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PERMIIiEE NAM• REBS rIm lu,lr <br />IvrJ,l,r ]nm.rL. Jf/nnrl <br />NAMt-_~ ~ LCD AJ. ~ O_ (~uLI.9 .~ ZN F. ~ - - - <br />ADDRESS 1 ~11'l! SDI( TI'i 1A_[,E_ _ _ _ _-_ _ _ _ <br />---Y-LA~:iTAEF ------.-S7~BbG~.7~- <br />FACILITY ----------------- <br />LOCATION-_-_-_-_-_ --_-- ---- _-_- --_ <br />cn•nn ncrnu nn ccrnnnm <br />NA1lONAL POLLUT ISONARGE ELIIAINATION SYSTEIA IA'PUES/ <br />DISCM MONITORING REPORT /D,NJ7/ <br />17 //7-/9/ <br />n <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR A+O DAV YEAR MO DAV <br />FROM 91 TO <br />/]0.1b Q1-lll IJdJL OAJA r)RJ01 /I0. t/I <br />P - FINAL • <br />STOA!ISiATE3 DISCfiARGE <br />BINOR !!lITRS <br />NOTE: Read inslructlons belore completing this loan. <br /> 1)Card Onlvl QUANTITY OR LOADING /I Cord Onl/y QUALITY OR CONCENTRATION NO FaEOUENCr SAMPLE <br />PARAM EIER /Ib-S)I (31.61/ IJ8A5/ /Ib~l)/ /31~6q <br />EX OF <br />TYPE <br />L+I )l/ AVERAGE MAXIMUM UNITS MVJIMUM AVERAGE MAXIM WA UNIT$ ANALr515 <br />~( SAMPLE ##v#r# v#v### ##r%~v# <br /> MEASUREMENT <br />' 0 <br />'vti00 i <br />' ~~'¢'~~~ ####a# L`3# ~ <br />C #EtG#~ O <br />Q N(,F/ RAH <br />v <br />. REQUIREMENT ~#` <br />r , _ ~ <br />) <br />v r , <br />TOTAL <br />LIDS SAMPLE ..,-#### ##3a:## ,.Y:k##~ y-##### <br />, A+EASUREMENr <br />U P E N D E D <br />~'C530 1 0 O PERMIT ####r# ###r## ## ###### ###### REPORT RCP./ 3A8 <br />c P T REOUIREM ENT T##T <br />OLIDS, SLTTLF.A9LE SAMPLE #;:#:`-3# #3#### ##;##,"- ##~Y-i## <br /> MEASUREMENT <br />OS4S 1 (~ O PERMIT #'~###~ ##=f'-F## ~ vy'rr #+K=f##'+t ####'~'•F' O.S VCE/ BAB <br />~, REOUIREIAEN7 k### <br />IL A1D GP.EASE SAMPLE ###r## ###r## ~#Y~#r v##### <br /> MEASUREMENT <br />A4 J7F <br />ETR-GP <br />T!I <br />3E <br />ON F <br />. <br />. <br />. <br />c <br />OJS6 1 O O *'~##%.=# #####~ r#r #####~ ###### LO 9CE/ RA9 <br /> REOUIREIAENT <br />!?Oti <br />TOTAL SAMPIE ###;kv# %}+•`-~++~--,5 -A.Y'~S###'+r =k+##'+FY <br />, MEASUREMENT <br />(AS FF <br />) <br />, <br />104 i 1 0 0 PERIAIT ##•:-##.". ####;.# ### ####•#:• #####9r REPORT RCE/ RAB <br /> REQUIREMENT <br />c•c cr c r <br />~r,ON <br />IN CONDUIT' OR SAMPLE ~ v+.vv +"-##### ###v'>;Y~r <br />, MEASUREMENT NO DISCHA GE <br />'0 TAEATHEKT FLA3T <br /> <br />~.:v050 1 0 O REPORT REPORT ###### ###### ###; ## •`-rr EERLi MSTaR <br />~ o r REQUIREMENT #C;# <br />SOLIDS <br />10TAL SAMPLE ##~### ##n'rr#,"n #####; ###### <br />, MEASUREMENT <br />Issa(.veD <br /> <br />70255 1 0 O PERMIT ###### ####;# ### #####-'X ####?# REPORT TRLY RAB <br />A•T rr r; MT roncr y A T rr REQUIREMENT At`_4 ~ h(: <br />rJ Ar.t EITITLE PRINCIPAL E%ECUTIVE OFFICER I CERTIFY UN pER PENALTY OF LAW THAT I HAVE P <br />AND AM FAMILIAR WITH THE INFORMATION SUBMITTE ERSONALLY E%AAIINED <br />D HEREIN TELEPHONE D Ai E <br /> <br />Brian P. Dunfee , AND BASED <br />ON A1Y INQUIRY OF THOSE IfJDIVIDUALS IMMEDIALELY RESPONSIBLE FOR <br />n <br /> <br />Manager OBT AINNJG THE INFORMATION. I BELIEVE THE SUBMITTED INFORMATION <br />IS TRUE. ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIG //J <br />lr (if <br /> <br />nm <br />nt <br />l Studies <br />E <br />i NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMALION, INOIUDING <br />T <br />P <br />BI <br />ILY <br />F FI <br />MPR <br />M <br />T 6OZ 774-5253 90 07 25 <br />nv <br />ro <br />e <br />a HE <br />OSBI <br />NE AND I <br />ISON <br />EN <br />L <br />O <br />SEE 19115 C. ` 1rN11 PND <br />I]19 <br />]] U S <br />G <br />P <br />Li <br />d <br />A <br />J <br />J SIGN ATURE OF PRINCIPAL E%EC TIVE <br /> . <br />. l <br />rna <br />a un <br />rv r <br />nr vamrn mar rn <br />u <br />. 1 <br />r Jinn up ro 110. ptl <br />T AREA <br />TYPED OR PRINTED awo. maximum imPruonmrnr of bn.rcnbmonrb an,I3 ymrz) OFFICER OR AUTHORIZED AGEN NUMBER YEAR MO DAr <br /> D D <br />l.Vrn nltn I Nwu [A rLglVgl lun Vr qn1 vIVLHI IVnS /HeJerentY all a!(ar/ImrNS here/ <br />[Y :CO DIiC'IAP~~E OCCO!JS R.°,P~RT 'ENO DISCHARGE''. OILE AND GREASE; SEE FOOTROTE F/. <br />EPA Form 9O2O~t (RBV. 9-BB) PfaVlOUS edi110r15 maybe USBC. (REPLACES EPA FORM TAD WHICH MAY NOT BE USED.) PAGE OF <br />0038U/1C0509-1744 1 ~ <br />