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' ~ NwM[r.ppw[u (lncludr - ~ - <br />Nalnrllacnbn IJdlJlrr[nr/ <br />~P~E~I[A/~~9/C]BD~n ~L~[[I[Ii.DAI1~.' p1p IS ENLCA_lSI11E)---__ <br />-F1rAGS2AF~__-- _ _ ~~ B 6fl_D L _ <br />119' <br />rlOw ~~_~___~ <br />9e nnwet_n n_ zm.r[R <br />wwnoNAL rouDT7l~foncN Ua[ [u MlewnaN lrlrcM /NfDES! <br />DISCHARGE MONITORING REPORT /DMRI <br />716/ f 7~l9 <br />PC MIT NVMw[w P'ONA.c•.4Y.[. <br />MONITORING PERIOD <br />r[wn MO Gwr reww Me Dwr <br />IROM TO <br />/707L /17~.!b 176711 /Sb. 1 /79.7-1 / L <br />1 <br />HINOR Form Approved. <br />(SOBR NV)OMDtNN PQg0~0004. <br />F - PI N A ~4PPloval expires 6.30-91. <br />NO PRECIP.2LH-PLDNE <br />aaa NO DISCRARGE )~1 aaa <br />NOTE: Reld instructions b[fore comPletinq this form. <br /> (J Card OnIYI OUAHTITY OR LOADING 11 Card On1Y1 GU ALITY OR CONCENTRATION YY LOU [NCT <br />PARAM [TCR (Ib-11) (61-0I) (NIS) IIAJI) (SI-0I) HO. GT [AMPLC <br />TYP[ <br />(37-11I V' NAVSIa <br />• <br /> AVERAGE MA%INUM UNIT! MINIMUM AVERAGE MAk1M UM UNIT! 6741) (b•dkl (69-16) <br /> EAMPLE as#a'~fa '~--^.aaa:s (~ 1 aaaaaa ( 121 <br /> MEAEUREMENT <br />00 1 0 D PERNrT aaaaaa:~ aa~aa#~ _,. B,5 ,<, aaaaa"a 9:0" eElCLT RAB <br /> <br />LUP,NT GROSS VALCr wEp W REM ENT <br />~' ~ <br />~ a:~~ ~ <br />aaa# <br />!I~ .s ' <br />a`.~' <br />. . <br />IDS[ TOTAL EAMPLC +-..aaa #aaaaa ( ) -,.aaaa ( 19) <br />P uNDED NEABUREMEHT <br />30 1 0 0 ~ PfgMlr ez~ aasaaa" aT3aaa ° <br /> <br />,.. ,._ <br />a^- •aaaY3~ <br /> <br />r. BEPORT, . ~~,REPOR? NCE/'; RAB` <br />7E GR SS YII ~ wEGU1wEM ewf ,- <br />Y V <br />IDS, SETTLEABLE lANPLE aaaaaa aeaa,. ( <br />) raaaaa aaaaaa ( 25) <br /> MEASUREMENT <br />u5 1 0 D ~ PEeNIr ~ ~aoaaaa.~ <br />9 aa:.aaa~- aaa "~ ~caaaor~ ~ aaaoaa ~°'REPORT: ~ NC1E/ @AB ` <br />LU NT G O OA D REGUIREM ENT. k' " r ~ ~ ' aaa$ ~' ~ ~A <br />S' <br />N, SOTAL .AMPLE aaa.-aa acacia ( 1 ~„n,.• ( 19) <br />(AS FpI MEASUREMENT <br />45 1 D D PERMIT xaaa~aa: aaYaaa• " r <br />~ .: ~ar A' <br />4~aaY <br />`%REPORT`~ <br />~ „REPORT`:~ . <br />NCF./ <br />. <br />RAB: <br /> REGUUEMCwr ~ ~ ' ~ <br />~ „ . . <br />I ~ <br />r S ~ <br />'~I, IN CON DU LT 79 suMPL[ <br />MEASUREMENT I,~ <br />~ ( 03) aaaaaa aacaaa ~,.~~~ ( ) <br />fl TREAT'1E9T PLAN, In[6 <br />I G Y G <br />SO 1 0 0 ~PERNIr ~ <br />' ,REPORT 0 IONAL ~.aaY;:aa.. ~~.aa~~a~. .~~aa.aaaa` as ~ ~EERLY 95TAN <br /> R[pUIREM ENT ,;yp. ,. . . <br />IDS[ TOTAL lwNPLE aaaaca aaaa,• ( ) ,..aa- ( 191 <br />SOLVED MEABURENENT <br />v5 1 D 0 ~~:ERw1r ~~ aaa'zaa:~ e ' aaraaa. aaa ; .aa#;:#~' OPTIONAL `. ~-=REPORT , TRLI, RAB <br />., <br />T UE ROSS 11, ~ wfOUIwEM EHT ~ - aaar .~. ~3~ .p <br />r , <br />3ND GREASE wAMPLE aa,•aaa ( gll) aaaaaa aaY•.-.- aaa,-,n ( <br />1 <br />N A L M[AlURFM EHT <br />~6 1 0 0 PERMIT :' ~ REPORT -a#aaar ES=1 aax~ara" aaaaa /a~aaaa. %aa EE1IL2 ISUAL <br />/ wfOUIR[N [NT . ~ ~ _ ~ ~? ,.g ~r - <br />I ~ E I - _ <br />!/TITLE PRINCIPAL [kEC DTIVE OFFIC[R ' C[wilrv uND[R rLN.Lrv 01 Uw I IvE w[wyJN4LY EurM[O <br />ANO AM [IrYrLIAF VI'LN TN[ iMYpPMw[ION SV BYITf[D NERErN ANO NS[D i[LEPNONE p A T E <br />^y T C <br />Vn <br />- <br />Q~ ON Yr INW'Rr O[ iNryC INOYrg145 rYY[p1[LLY wC510N5reLL IOw <br />oer.INIIK <br />rN[ INIOIY.NOH I ![u[v[ rw[ SVerm[O INIONY.rION <br />ILh 1• .Y <br />I <br />' r <br />'S !W[ ACCVwACE AND CCWREfC ne[ T M[PE Lw( Sfi <br />A <br />I If~C ANI V[NAlil[$ fOw 5J[MIrtING <br />~L5[ iwf 09YAIION INCLVPNG • <br />r <br />Envlr <br />p[1 rn~lliul J'TID IQS <br />~N[ PbSae.L.rv 01 ImL ANO IrRw20nY[nr 5[C b o5C C'OJ/ INO /~1 0 <br />. <br />]]USC 1']19 rPmAllu~. <br />Mrr r(r- /Y/uN. nr•I inrludr An <br />I•. II'Irr <br />. Y SIGNATURE OF <br />PgINCIP E%ECUTIVE O ~ ~p [5~ / <br />TYP[p OR PRINTCO u <br />r <br />p <br />•.d.v..u.m.n rn~Pru.+.m..n ..l b'lusn4n•.nl..endrm.. OFFICER OR AUTHORI2EO AGENT AREA NUMBER YEAR MO DAY <br />enr wnu urLwnnrr•rr yr nnr YrvLArrVNa 'nrlrrrnrr Irrr urrurnminrr nrrel <br /> <br />1 <br />1] <br /> <br />d' <br />L • <br />V <br />J <br />'.:0 DISC9AR;E OCCURS RP.pORT '[RO DTSCHSRGP.'•. OIL AND GREASE (OEG) -- IF A 9ISIBLE S4EEN IS DETF.CT4D A J <br />": SAHPLE SHALL 9E COLLECTED AND ANALTZF.D FOR 05G. REPORT S0.HpLE RESULTS AS AN 0.iTACfl RENT TO THE DAR. <br />rr 7 (R v. Pn 'aa W on! us • 1 Ilcc r r MN1 r [ ~ ~ r.ac or <br />00002/910't01-1719 1 ) 1 i <br />