Laserfiche WebLink
PERMITTFE <br />F'arW :• M1Rmr ODRESS IlnvluJ~ <br />rl J/1l rrrml NATIONAL POLLUTwNT NARGE ELIMINATION SYSTEM I \1'L l.e, <br /> <br />DISCHARG ITORING REPORT rllUR1 IOVeO. <br /> <br />~30l0.0Uf4 <br />NIME <br />_--- ~~_ _ _ _ _ <br />_ <br />_ <br />I_.1 Ill.lgl <br />exprsJ 9~J0~85 <br />A DDR E66__ _ <br />L~_ __ - .. <br />----__;` -~-------- ------- PERMIT NUMBER msC wwwGE NuY tl[w <br />------ <br />~ ---------- ------- MONITORING PERIOD <br />F CILITy <br />~' <br />'------ -- <br />-------- ------- YEAR MO DAY YEAR MO DAY <br />LOCATION FROM ~ TO <br /> I: o~?n I:7~~11 171~n1 f16 n1 I]o.]v, 11od)I NOTE: Read indruclions belore completing Ihic lorm. <br /> () Card Onl/~) DYANTITY OR LOADING 1! Cwd Onlrl QUALITY OR CONCENTRATION <br />PARAMETER Ub~111 IS66/1 (1A'~11 (!b-S1) (S161) p0, CwEUOU`NCr BAM PLE <br />E <br />(J1-17) EX AN ALY515 TYP <br /> AVERAGE MA%IM UM UNIT6 MINIMUM AVERAGE MA%IM UM UNIT6 <br /> 62-611 (AI-0tll Ibv.70) <br />`' <br />. <br />; <br />l 6AMPLE <br />( -- <br />• <br />`Vf <br />L MEABUREMENT <br />.I <br />+4Gco 1 <br />PERMIT ~n] (T 1 <br />~' I <br />F~ <br />~F~ <br />' <br />Jli v/ <br />1') <br />L REQUIREMENT " <br />TC,• <br />~ <br />1 <br /> I f <br />-`~ -- ` <br />l 6AMPLE <br />, MEA6UREM ENT <br />`~ <br /> <br /> PERN IT <br /> REOVIR EMENT <br /> 6AMPLE <br /> MEABUREMENT <br /> PERMIT <br /> REDYIR EM ENT <br /> SAMPLE <br />C1 <br />I MEASUREMENT <br />N <br />W PERMIT <br /> RBOUIR EMENT, <br /> SAMPLE <br /> M EABU R EM ENT . <br /> PERMIT <br /> REOUIRfiMENT <br />~ SAMPLE <br />~ MEASUREMENT <br /> PERMIT <br /> REOUIREMBNT <br /> 6AMPLE <br /> MEASUREMENT <br /> PERMIT <br /> RHOUIREM ENT <br />H AM E/TITLE PRINCIPAL E%ECUTIVE OFFICER I CEPTIn VNpER rtNAL TY Or LAw TNAi r NAVE v(RBON4Lr Eawuw[O <br />Mp AY FIMLLrAR NITN TwE MrORY ATION $UBMITTEO NC R(IN AND BASCp TELEPHONE D A T E <br /> ON Mr MOUIRV O! iNOBE INGVIDUALS MYFp ATELr R[SPONSIBLE rOR ///~ <br /> <br />JdR°S a. :.linen OBTwMMG INC INFORYATrON I BE LrEVC 1NF SUBYrTT[O INPORYATIOn <br />r5 TRUE ACCURATE ANO COM PLCTE I AM AwARF TNAi 1NC RC ARC SIG T i- <br />~ s,~~-+~-^"~`~n ~ <br /> <br />P <br />it <br />r <br />' <br />NIFICwNT P[NALTIEB rOR SUBMITTmG rAL$C rNPORMATrON rNCLU6NG , <br />` <br />JJ <br />e <br />r7 <br />s <br />h <br />~anaeer - TNf POSSIBIUTV Or rIN[ AND rYPR60N N(NT SEC rB USC 1 r001 AND <br />TUR <br />SIGN <br />OF P /r~~~ <br />V <br />~ ff (.p r'] <br />/ ~ <br />- p <br />F p <br />G7 L <br />iE <br /> <br />,u wrr. nla• <br />l]usC! rT9 rYrnalur..ner. rAr-r • midr /~~. uY n. ll•ur.• A <br />E <br />gINCIPAI E%ECUTIVE U Y <br />,rLJ-. / L <br />i <br />TY PED OR PRINTED o•du. ma u~~um m~pn n+l nuvU../A~w..n Ae~enrA. ondS •.r•.~ OFFIC ER OR AUTHORIZED AGENT AREA <br />NUMBER <br />YEAR <br />MO <br />DAY <br />ANO E%PLANATION OF ANY VIOLATIONS IRgrrvnrr lilt uuurumrnn nnrl <br />EPA Farm 3320-1 (Rev. 10-79) uHTiLO6UPPLY I6 EXMAU6TED D (REPLACER EPA -ORM T-40 WNICN MAY NOT BE UBE D.1 PAGE OF <br />