ <br />"7~2150V P~~S FV <br />NPIIONAI POLL U14N NARGE ELIMINATION SYSTEM /NPDE.SI <br />OISCHAR NITORING REPORi(OMR/ <br />1716 //]-ILl <br />1 <br />PERMIT HUMBER DISOHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAV YEAR MO DAV <br />FROM TO <br />R6?JI R1-IJl 17+751 lI6~77/ RR-19/ 176311 <br />F - PIUAL • <br />s'eonnNAtEa clscRARCs <br />BINUN AY1'RS <br />NOTE: Reatl instructions before completing this loan. <br />LT2.. C' I r <br />lJ C'Prd On/y/ QUANTITY OR LOADING <br />(+L'urd OnA/ pUALITY OR CONCENTRATION <br />NO <br />FgEOUENCY <br />SAMPLE <br />PP RAMS LER Nb-3J/ (3+61/ p9~+SI p637/ pJ_6l1 E% of TYPE <br /> <br />IJ''L) <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS <br />/e7-6J AN4L Y515 <br />/M~oRI <br />169)0/ <br />ill SPI.IPIE i-33YTY v. <br />YY###Y iA#YYT# <br /> eEaSURE MENJ <br />/1;477 i J 'i ':=='~+~ >r<####=< =~ ~e5 ;#^Y#3C 9.0 DICE/ NAB <br />_ _ <br />' REQUIREMENT r# I ;~N <br />~ / <br />r1 <br />1 F <br />_ <br />~r'~j Dv <br />'S~ll ~: .~L SPrAPLE +3x3::3 ~3#33# 33343+`. ####+# <br />~ <br />'cNUP <br />D MEASUREMEIJf <br />. <br />J73J 1 J U PERMIT ##3Yk## ###3## r## >G#3### ###### REP08T NCE/ RAB <br />_ REQUIREMENT <br />+r <br />l <br />, <br />!JLIllS, SETPLEh!lLE SAMPLE ##3### O•:33## ;.33333 .3t#fi# <br /> A1E a5UREMEN( <br />f <br />:545 1 J Q PERMIT #33343 ~~##3$ YY ^*+'~#33# #33##Ak Q~S HCE/ BAB <br /> REQUIREMENT <br />_ <br />~~ 1 YY <br />AIL AND G6Z95Z sAI.+PLE 33;:33# YY3##Y ##3#r# ###3## <br /> IAEASUPEMErR <br />'f R-GRAY 93Td <br />' <br />dcUN :i Y <br />'7556 1 0 0 PERAnr #3#### ###### ### C##### ###### 10 NCE/ RAB <br />r .] REOUIREAIENT f w3 F• <br /> <br />IuoN, ToreL SAMPLE r;:3;f33 ~:#Yr~# ##C33# ####t# <br /> <br />, Pte 61EA5UREMEN f <br />) <br />(A <br />.,1045 1 0 0 PERMrt .4#### 3##### ### fi##### ##$4## REPORT ttCE/ RAB <br /> REDUREMENT <br />~. ~ i. <br />YL~JY~ I:7 CONUOIT OR sAMPLE NO FLOW ~ #333#~k ~~3333 +33;14# <br />[~ TR3A2tlENT PLAUT 'AEASUREM[N1 <br /> <br />5,.50 1 7 0 PER'Alr REPOflT flEP08T ##3### ####33 ###### ti4:A EEELi NSTAF <br /> <br /><<tu=sr can., V REOWREMENf <br />r <br />4.^~C:# <br />SJLIG:;~ TCinL SAMPLE 333443 ##343# 3~S#::## ##$3,:c# <br /> <br />LC350 I.IE aSURE IAENI <br />LYJ:D <br />7 )255 1 J J RLRAIIT Ot3#f'3 %#44## 333 ####~.# ###### REPORT TRLT RA8 <br /> <br />1~- '`'ii.i;;ii L:ii~-iliii ~. <br />_ RE OUIREIAENI <br />r:nt: ~ <br />t ti <br />.1 : i. <br />_ <br />I 1.4!^L 1111 E PIONIa V:.I ErECUII\'E UFEICER I CEHnGY UNDER PENALTY OF LAY/ THAT I HAVE P ERSONALLY EXAMINED iEIEPHONE DAZE <br />l A .D 41A FAMILIAR WIiM THE IN WRAtA ZION $U BIAIT LED HEREIN ANU BASED <br />I ON MY It.OD1RY OF (NOSE IN DIVIDDALS ILA IA EDIPiEIY RE SPON 5181E FOR <br />y <br />I <br />Brian N <br />Ounfce <br />1'Idna Lr <br />9 ~ OUTA.I;.;:G 111E INFORl.!A!ION I BELIEVE iNE $UBL!II!ED !NF DRMA LION <br />' <br />. <br />, JANE IIIAT LIERG ARE SIG <br />~S IRUF ACCLIRAiE AND COlA PI CIE. I AAI Al _ <br />C _ <br /> <br />Environmental Studies <br />NIIICPNI PENALTIES FOR $UBMIiTING FALSE INFORMATION INCLUDING pp <br />6o <br />774-5253 p <br />9~ <br />04 G <br />26 <br /> IHL POS6~81LIIV OF FINE AND IMPR60NMENI SEE IB u5C 6 1001 ANO SIGN AIURE OF PRINCIPAL E%ECU E L <br /> <br />I.FEL UU PLAIN IFU i ~ U S L 1 I)Ilj /I}~nu/un vnJ~% IAnr Vwub+ mY m. IVJr Jinn ul' I^ tIU,IM4 <br />+,.e•~~u•••'•~•m ~~m^~••~mrm ~•./brL,rnbm••nrh, „~d i.rm,) <br />OFFICER OR AUTHORIZED AGENT <br />AREA <br />NUMBER <br />YEAR <br />MD <br />OAr <br />,.U1.11dLNf AIJU EXPL AN 411prJ OF ANYVWIAIIUNSlR. J; rrnu•Jll ulm.hminb hrrr/ <br />1 P t:U CISCIIAPGZ 0(: ('U RS nE11)riT `NO DISCIIARGE°• OILE AUO GREASE, :TEE FOOTNOTE F/. <br />m <br />N <br />m <br />L/'AFOJm 7JM11RBV.9$JiI P/BYIOUS B(1r(IOnS (ney oB USBO. INEPLACE$EPA FORMTAB WHICH MAY NOT BE USED.) PAGE OF <br />!)0379/luOSN~-17114 1 ~ <br />