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F'ERMITTEE NAMk. ~SS•p,.i,4 isWryNrrlxu,w l/OJO.rwU <br />NAME ' <br />i;ULU '~4t. C!•IN:I'iiJY L.Pr <br />ADDRESS C, L11.:) r: Y r1 '•1 T ': f' <br />`,731 ';':'6'4!. !?T:;tI;:6Y l3 <br />FACILITY <br />l <br />NATIONAL POLLUTM. MOE ELMINATOM SYSTEM (NPDESI <br />DISCHARG ITORING REPORT IDMR/ <br />x; <br />! PERMR NUMBER D14CHMOE NUMBEfl ( U tl ~~ ~' ~' 1 <br />~ - F' ? h r. 1. <br />d 16.E 1 MONITORING PERIOD ~ r N C! s. I <br />Form At. d. <br />.,. .,OMB;N 4004._., <br />Approve ree`OS-31-98 <br />YEAR MO DAY YEAR MO DAY <br />_, <br />OCATION <br />TO q4 17 ~) ...;; .in ••, ..;•... e• c ~ I ~ ;:{ r: <br />rl 1\ <br />P~ N~n. ~,(~! t ~ FROM qt3 L!) P1. <br />.1'n <br />ifl C <br />,( <br />: <br />-` <br />_ <br />, <br />, <br />, <br />. P. <br />, <br />NOTE: Reed InetnrAlqu beiwe 2eTPltlinp thb tofm. <br />-rr^Fe=+-}y?-«I~ r-f--r'-F-;~- 1 !16311 /71-731 !7476/ 176771 I7B-791 1.~3I1 <br />PARAMETER 13 Grd Only) QUANTITY OR LOADING !4 Grd Onryl QUANTITY OR CONCENTRATION NO• FREOUENC'Y SAMPLE <br /> (46531 l5b51) /38-151 4653 151-61/ Of <br />l31-371 EX MALYSS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS (u-e]I 360-5B) 159-70/ <br />• SAMPLE _ Roc :r.} ~t::: ~.:'t :.`-:S :: :5,}rt : ,;: <br />~ <br />~' f t ~) _ I`J/. i <br /> MEASUREMENT ~,H G <br />, i ~ /: , I ; <br />J:),i ll (1 ~i U it '~.'~'PE.RMIT:~ ~r. ~t'r t,:~r,: it z: C'-.~~~ <br />~ <br />~ ~ ': 4:fri;:-s p; I::;r <br />~ <br />~ ~:~ri6;1 r<~i5r;: .',ly !{..'-..~:.~'~ <br />~ <br />~ .. <br /> <br />.Y <br />.Fr'i.U c:r.., i;F~~S'.'; l'.A I. IJ! REQUIREMENT .. ~:~:: ~~~~.. ~. ~ <br />:~ <br />' ~ ~ ~. L:::r: r,: : ~;: <br />*'T. :: Tw~O ta <br />~ .. ..: (: ~.'.T ~u.,~,. <br />- ' <br />. .. <br />. <br />;UI,: ll`ir Ci7 ~P F, 1- SAMPLE .:, rt;g¢q .':+'; SI .1,t -t .,,rn~tr ( <br />, .) <br />~' I <br />, <br />il;; t' r ~ it . L` MEASUREMENT L~ "~ L/ ; <br />. ~ <br />1 <br />,J`,3U L U ; PERMIT'., rr,:.^,161p rt.. :::: :::....:: ... <br />. Y,.., •7O-:`.'Y <br />: <br />r,: KI:< rc,. r <br />~G'. re •5~1k .: . <br />'j5 :' ~' <br /> <br />~ r..:::... ':. .: <br />7', ~~ <br />, / <br />~:: <br />~ r,±? . <br /> <br /> <br /> <br />. <br />REQUIREMENT <br />... <br />. " <br />.. .. . <br />" "' "' ' <br />.. .' <br /> <br />1.1~:(71: <br /> <br />.'.. <br /> <br />.'•{' <br />r.n. <br />~~ <br /> <br />:'1!. 'T.'I 'l.'1~.'Y~ <br /> <br />/I <br /> <br />J <br />"),: ?-.:l <br /> <br />r SAMPLE -•r:O r:n1;1 •5 ~a;r rt r-:;c ~-Y::`{::•c': '1 ~:+: I;I;c r: <br />( ~ ~~) <br /> MEASUREMENT G~,';y t~ 1/r ;~ I(.J <br />)l7':J :, I :~'.PERMIT.~.~ r',t r:k}'..c ~rt'9~ :~:.. iX"rihv~:;r :] <br />Y :: {:;: j; !; ~, rl ft~:c':: " 'yr :}ius it;c;:. ./~.4'.. <br />-~ , ,.. <br />:r:Ll/h. ,,: ~•!, ~1: , ,.,1.1.1 REQUIREMENT <br />~.. .'.. :' ~.: ~~ ~ ~ <br />.... ". <br />'::~' . ~ <br />.i '• <br />'t /r ~ ~ ~ ~~ <br />.,` <br />JIL di~D l~!<J'ii! SAMPLE ,~:.r C: {c:f: O:F..^,:ie t`; ;c frt ye:•: 1 is I: :;>~,rri•y <br />~IA ( 1 1) <br />C' ,I <br />(I' <br />• <br />~ <br />/ <br />~ <br />l: •,i)11 l~',: CD-I; It }. 'i °I"~I MEASUREMENT ; <br />~ j <br />.ni'1'_.6 1 (1 ll ~ . PERMIT... K:: 4Tt r}(:" <br />' >3S<GG1: .xj <br />~..' <br />~~ <br />~ r,:icR r 4.Y: f,+t;a:: rt:'. ey,Y :}.;:'>y:': ': %t..11. '. <br />~. •.'; G''i..i }i .: ti a r- <br /> <br />... -, <br />t 1~•,• B c <br />}(:. (. :.',; ~. t:' ~ U..LU. EOUIREMENT <br /> <br /> <br />R .. <br /> <br /> <br />. ..'.. .~ <br /> <br />..: ~ .. <br />~ <br />~ <br />.: ..~ '. .. <br /> <br /> <br />,.::+p r,: <br /> <br />.. <br />::. .~~. ::~.:...'~ <br /> <br /> <br />.:'T'1, i::T :;:; <br /> <br /> <br />.rl <br /> <br /> <br />.rT.. <br />,Lr', r ': .:/ i 'I L SAMPLE ,I,r i7 ft{I¢ '1; w:-•••'c y:>}io51yM - ) <br />~ ,; r}~ <br />( I <br /> <br />(@:; ~_) <br />MEASUREMENT <br />(. •'. <br />! <br />l~ ~ - ( <br />' / <br />(~1 <br />11:; ~, ] i (: U :'.'PERMIT ~: : r7 Cc:j ~ri. ~~r: re fk ra •;41p~1~ <br />. <br />~ `I°~. :r S: ~e:: YO t;i rt>l <br /> <br />~ <br />~ :3:.: .r: <br />.... <br />. <br />:: 'rj :.~~,n: ~ ;i~.. <br />. <br />~ <br />. <br />1 i:: <br />"~i <br />I.., , ... 1 <br />..-U C, f;'f l~ 1tC,'::~ v A {. 17 . R.EOUIREMENT <br />... .:: ....... <br />`.~." .. ::. '.. . <br />. <br />.: <br />..' <br />rtr. ( <br />.. <br />..' .: <br />n.n.t <br />"~5.1'C;.. <br />. <br />:.'r';:A.7:1~~~: <br />(..- / : <br />t.• <br />. <br />`q ~-f, ~ <br />. <br /> <br />r L,.t~, 1'i CJP L'.!; :' r: If <br />SAMPLE <br /> <br />~ <br />p; <br />,;: tt,::y:, 1;: :} 1 j:5 {i'n:: i ::: C::: `::': <br /> <br />~' <br />, <br />I <br />'h.t.! '!'i'.''n'1'it E';r !'LA!:'! MEASUREMENT Qro-(-; t,•, ~4. ~: I <br />// !. <br />,iil„p i U '1 ::~ ~PERMIT~ :: ~. :)1'TSDt .4 L: ~.~:~ :..~.. fig?O.A:T G'"<IX rr fit:?:: <br />~ <br />' s: r,: 1:115 t,a:~~: <br />' <br />: -:c r~:;~;: <:: '.. .. <br />!,. <br />. p;.~~y ~ ,i„T;: <br />t'F:.ili:f.:' C•i'I-:~•S l'Rl,!I° REQUIREMENT .''34DA~ 3Y•+ Gr1I1,Y •'iY" !^.~GD <br />. <br />~ <br />'::~.: <br />~~ <br />. <br />:. <br />. <br /> <br />. <br />... <br />, . <br />~~i:i: FSr 'i'i.'Cr:. SAMPLE .7(7:5 Cc w. r. Y,r.1{:.+:a ;c 1;: ;:r{r.? 1;:;1 .•1 :.,y ( <br />'1 <br />.1) . <br />' <br />c.~, ~ 1 , MEASUREMENT 'I ( j(" (, . <br />• <br />-:i ( _ <br />1 <br />, , . <br />L i, <br />( <br />111 "%'; 1 1, it <br />-, ~~ ~ PERMIT.: ..~...',:!, 15 ir,p C~:.-' '. ~i~:1Orx lk l;c 'r, : ^.•0 <br />:- <br />.t <br />'rS'~" esi 15 Y;. '.Yi ::: 1: S,ti .c. <br /> <br />.:.'~•': <br /> <br />~ „). <br /> <br /> <br />.. <br />. :•i•l.L h. I, I' iih(/~': .,r 1. (11 REQUIREMENT.. ..: :..:: ~~:.:: ~: ~'...:: 1"~: ~:: ~.' r: rcr.n <br />~ <br />~ <br />~ <br />~ •:~. ~-+y~. <br />~^:a~: a /1 .. <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENKTY OF <br />AM FAMILIM WITH THE INF0 lAW THAT I HAVE PEftSONAIIY E%AMINED MD <br />11MATION BUBMITTEO HEREIN; MD BARED ON "~ <br />~ <br />"~~ <br />J TELEPHONE DATE <br />_ MY INDUIRY OF TNOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br />OBTNNING THE INFORMATON, 1 BELIEVE THE SUBMITTED INFORMATION IS <br /> <br />' <br /> <br /> <br />' TRUE, ACCURATE MD COMPLETE. I AM AWME THAT THERE ME <br />SIGNIHCANT PENAlTIE9 FOR SUBMITTING FALSE INFORMATION <br />INCLUDING - J~ ~! _ <br />•~ ~~Ax ' <br />' 1 <br />~` <br />~ , <br />T <br />E POSS <br />LITY OF RNE MD <br />MPNSO <br />MFNT <br />SEE t8 U <br />B <br />f 1001 MD ]] <br />C 1 ~J ~'~ ? (t <br />~ <br />" ~- <br />~ t I <br />_ <br />;; <br />; , ~ , 1 ,~ <br />' . <br />. <br />. <br />H <br />IBI <br />I <br />N <br />. 61 ATURE OF P111NCIPAL EXECUTNE <br />A ~ <br />~ <br />J 1 `~ <br /> U.S.C. E 1 ]le. Ih,WW. 1n0.r erw mrons nvy I`rA.W rANa W ro 710,000 <br />TYPED OR PRINTED wor nt..:ts..r tttwwnt.etraae.wtemenm. rlCe Y..n1 JOfFlCER OR AUTHORIZED AOENi coDE NUMBER YEAR MO DAY <br />COMMENTS AND EXYLANA 1IVN DY ANY VH)LA 1IUnS IHerBlenCe e// BTre00Tenrs nets! <br />;!:i": L it%:-l'. '-!TLC's !.I'.T?' F.ppL7r.S ONLY IF C= 10-YRr '0-RR ?k!?CTP 'F.VFPT I3 C1.ALKF"~. '" r-; •I,. ct:p~nl'h;~ PY <br />„_,i: !;, '!':;:: lic^:. Li"; ^.''' u11. ;. SOT H'r; AF'PLIi'.G TO ~F.PONTF.D I: !'ASURF.MF-HT~- -SrL: •.n.l 8r ;~ 11 ~:;~ r.t~. i(', !~ . <br />}PA oiin 3 0=1" 108-951' Previoub editions niey be"u'sed. r (REPLACES EPA FORM T-00 WHICH MAY NOT BE USED.) PAGE OF <br /> <br />