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rkgMlTI EE NAMEIADDRE56 f/uiWr ~ NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDESJ <br />Fariliry Name/Lavrlon VdUf~enrl DISCHARGE MONITORING REPORT lDMRI - <br />NAME_~~~~~O,y=L,Y --- --- --- R-16J l1J-1PJ F - F IYAL <br />ADDRESS 533.5 -i4L+7 A.Y .--1:1-------- ~- ~ ~ pONU (SY/Y) TO D8Y CH K/~PA <br />_ --- - - - <br />__-~'. ~.IL-R !mil ~(~,LL~^ PERMIT NUMBER DISCHARGE NUMBER <br />. _"~--~--- f <br />- ------'----------- - ` ` MONITORING PERIOD '~ I <br />'AGILITY -,~ - YEAR MO DAY YEAR .MO DAY I - I ~' , <br />------'------ -- `A <br />FRO '.TO <br />.OCATION <br />---=-------------- ' : "~ u - _ ..- ~~ nIHOrt ,.. eut12T- <br />- ~ I ~ -~ Raul Rs-u1 [7~-ul (ta-1J1 (ta-t91 /3a3U NOTE: Read Inelruclbns beloro eomplstlnp thls lorm. <br /> l3 CaNl Only) ~: OUANTITYOR LOADING - <br />' <br />~• . ll Cold Only) _ - pUALITY OR CONCENTRATION <br />~ <br />~ NO. FREQUENCY SAMPLE <br />PAMYETEp { ~~ NO-!31 i <br />(JI-6p <br />. Rdal1 <br />N6-J31 (JI-61/ ,EX DF TYPE <br />/37-ij/ --i <br />• <br />~' AVERAGE Y'. -- "•MAXIMUM' UNITS ' ~ MINIMUM AVERAGE MAXIMUM UNITS ~ <br />O1-41 1!NALr515 <br />~ l61-Qal <br />l6R701 <br />PFI ~ ..~ ~ :J <br />C SAMPLE !Yt ak$.t `~ LIGT}~IkAk'- - <br />~ <br />: '... k#kpkk ( r l_' ._ ~ n w 0 <br />: ' <br />, ~? MEASUREMENT ~ - ~ n `~ u <br />r `, _ u I J . _ ~ <br />. <br /> <br /> <br /> <br />~uLiDS, TOTAL = '` 6AMPLE' i <br />" Ip6aVIXS#t ~ oC~okio r `~- <br />. i " OaOa{4k - - - ~ - <br />~' <br />'~ 4 C <br />- ' I <br />~USPENDED .i -.~ ~ MEASUREMENT r <br />- ti` N <br />'' - 1, - <br />- ~ ~ ~ ` <br />~ ~ ' ' <br />I;U53G 1 0: '-'0 S - I k#a p,l r ~' <br />' <br /> ~ ~ ~O~ i ~I•,.,. <br />~v6IDS, 5)rTi'L'EABLE S Ob>Ak~i_' r~ O-0IO~QO ~ ~4 y, <br />it S ~~?klrrlR{I #>a~ # IM I y~ _ ~. _ ~ ~ li <br />~ <br />I MEASUREMENT ~ 11[' W? <br />:7 V+ ~ J <br /> <br />II <br />. I" ..'4 <br />' <br />p ~ <br />uIL AND Gtt EJ-S£ ~. - <br />' 6AMPLE tp9kQIC m }YP- - d ~l-01>gkk <br />-~ _= ri9~!'DOOI tr _. [,~ I } -' =~ :' _ ;.I `• ~ <br /> MEASUREMENTC -• - .; I <br />F'k~UN EXTfi-4RAY ISdT <br />( ' _ _ <br />u U S r 6 1 =~ G. '~ T.~.. a~aY <br />~. o av ~'s. .. ~, <br />I"' ~j'Q ` - ' 8 <br /> I <br />J ~ <br />..c. ,t <br />IHUIi~ TUT~L" `; ~"' l BAMPLE r: ~ +llkkkk~~ '= ~yYy11C01k: <br />' <br />- I <br />'i ~ ~ grVL•~Ikq? ~ ~' ~ ~ I <br />l p ,L is <br />n " ' '- r <br />~ - <br />(AS ~ F MEASUREMENT - ~ r' - <br />3 ' .. <br />,~~ <br />' 8 <br />.- <br />. u E <br />. <br />n ' <br />, k «k r <br />r. k ~ ~ , <br />. <br />IN EUY DU IT ORS <br />FWN ,6AMPLE t ni+dl6~k' <br />~} c. ~ O. '? n d i I(10~+Y#kOt lkk O~L•k ~. kSk {TJk. _ - _' r ~ I <br />, <br />Th}iU TREAT M~ <br />iT PL11 N9 MEASUREMENT' _ -' <br />" ~ = :l S. <br />~ ` ' <br />0 1 ~ U <br />SOU` " <br />PU1M ;,' .:$ -. Ippi~ <br />~ a: ~Ip>~rq p,. <br />~ aua ~' Y TAN <br />., 1DU~EM T .;Y., ..I 1 <br />2 l <br />'.y. <br /><'~": kS:k: .v"t. , <br /> . <br />'^ ~ ,. <br />;~)L1L'S, TONAL - ,. BAMPLE ;> .Ipkalo#tY o~xyAxaa vaaoa~ ~:0,'4;?k L .I <br />' . <br />I <br />11550~YEU~ MEASUREMENT _ . <br />c <br /> <br />7L 1 35' 1 .' 0 1 L •- <br /> <br />°E <br />:~"` <br />~ <br />~ <br />E <br /> <br />~p0¢''~' <br /> <br />~~, <br />,, <br /> <br />c~lo <br />.. <br />~~OI4 .~ <br />:, <br />;'.&~a~>??as~` <br /> <br />ffi REpb T~ ~ <br /> <br />~ <br />•I <br />;ir <br /> <br />~>~,i <br />' <br />fl B <br /> p <br />Ea <br />Ul <br />MENT jt <br />' <br />' r <br />i <br />NAMElTI <br />LE PRINCIPAL EXECUTIVE OF FICER 1 CERTI FY UNDER PENALTY OF LAW THAT I NAVE P <br />T ERSONALLY E <br />EI XAMINED 1 .TELEPHONE DATE <br /> <br />F:iCF4ARD li.": ATKINSON .. ~ N; AND BASED <br />AND AM FAMILIAR WITH THE INFORMATION SUBMIT <br />ED HER <br />ON My INQUIRY OF TNO$E INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br />TAININD THE INFORMATION <br />I BELIEVE THE SUBMITTED INFORMATION <br />_ <br />~ ~ ~ r <br />~ ! <br />~ :' <br />VP LeLAD/ENVIROfirMENTAL AFFAIR . <br />OB <br />IS TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE 510- 303 824-4115 91 10 i)tl <br />_ <br />~ NIFICANT PENALTIEa FOR 9UBMITTINO FALSE INFORMATION INCLUDING <br />' <br />' '~ THE POSSIBILITY OF FINE AND IMPRISONMENT. 6EE 1a U.S.C. <br />I 7001 AND <br />I <br />L SIGNATURE OF PRINCIPAL EXECUTIVE <br /> <br />TYPED OR PRINTED rrhsdi / <br />JJ U.S.C. 1 IJ1B. !Plnallb urWn rAae srarora moy <br />re MO to !10.000 <br />aMwmminrum llny0omm~rrd~r•YrnlmonrbaM lFnan.l <br />OFFICER OR AUTHORIZED AGENT <br />NUMSEp <br />YFM <br />MO <br />DAY <br />~OMMEN7 AND EXPLANATION OF ANY VIOLATIONS /Rf,(nena a//allathmrntr hsrt/ ' <br />F~4 UIL 6 CREASE„ SEE FGUTl:OTE. F 1'1 ^.Rc'. F`'ri•'I'i'. ScTTLLAf•11'. S~1iIU5 Tt.51' F~:'~OI~tEG' UIiLP IF <= IQ-rH. 2U-II <br />tli-LP tYF.NT I: LAI.IFP. 1F !'LP,T" AI'Pfil)Y1:[. ^Y d~C.PA T_°.i /~ i~r~•; Lr'II'f? :1 LL t1~,'I 1.~ AI'PL.IF:!'~ ?(~ FF:F')1lTC[' <br />SPAT FOT TF~-~ (.~EB~PfIY(OUS ~IfIORS mIy bl Dald. IpEPLACES EPA FORMI pCH MAY MOT SEU5E0.) OF <br />