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F[RMITT[I NwA/• ~. OR[if /(n[([dl <br />14Attr NDR[/Loar ' ;' IJJIrInt/ NATIONAL yOLLUrA ac NwwcL [LIMINArIOH arsT[M fNYUES/ <br />D18CHARNITORIN6 REPORT /OMRI <br />tl/1EA8- ~!'[l0.1 ~tt.CCP__A 11Y---- --- <br />1-l6 17./9 <br />t1 i NO R <br />Form Approve <br />AoO~E efE rnt.ny~~ R T M F-------- --- .I n ^ If (SUItR NW) R(g1ASTND. 2040.0004 <br />_--~j~~TATF N~jj,J/g]'1~--- --_- /[KNIT NUMB[R RIacNA+aa NVMa[+ F - FINAL E%plrei 9-30.91 <br /> <br />-------J'1L II11L4L- MONITORING PERIOD GUI,CR A 56DI POND/GOOD SPG~ ('il <br />~ACI TY ______________ <br />YEAR MO DAV YEAR MO DAV <br />LODATIOR IPOM <br />----------- ~3 G1 O1 TO ?. C•3 31 <br />------ ~v' NO [•ISCHAARGE 1 1 !~'' <br />lao~lll 1~7~73/ (71.1J1 lab- / l1a~a9i IJa // <br />(' D G K N S D y NOTE: Reed initruttiom Wfore pleDnp thiE form. <br /> (! Cord ONy) QUANTITY OR LOADING (1 Card Only) QUALITY OR CONC[NTRATION <br /> <br />PARAMR[R <br />(16-JJ) (JIfi!) <br />(JdJJ) (16 <br />7J) <br />J16/ <br />NO FREOU EHCT <br />BAMPI <br /> . <br />( <br />) . QF <br /> <br /> AV [RAG[ MA%IMUM UNITB MINIMUM AV[RAO[ MA%IMUM UNITB 67dA (6168) (69-rU, <br />DIL AMD GREASE BAMPLE aoacLav ( yq) 4T,LLYC#0 C4pd#1} O140tk~4 ( ~ <br />rIgV~L MEABUR[M [NT <br /> ~. <br /> <br /> M[ABUR[M[NT <br /> ,Y'«Riilt~, r` ~ ~". °, » '< .b1 ~ ' ', s '.tea-• ~ ~ ;d ' "" n.;;»v <br /> <br /> <br />' tAMPL[ ~ q <br /> M[wauacYENT <br />~ <br />.. <br />• ~ ~, a ~ <br />.ihtM 1~°,~ <br />~ <br /> <br />w ~ <br />.~e <br />C <br />^ .~ .,", <br />~~ <br />~t ~ ~ ~ . , <br />~ <br />y~ ~ ~. ~,~ <br />i,L~nlg~ <br /> i~~Illft~l,Rti~. <br />° ~ S <br />~ , » , k 'g ~ ,~'b'w <br />~+ `¢ x. ~,b~a <br />' ~ ~ ~ ~ ,~~x.a . <br /> : <br /> BAMPLE r <br /> MEABUREMENT <br /> '%e.-)CR~I IT'~;e. <br /> <br />1 '.~z ;r.x <.~n'~.vmy, °a <br />~ti x R~au <br />~ <br />~ ' ".~'~pr ,R„F„~s a;«.s.'~~',; <br />+ <br />~~~a <br />, <br />1rX'e uw6Rizma Y~~m:«`r'~ <br />~A'i <br />..yy~ '® <br />" yaa ~~..,y .. <br />'M>x ~' <br />~ ~ •'~ <br />e <br />~ <br />° ~m~ ~r <br />~ <br />' <br />~' <br />' .a.:... <br />, <br />er <br />4` <br /> : <br />11Ct1U(qq[NENTa <br />" Y <br />;r> <br />o- ~s <br />~ 6 . <br />. <br />~ s~ <br />mma;a• ae «<« ' <br />b:~ <br />~ ~ ~ ~a <br />!v° <br />~ s <br />.~';w; ~ <br />.w'~ <br />~ <br />" s <br />w. <br />" <br />:~ <br />~' x ,; . <br />p <br /> : .R Vm'o- <br />o-`w F.~ mrtm%9p ~.®Y° °4#;° . <br />,eW w,.ea<" <br />'t~ Yea ,$r, ~ , ~~.w <br /> BAMPLE <br /> MEABUREM[NT <br /> d 2e 1NCR1IiT:a ~~Po«'"»~«~a••~#`° '~ ei ~m,.~~.rua°e.+~a ~' <br />'~ <br />« g"x,'(i«.%N-J~wv~'~« <br />. <br />" vawg,~%'e~r.~:''s:.:~ <br />I ds. i.~~'~aa~:.::.y <br />v - <br />. y~'~ <br /> ?REOYIRiM g~1T~ ~. ~es~+an.mR~ata S'~~ <br />~ ~'x4 ~® <br />: <br />y~¢¢i~n <br />`e <br />~ <br />~ ~'. <br />~"~3-^4x o. <br />8 <br />~:$ <br />~ <br />' <br />i ~m..ttv„q~q~c.. ~ <br />~ ~~~~ z~` <br />, <br />~~ <br />~, <br /> $~d., . 'Cw <br />~ ..g,«~ 'aXm i..~ <br />Y <br />~~>L~ R q <br />~ <br />: p., <br />~&~ny'xd .'S..•d Sf~m ~ <br />~ '4a~`;o-iM .~ ~ <br /> BAMPLE <br /> MEABUREMENT <br /> <br />o-H6.~ ... .e~ek <br />d P[R1[rrwa <br />w~ R Ad :~p gP' <br />S <br />,~~n & ., •.V dq.~m¢$~,wk xn <br />w• <br />a~.x., ab$'.bn., w...y <br />~. <br />~ e .°PY" $b.d -y. ..9.Pb.. ~~e": <br />0'd • ~; " <br />,<~ <br />~ •.~aa:k' ne s'~''~"; <br />.;;~ H°4wy.~ <br />. <br />° <br />~ <br />: <br />r. "y. <br />dT'. <br />P' <br />... r'.~x, N',4. <br />' <br />Ae: .., <br /> FRrpy1R[ML,NT . <br />w .a g'.m,»xk as „ <br />~y«~4~~«'.Po'ti;.~'°;,°, ~ <br />~k y: <br />g <br />v F'z a'~ v <br />' 6 <br />x <br />< <br />`"° <br />e°We a.~.e'e:: <br />' Y <br />s <br />; <br />99 b.~s~. <br />v ~ <br />ors' i~a <br />xx~; a y~ <br />+ e :.' <br /> .k #'B°~:nkk Yx mw« k <br />»~9 <+h d . <br />_~"$' .aka' %ti B <br />A~ r <br />mx.~'67Aya..~ ~'k F ..c <br />•k ~ <br /> BAMPL! <br /> MEABUREMENT <br /> x>rcll[RMIT :'ax .e«e3ai„("B 5.&s: «'&'Sx$!eg,g-t. $ ~,~. '~s, ~® :. ~o- '.s~a«".a. Asa. ??'S a( <br />a <br />M1 hbro=b~; <br />a «r~."~4,~'t. <br />r(~8~; ;": <br /> <br />` ~'S~ <br />'~ i.S i. w:ti <br />•4 <br />" ~ <br />^.ep <br />ya.wa <br />~ ,x <br />m ~ <br />%P.xgfFw •k•. <br /> b8x Fm vga <br />s <br />~~ ~0w <br />Y.«&. <br />~ <. <br />~ .~°Y'a <br />~° <br />„ w&n °~P C4a: <br />NAMERITLE PRINCIPAL [%[CUTIV[ OFFICER I CERnrr UNDER F[NALTr or uw TNAT I NAY[ R[RSOHwLLY [[AMnr[p <br />/// <br />~~~ T[LEPMON! D A T E <br />AND AM FAMILIAR WITN THE INF011MATpN SUBMTTTCO NEREIN ANp BAS[D <br />/// <br />/ <br />ON MY INQUIRY OF TNOSE IMpVIOUALS IMMCdAi[LT R[SFONSIBLf FOR <br />OBTAINING THE INEOII <br />Y I B[ <br />I <br />TN[ <br />T ~ <br />/// <br />~ / <br />/// <br />MA <br />IO <br />EVE <br />$UBMITT[p INFORMATION <br />L <br />Richard G. Atkinson IS TINE ACCURATE AMD COM0.ET[ I AM AWARC i <br />rT <br />CR <br />A / <br />~ <br />1 <br />N <br />TN <br />E <br />RC SIG <br />NIFICANT PFMALTI[5 FOII SUBMITTING FALSE INFDRMATgry WCLUtlHG / <br />~ <br />-- ' / <br />VP Land/Environmental AffnirR TNF POSSIBILITY OF T1Nf AND 1MRR50NMENT 5[C IB USC [ 1001 AND <br /> <br />)]USC 11319 Ihnnhr. un1•r IAw MW1.. n nrldr /m. .Y o. rlu Rn <br />. ur• SIGNATURE OF PRINCIPAL E%ECUTIVE - I'I <br />TYPED OR PRINTED n•d..•mr..m.In lma.r..nnl.rlr ,r/I.1u..nEnnnlA•and],Nr.l OFFICER OR AUTNORIIED AGENT A NUYBER y[AR MO OA <br />AND [ItPLANATION OF ANY VIOLATIONS IRr/rrrn[r ul/ unuL'hmrnd hrrr) <br />SETTLEABLE SOLIDS LL"IT APPLI?`; (tltLY IF <= 1C-Yilr 2(t-HR ~FF'(_IP eVENT li CLPIrEI?. Ir CLAIM APPROPFD Pv <br />MQCD1 TS' F. IPO!1 LIMITS uI1.L NOT P5 APPLIT:(? T(' `iEPORTF.D yrq,:;ryPr;«(`;1T>--'cc I.i(.11r PG U .^.NU I.I'.1Cr F'; / <br />.. r Bv. `Yedi !rd tly De sed. -- - - • IREFLAEEi EPA FORM T-t1 rNICN YAV nor BE Yi[P.1 PAC[ OF <br />'llu;?f;/e~.lonn-tarn <br />