Laserfiche WebLink
PERMITTEE NAME/hu REBS (rnrYbF+clbryNw'L«+nm l(D~..«d <br />NAME ~ li i.', f, r <br />'',":!. C~: :t'. .Y L.G. <br />ADDRESS ~(1 ~r)~„ ,1 ±]l.,v <br />is ~..,. ,. ('O E!]fi ll: <br />FACILITY ` <br />LOCATION <br /> <br />NATIONAL POLLUTANT D SCNMOE ELIMINATION SYSTEM NPOESI <br />DISCHARG ITORINO REPORT O~ <br />l7-16 17-I91 <br />rrrnrnn nn~ <br />PERMIT NUMBER DISCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM U? ]p p] TO 'lf 1 ] 7] <br />l2P11) 111-I31 !14151 !1677/ l1b-191 130-311 <br />p - ^T qqi <br />r•; Cf•D <br />Form Approved. '~ <br />~ ~Approv rea~05-31-98 <br />.. ,~+'. <br />.NOTE: Raed Inetrucllone befor I eoTnpletlnp~thie lorm. <br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING !/ Grd OnlYl QUANTITY OR CONCENTRATION NO FREQUENCY SAMPLE <br /> (06531 (5461 (38-45) id653 154bI1 QF <br />131-371 EX 'wALYStB TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !i1-d31 l6d-66) 169-701 <br />41i. nH.i is ii4k5'• SAMPLE <n`. E: rr Sr} ( rl~) I;n tn`.it o} ~::}Y::h+l:} is r; :':::: ~.' I ~ <br /> <br />, <br />MEASUREMENT <br />~ <br />(? <br />/ I \rlr, , <br />~, <br />` <br />~.lU. I <br />h4'J {I t, I i) ;) ~~:~ PERMIT ?:: ... :}tY to '0.t}r:'. O.: ~'~' ~ rc,e] <br />.. :;t':Xrfi t}i}fF"':' "!Olp ypfR a:{c :: :~'~'e ae 4y:r`::i'r.~.~. ~ ' <br />i:~l <br />!' <br />" <br />i '.]rn, I <br />P i' i.ll ::': I L, F: r1:;'" 7 F III REQUIREMENT: ~:... ~. ~~ ::~ ..:: ':. ~. r~~•p :..' ..y. rl= . <br />. <br />. 1 <br /> SAMPLE <br /> MEASUREMENT <br /> .: ~.: PERMIT. ~ ~ . . .. ~ <br />:. ......... ~. <br />,.::. : <br /> REQUIREMENT ~~~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~ ~ ~ ~ ~ ~ : <br /> REQUIREMENT: ~ ~~ ~ ~ ~ ~ ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> <br />.. <br />PERMIT .". .... <br />...~: .. . . <br /> <br />:.. .:. <br />~ ~~~~ <br /> REQUIREMENT •_: ~ ~~ ~ ~~~~~~ ~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERid1T <br /> REQUIREMENT ~ ~ ~ ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> <br />~. <br />RERMIT~. ~ ~ ~ ~ ....... <br />~ <br />~ ~ <br />.. ........ .. <br /> <br />~ ~ <br />:~ <br />~~ ~ . <br /> REQUIREMENT ~ <br />~ .. .; .. . <br />. <br />~ .. <br /> SAMPLE <br /> MEASUREMENT <br /> .. PERMIT'. ' : ..... .. ... ....: - <br /> REQUIREMENT.: ~'....:~: ~::.:.:.. ~.. <br />.:.. ~ . <br />: ~::: :~~ ~ ~ : ..:.. ~:...y,t .. <br /> .. . t ... <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERT <br />AM FA IFY UNDER PENALTY OF <br />MILIAR VATH THE INFO LAW THAT I HAVE PFASONAILY E%M11NED AND <br />RMATION SUBMITTED HEREIN; AND BASED ON ~ I TELEPHONE DATE <br /> MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR ~ <br />~~ <br />1~ <br /> OBTNNING THE INFORMATION. I BELIEVE THE SUBMITTED INFORMATION IS ~i~ <br />Y~V~ <br /> TRUE. ACCUMTE AND COMPLETE. I AM AWARE THAT THERE ARE YY <br />_ <br />~ INCLUDING <br />SIGNIFICANT PENALTIES FOR SUBMITTING FALSE IHFOMIATION r - <br />-• , <br />n <br />I 1 ~ <br />J ~ <br />' , ( <br />1 <br />~ <br />~) I, <br />~ ! ~ <br />I ~ <br />~ I I _ <br />~ <br />II <br />' <br />~ , t \/ t ~ <br />_) ~ <br />f l THE POSSIBILITY OF pNE AND IMPNSONMFNT. SEE 18 U.S.C. 1 1001 AND 73 IGNATURE OF PRINCIPAL EXECUTNE I ~ <br />' ~ I 1 <br /> U.S.C. E 1310. l/lrrltlr+ud+r fM+. +beM+rn+Y tirald+l+w+W ro SI0,000 <br />TYPED OR PRINTED W n mvlmr+n inPn+>+nnr el brwwn a monN+AM b Y++rAI OFFlCER OR AUTHORIZED AOEM CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRs/erence all eltechments here! <br />_.::'f]'Lcd!'L!S .."•'1'...'i..`.=. LI"il' i1pFl.T[:5 ONLY I}' C= ;,Il-w2• 2~'iil'. PPECTF EVENT LS f'LAI."f.^., 'F• 'I t'.• :;Dl'~'!"~ :•y <br />r,~~i:b+ '!'.;S `~ TLiH~ ?.1"ITS +: ]LL ;1pT fiF k2fLIE:! ]'D iF.POF.]'Fp `IEASURf."'EN'fS--S F. F' I.P•.lF, !ti: a i' i. .Sf~, '~L: E.. <br />EPA Form 3320-1 108.85) Prevloua ed10onB mey be used. (REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.) PAGE OF <br />onoacinl,,, ,._, ;, , , <br />