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lunbq Nmuc/Ln'/ ``}I WIIen•~nlrl <br />NAME-~~a` {.' ~+•. ~--2.H.~A~~ laAL a_----- <br />---g73LilA'L~~li: " 'tALL3-------- <br />FACILRT <br />LOCATION _____~___ ~ _ ________ <br />~Att!I7-R.. D. flSf f-T')N_ P9c;in F+IT <br />DISCHAR - ~ NITORING REPORT 1 UMR1 <br />1.-I ,. - ,17-19) .~I~,aR ~ y- <br />0 ;; H 5 (? ~.~ '1 D 4 (S 0 9 F q M) For]mA~proved. <br />PERMIT NUMBER . o~¢RAwcc NuReaw F - ~ P I N A [. oMB No. 20x0-000a `~ <br />MONITORING PERIOD SP.C Zr+ Pf1H0~Prwa~p'r~s s"T'~ ,~ ERR ~,. <br />TEAR MO DAY YEAR MO DAY <br />FROM TO .`-'`•~ [I7 DI SCRA4.° '--1 +a •.`3 <br />nan l I na v I r teas l ~ nban nxa91 I ra-a I NOTE: Read instructions belDre completing this form. <br /> (J Card Only) QUANTITY OR LOADING (4 Cerd Only) QUALITY OR CONCENTRATION <br />PARAMETER (46-53) (54-61) (J8-45) (46-SJ) (5461) NO. F~~F FYI SAMPLE <br /> EX AN <br />~ TTPE" <br />(JJ J7) ALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS (6167) (6448) 169 ]OJ <br />7[L AND CR°AS£ SAMPLE `~'~^"~'v .` ('~4' $i~r .~. l`-,"i ~' wtt wr ~+ 4v v~.•: .- <br />Y L '~s ~ A L MEASUREMENT <br />91065 1 D ~ PERMIT Rrp7<{kR <br />~ (Ti=1 14#0tr'rF ?AI~QIIR IOtpM`#!# f,.~:' <br />ESKLY• <br />I;UA[. <br />-tFLOr'Ip ;RJSS YALLIc REQUIREMENT LHp !!A[ :l7=D '~'<'~'- <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT" <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~ <br />- ~ ' ' ~ . <br /> REQUIREMENT ~ ~ ~ , <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~ ' <br /> SAMPLE <br /> MEASUREMENT ~ ' <br /> PERMIT ~ ~, ~ . <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~ ' <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER 1 DERnFr UNDER PENALTY OF Lqw THAT 1 HAVE PERSONALLY E%AMINED TELEPHONE D A T E <br /> AND AM FAMILNR WfrH THE INFORMATION SUBMITTED HEREIN. AND BASED <br /> ON MY INpURY OF TIYJSE MQVIDUALS IMMEpgTELY REBPONS•BLE FOR <br />' OBTAINING THE MFORMATION I BELIEVE THE SUBMITTED INFORMATION IS <br /> TRUE. ACCURATE AND COMPLETE 1 AM AWARE THAT THERE ARE <br />$IGNIFICgNT PENALTIES Fdi SUBMTfING F <br />SE INFCHMAl10N INCLUp <br />C <br /> gL <br />N <br />THE P0551BLIrv OF FINE AND MPRISONMENT. SEE IB USC 1 1001 qND <br />33 US <br />1 <br />3 <br />P <br />h <br />l <br />i <br />d <br />i <br />i SIGNATURE OF PRI CIPAL EXECUTIVE <br /> <br />TTPED OR PRINTED 1 <br />19 / <br />ena <br />n un <br />ese Remrcs may <br />C <br />l <br />er T <br />nrlude l <br />no u0 to <br />510000 enJ or maa•mum imORSOnmenr o! benvrrn 6 months ]rM J y<aa) <br />OFFICER OR AUTNORRED AGENT AREA <br />NUMBER <br />TEAR <br />MO <br />DAY <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Re/CmOCt ]ll ell]chlnMls htrG) ~ ~ <br />S~TYL°49LE 5)LCOS f,IYIN 1PPLI°i ~•ILv rc ~= 1^-[R, 21-4R PRECiP °.YE1I1' ISCLAi!"F..D.' IF ^LAiM APPRDYFD Rv <br />y~y0, ASS IRIq LIMITS iICLL NJ! nq 0.PPf.IFD rp 4ftPORT?D ?1P.ASI1°.F.RENTi--S@F. I.l?.LA, P~ 4 AND i. R, 1D, o„ n. <br />EPA Form 3320-1 (Rev. 9.88) Previas editiarrs may be 168rJ. (REPLACES EPA FORM T-40 W HICH.MAY NOT BE USED.) 00 2 D 5 / 9 U 0 9 2 2 -16 5 7 PAGE -/ OF <br />