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PiwMRTea Nw Dwue (Include <br />F~cdlry NenM/LOn IJJpenr/ <br />NAME-~~.... SZ~~1.~.Zy~~------- <br />woDREp~ j,J] jjy~ "1111.£-_ -------- - <br />-- -SI31 ~.T.lT.E-HJSEH1d 1J(~ ~ ------- <br />---~~~-------- CQ916u7i- <br />Pwcrurr <br />-------------------- <br />LOCATION ___ __ __---_--- <br />ATTEtt RICHARD G ATSIFSDp <br />nwnoN wL •ouurw cHAwcE EUMlnw noH •rsrEM (NPO!'SI <br />DISCNAR NITORING REPORT /DMRI <br />1~l I7-79 <br />-lr ~ n( <br />/CRMIT NVM BER ~ olECHwwRr NUMREw <br />MONITORING PERIOD <br />YEAR MO DAV YEAR MO OAV <br />iROM U TO 1 . <br />11011/ 111-131 /1I~13/ 116 l l18~191 /30. / <br />1 <br />MIFIpR Form Approv <br />(S U 5 R ~ !i N) M r0Alf3TNo. 2040.0004 <br />F - FINAL E%plreB 9.30-91 <br />LOADOUT LOOP SEDI/MILSO!t CAF:c°• <br />. NOTE: Raed inetruetione before completing this form. <br /> (3 Card On1Y) OV ANTITV OR LOADING (1 Card Only) OU ALITY OR CONCENTRATION Fq EOUENCr 9AMPLE <br />PARAMETER (~6-11) (J~dl) (38x3) (1633) (31fi)) ND <br />E% OF TYPE <br />(37)71 ANALrala <br /> A VERAOE MA%IMUM UNITE MIN <br />I M <br />UM AVERAGE MUM <br />MA%I UNITE 616)1 (6168) (h9-IU) <br />PN BAMPLE <br />E <br />U <br />M :l 'L 4`=i rt.-:'ti'.S ( ) // <br />g <br />6 <br />~/ / ,-J.~^i'^ /~ <br />L /~ <br />nr ( 17) ~~ 1 <br />Gin <br /> M <br />AS <br />RE <br />ENT . <br /> <br />07400 1 D 0 <br />''6~niri,T«" ~ <br />a~~R?CA~T~fi~4rg.o° <br />PoR~I <br />"~.~~~ <br />~ <br />##= <br />~: `m;°: <br />° <br />~ ~~•t~z:; <br />`;;~ixi ''r' m. <br />l <br />~~w1;~;~:~~e <br />m®e <br />,f;Fs%~X <br />~F~t~~s <br /> <br />(` ~1~6GSU MeN~' <br />•"A L ~' ~~ <br />$o-& <br />°'W"a <br />~ g <br />_ <br />.r a v<. <br />'6 «s.e . <br />ra..` <br />~ a<aac,' .s®« <br />~ <br />x <br />` . <br />x«p na.«.a .wap sSx®r <br />IP >'~m ~<~~ <br />' <br />EF_ I.UEliT GROSS VALU <br />«~~~ . °r.«> , <br />~i .¢ <br />x <br />, ~~"« $,".x. e, <br />0'1 <br />~a.k « <br />:# <br />~. $a <br />~«~" sm~. <br />= <br />>~ C <br />r 3.Aeffia <br /> <br />m m <br />SOLIDS, TOTAL BAMPL! *~'#~:## "###tt3 ( ) •`•:t##~ •1 <br />1s <br />2 <br />s ( 1g) p1( -- (, <br />~/ti <br />S'JSFENUEO MEASUREMENT . 1 ~ <br />~ <br /> <br />00530 1 C 0 i$9~a va= <br />~ ~8EgqEp~1T'A g..« <br />~~~#~~ <br />-°~ ;q~~.". <br />#ac <br />~8~'~'4r?"~e~~~as o-"k °ea <br />~~ <br />~ <br />~~~~a;C o-9 g~~` °bx <br />~$~" . r;~x". a <br />~m eA <br />$t~ "tl$x <br />~ <br />1E73e <br /> <br /> <br />F <br />Rt <br />iOLlRRIe.HI~ <br />awm~`.~w. Q' '« m <br />~ <br />"~. <br />w~m~°,^'c°"+~,ce <br />>a"~® <br />~ <br />n.y a•s <br />~ <br />` <br />~> <br />~ . <br />. <br />; <br />~a <br />ap a.¢z <br />nr~nm j«ac.n m <br />~~a,s <br />ex . <br />~ <br />s <br />~ww<a <br />E <br />FLUENT GROSS VALU ~ <br />~ ~,~~. <br />z ~~~~ p <br />~~~~~« <br />~s:a ~ ;~~~~ <br />~; <br />~~~~. ;•#:-# w<em <br />M~,~ <br />. <br />Aro.., ~> <br /> <br />~ •,z ~ ~~r"~ <br /> <br />" rte" <br />SOLIDS, SETTLEABLE SAMPLE #ao### C##C## { ) #!=##IF`# ####«:k L• <br />I ( 25) OI -T <br />/ ( <br />r <br />~i <br /> M[ABUREM[NT O. O I a <br />a <br />cos is 1 a n ~.~niiniii ° " ~ ~aa ~~~ ~z~ ~## ~~a~° ~>z~~~~m s ~~w$~~s®; aA ~ . .. _ A, , <br />« <br />P <br />FFFLUE <br />T <br />SS Y <br />U ,:1t§pU1RE16E~E1~IC ° es~am r <br />em. «a <br />«~ <br />ce a 'k aar~w«s«„ <br />om <br />~ 'y <br />' ne°~ar-'r^«s.' <br />= <br />""'" s awa. r "' <br />i <br />?'~ <br />~ <br />a <br />' w«: =~w <br />~ <br />-sa'° P <br />~a.,a m~<® <br />« "I" <br />. <br />n <br />'« <br />`~a:' <br />ti <br />G <br />F <br />D <br />L aew« ~ <br />:r <br />,. ns a~k.a <br />; .e <br />G- <br />' ~n~~m. <br />< . <br />~ <br />ma <br />x <br />a a ~ <br />g ~ , <br />~ <br />~ <br />OIL pNU I;REASE BAMPLE #G#:`.## ##.r~## ( <br />) ##fi';L~. 3#>rs~v ( 19) _ <br />FREDN ER 1'R-GRAY UETi MEASUREMENT - <br />S <br />c'o5.6 1 e o &a~w PERMj ~T;'a° ra" <br />~~#~;~$;; ~~e <br />« ~~;~~~ <br />#Yc .~ks, Ry <br />w.,~~~~~x`<~ <br />~~m~~~~#~~: n ¢~., ab <br />~k~a~g~a~~s <br />~~~ m '~' <br />~~ <br /> <br />i,. <br />~q'~a~ <br />`~ <br />( II i111l <br />. <br />REM <br />" <br />~ ~a'~ssa <br />";~ <br />e"~-- <br />"" ~~e~~~~g~®% aa <br />~~ <br />~. <br />~° <br />€ eeea <br />' ~~%&'# <br />se~ x <br />« ewx~ <br />~ $ <br />v~ z~®g <br />a> ~ <br />a <br />'s,• <br />x;z <br />EFFLUENT <br />:ROSS VALU. a <br />~ <br />8 .: <br />a <br />~~; ~.~ t#?# ~ <br />~, <br />vxa <br />- <br />~ ~>~" <br />a <br />a . <br />®. «a ; aza, <br />lii7N, TO'FpL BAMPLE r##r.#tt ##z[:=## ( ) ;4#a#>::« /1 <br />I ( 1g) of <br />! <br />7 / / <br />y <br />(pJ FF.) MEASUREMENT I. ,l ~ ~ C7 r/A <br /> <br />61745 1 0 0 <br />"'"-Enrirc~~~ <br />x>=„rX~14~~~ss<. qx ~ <br />#sk m#+~;~ <br /> <br />a <br />### r <br />~Ixs {¢'+f~.#gg <br />~ " ~.r. ... <br /> <br /><~'x ~a <br />' <br />« ~a°=« <br />~ ew IDdcq. <br />a Saga~b <br />~'!~a~~ <br />•°~~ <br />s <br />=~ <br />t5^~«. <br />~ <br />: <br />k <br />FFLl1EN <br />GP <br />S <br />[ a1cn111R MenT <br />f• ~,~-.~~~ <br />s~ <br />> ~ ra aka <br />x~¢ <br />°, <br />r <br />a ~ vedx~<zA„„y ax # <br />®, <br />, <br />s, sir"saws. ~sPo=~ ,,., <br />q a ,H <br /><, <br />, w#.0 <br />xe. <br /> <br />, <br />.OS <br />T <br />YALU <br />- <br />,~s•« <br />« <br />nea. <br />~~, »» <br />« <br />~ <br />~ <br />^"A ° <br />#~' <br /> <br />a <br />@ <br />r <br />~M «uem <br />FLJN, 1N CONDUIT DR BAMPLE <br />MEASUREMENT <br />~ <br />bN~ <br />bNR <br />~ ( U3) ##C#=~ =fii=### ##t##+`• ( ) °'o~ ~s,s~-+~ <br />THRL' TP,EdTlIENT PLAN , , <br />'0750 1 0' D .;a~ERi>:)i-~~= OFTt9~:kL~ .ag..l~EP~1~~°~; `m~~uk~; ~x~`~"~'~ <br />~ "r"~s~~zx ;:u;~ a~~ ~~~;G~° ®~~~s <br />1 <br />FF'LU' NT r <br />t <br />RDSS ~N59~i~R61~81fF as '°:Y ' <br />~ «-4e ffi ~<a <br />' <br />~ ~i <br />~~f~~Yxa <br />~^~ <br />w' `~a <br />~~s~aa3 <br />~:~3a <br />$ a~"$ <br />'~L <br />~~ <br />'a <br />m~~'i <br />~ ~k-s <br />~ <br />Y <br />I 3.e~ na;~ <br />, <br />. <br />VALU ~.~~~ . <br />~~.: a ~ PG . <br />. <br />m <br />~ . <br />~ <br />.e <br />~ , <br />. <br />A <br />.,~ <br />, <br />d <br />° ;:#'2 ve w. . <br />ww <br />~~ <br />SOLIDS, 1DTAL BAMPLE ~#t'+## #$#~## ( ) ###CC# 3##~#t: <br />~ <br />D 19 <br />~ ) 6(1 Grab <br />DISSOLVED MEASUREMENT ~ 07 <br />711295 1 r n z: °=P.ERM IT"g ~' ~~`~>~~,'~r~°® ~ea~v~~^'~s' ##~ .a.~;:wG~~+ ~~® •~,~ 4s k~%v: »~ ~. <br />ry <br />w"°I~F:~~ s%: sg~°, a~~„ ~ <br /> <br />FFE'LUP <br />ST GROSS VAi <br />1J >RRQUigE I}. T <br />"~ na.+ .x, n..«pa'. be ems ..~.c, ~s ry' <br />w <br />,: <br />' <br />= °eN°a., s. a.. ., "?a <.«~m~.,<<n ~ ~` •«a.; <br />• ~ a..., <br />a® <br />'R <br />` <br />, <br />. <br />, sm <br />;; ; «,,._s. <br />p =~rL~ s- <br />. <~sm~<~, e <br />~ r <br />.r > ,<<. w <br />re <br />NAME/TITLE PRINCIPAL E%[C VTIVE OFPICER I CERTIFY unDER <br />P£ruLTV of LAw TNAi I NAVE FERSONALLV ExAMIncD <br />AND AY FAMILIAR MTN TM[ INFORMATION SUBMITTED HEREIN ANO BASED T!L[PNONE O A i <br />E <br /> ON MY INQUIRY OF THOSE INdVIWALS IMMEDIATELY R[SPONSIBLE FOR ~ <br /> OBTMNIHG THE wKCRNtlMJ:I I BELIEVE THE SUBMITTED INFORMATION <br /> IS TRUE ACCURATE AND COMRRC I AM AWARE THAT THERE AIR SIG <br /> NIFICAMT P(NILTIFS FOR $UbI1TTING FALSE INFQRMATgn INCLUDING <br /> THE ro551BILlrr OF FINE AND IMpR50NMENr S[E 1e USC 1 1001 AND <br />JJ USC 11T9 IP.mhv <br />u,do IArr tlprvnu w,R• wrl <br />dr h <br />r <br />In rlwlx/, BIONATURE OF PRINCIPAL E%ECUTIVE <br />TTPED OR PRINTED . <br />u <br />n <br />. uY <br />n,d ,,. mr.Inu,n Impn.,,nnl.nr.•J Arluwn E,n.inlA. and .5 <n.. I OFFICER OR AUTHORIZED AGENT A A NUMBER YEAR MO DAY <br />COMMENT AND E%PLANATION OF ANY VIOLATIONS (Rr/rrrnrr pU uuurhlnenD hrrr) <br />53PT'LEAdLE SOLIDS f.IMI[ APCLIES DNL7 IF <- 10-Yk, 24-9R. PPECIP :iYE~2 IS CLAIMED. If' CLP.IM APPROVED RY <br />{<~1CU, TS.i F. IPDN Lir?LSS WILL PrDT Rf, APFLI°D TO REPORT°D E'i'.ASIlP.°MENTS--GFE T.f1,1Ar P, 11 A!!r, I. `!. 1C, Pi; 5. <br />EPA Fond 1 (Rw.11-fIB) PrsvlDBB sdiYOAb m y .Ladd. ' IRE-LAC[B EPA rowM Tro WHICH MAY Nor BE usaD.) •wGE of <br />