REP36065 - Laserfiche WebLink

Home Browse Search

P[E~AD~/fR[!t~ _ Fa e/ l/di u,n TFAMC_ 7L. t1 '> ~C.aL f'r'l_r_____-___ wDOnEtE ace :. ,• ~_y l , . ~.-~~-'L....L---------- ----'--'~' a.r~.T a ---- ----- ------=-J 4 =`! - -wcluTv LOCATION _ n iT!t: GA.iI°L ti ?FA2_ 7+: tir'. :11 D'r --- ~DNAL~TA~M •R~INA~YATL~E DI RG NIT G R T /D z-16 17~! 9 PERMIT NUMB[R pncH wncF nuN.LR MONITORING PERIOD Y AR MO A AR M DAY J) Form Approved ';oMe:No. zoao•oooa Expires 9.30.91 E D Y YE O FROM .i _. L , TO Y S I •' .°+[: ~~~ ~~ T ^~•:' . . ::::: :: nD.zv rzz-1h /z4zsl /zb- 71 rza~191 /JaJ/l -NOTE:1Rsfd imtruetiom be}ora completing this form. (J Card Only) QUANTITY OR LOADING (1 Card Only) OU ALITY OR CONCENTRATION FR EOU ENCr 6AMPLE PARAMETER (16-JJ) (Jifil) (J8-1J) (1653) (J161) NO. Ex OF TYPE (3357) wrywuvcls AVERAGE MA%IM UM UNITE MINIMUM AVERAGE MA%IMUM UNIT9 b3dJ) (61fi81 (b9-7B) ~'{ SAMPLE .:: l::: tY{: fis'v'.':~:~ ( \ ) r.. ~ ~2I MEASUREMENT 1, (~ /. L'.CC`J I l.' ~ x.# .. ""«:° PERM IT< "~ a. SSA;Y:ks~Ai'a `9' F. ' y°j 9''~6n ~.~' aY R '~. 'k' >Fe ..-~ ^b<j46 yb xn.~my °~ a ' °a P~e~~ eq ~a, ,~.p- n's+ Yi ° x~Y. .Yn •pY : & ea>a ~ z . i° ti ~« xeY_/Y F ~ ~r: c lg t`* 'f'RAas. ~c #ovn E'FLU~iiT ~n ./ I G J.^ hL) W[Ou IREM'Et1T; a Ag, e'Y:" 8a eE6p ° a#.~ E; ~9 e 6<&Ya'ce&ID&g ._ ^ .. ia,. a. x p 3 ays ~% ~ a ~...s ~ , x ss i~xe.Y'4g0yg ¢.. a s , bQn Y• p ° a 3s j.°'.F %il>., Gt1 e. s , «y . , $Y. £n«.b Wx" vey ~5,x / SOLIDS, .GTAL 6AMPLE ,..~A.. ;.4 ... ax.x ( ) .r„ _ ~ i.3) C :1~ [ G.1 {- ~) MEAHUAEM ENi l'ti~ ~"J I C,' i; .o« >. a<a & P,EAA[1T ~ •°-~RV;Y.i??P•.ax n z p ".a.,°Y74 ~F:i~ ro?$wy `htr' " . . ' e~s^.'i °~r•'` a d' 9 »'1K..p ~'a«„ m.°.~ ~" " a"',~, n,A ns e A'e °'A¢~ 'ma.~s. ^, 'f s~'b~.~ s,~ " n..:aa ~ ~. ` \ c~ c v L l~ I 1 1 (; F REOAIREM'ffNT ., ~ ~ « # x x . R g ` y . A e 'ax sa sm. es c, ~$ a. :. ' ' F aa. sae. ° x ®x .tam w.,$ ~ ., A& .a ` $ `° , s •t ^ . x G. m .. s. . e. a J ' ~)~ ~ V ~. L ." .. n Q s : : ~ .. I T < st.. .,.. :/i~LS DSF u:~iT L'AS: L:' SAMPLE ... .~.. Y+-v :=X:k t ) ~fr:~ ~_~. ~ L-I MEASUREMENT ll C'~5 5 1 G C ~Y.. ~ •veaAiir•,= ` •. :I... ag;"AY~y/;~'~~`s ..iv xbSft•Y,iy:~</ > x' ~ x -, ~;6sF~/:i ^.'snY gA ° a is s. ', ,i2>r o-, 3~.'~~° e"•' g~ rJ A<ID•seY 4. ( #PV °" 9s ~° " '"?i<~°~ :' °m ,": ~t:r ti 'f UE G^( ` ' l EQU.IREM~NT;' 'R " -1 '° e n~~ x, 9 " ~" «Y~ " °a, s~~° », < .; a"" ¢ s~" ° ID Y -: . , r # ,`~« . A' `' a : , e '" ~ s ffi`, C f t:T J .iS I .~t. L l e. s « .. .,~ 5... % r"~ . r ~ ~ ~., 'r x ~*r s g. t°T°: a,: w `IT / .x'A YA GIL ~~t t. .F~:. IfJG 6AMPLE ~ . .:=1F'~ !%:.. n': {:..,'t ~ ) ~ l`rr. ~ . .:Si L: ~ ,'~) F~lGN ~.{iF.-Gt>,~`/ *1ET: MEAeUREMENT V'~5~~ 1 L Q '7 ~ a. '•. a«.PCRM fT>Y<# , m~w':k'"'r,).'34`as` w S °PS'z Yt~XFM~~L. '^~ ~£.H f.p 4'S° 4 . ¢a 5x".~z' s°4i+~~K+1.; ki n ~4 Q". °°. a:: pe, °n ~ ~:t.&.a diF~e :.Txiq tt.z^x„`x a'~ ' e ".~p. w~~, E. ~ ~ ., ", QJ~ ~°` C ~ic~gufnenl/=N~ ` . we~ 84.« 9.8' ' °= ' ' m i B 4" 3 9 Aa ^,g ~em :~ .ap s Yo- x ~# ; a «: "~ ° $1iw®x% y 9y ' ~ °r ~ ' xca ~ x n snA " " 'I ^ ' ` '~` '+e i m ~ tt« +. - P Sa ° ^ ' ° EFFLUENT GP $E YAi.tt .&:Y,• K, > . ;~, rg .:zr , > «~,A g« ffie. Y ,° x ,. g~ ;.. °M, e C.dl T %C ur ~ .,Ry p, . °ez . '%aa I .t O tl , T O T A L SAMPLE r :.::;[' fii=; .. ~ ) n r r v.• I~) ~b j Ft.) MEASUREMENT n ~ ,~ ) 'iF l Lr4 7 I FJ Q ~< a .~. •rs °•.FERNIi.: .. <"~vdn~:,..'~z< ~ a„ s'A`~.?1,Y'x.~'`z s. 'Y.`b i'+av ° ;If,.. "«a x>r,T~sF'•''a~' ^~: ° e~ AJ¢ °x~ °$ae~'• ~ a :~f i,Lg o n ~ ., ..° e ; ~ .. ~~i~si: ~ ` _ ¢m .. d~ y65x^s r 17 e I FF J G CS REAUiREM L~/TA . ,a Tls,x °II° ` s°~'t ° A .• x i, g x.,, *s ¢g Tr'< , ` r °" 3aa~ m ~y`ea a R ma ' «." s vo, a ? ~ s,; o- .~ ° z. " s' y, T e • :1 ® . a , E . ., VALi. L ENT ~, ~.~. a P ;;"~; ~m& e «~< ~~.ID~m r: - s a ~., ~ t ?fl~ e. . ,<^ _ «I,y F,04, Itl CONCUIT_ '7R SAMPLE _ ( Q3) _~~.::T;.-: ,.....-a ':;+a~:kr ~ ~ ' TiP.U TFtEr.7^!-ct7T FLA?I MEASUREMENT s'~oso ~ o e 4 `°'~~EE;r:l;rars: k ~~~is~~a~~~~ <y~Y •~.;~~~a~t a~ " $" &e~;~~)~~~~.n rp tlc.r% ° W ;,~~~~~;' •e# .e •>~~~~~~~~ & -~~-: vYq _ ° .. .. ~~' ~ ~~~~ °, q} w ~'(d ' L. I dT GkC5 t' U AL PE4U tREMEN,T~' ' ~~ ; t 'l ~# ~ e ` ~ ' b~YiYabw'~9•s d m ° ° .z %9.x~°@ °$~ ~ K°n 1 ~ ~' e., ~s ~ , . . , 5 Y J. G E: I. t / ; ~, ~, •~ ° ' . . t'k e ~ a~ Y >. : RS~i X l . SiC~ g a , '" ° ~ ~ x ~ x.> R xx:.a& n, w~rn~ ~ x S.JLIDS, L'UTFIL 9AMPLE :'It{-.•^~Y= Y,i•`.-'.:y7:}:: ~ ) {~%.`•~.. Irv. 1 ~' - rT_ssoiv~:~ MEASUREMENT /~ 7J25S I ,J ~ .®,°=PER~t m4: <.., 0.1T' '~ . °M~'X1'tF. zy` °~»° a ' ` ~ ~~~ 0j~aw.'f~r e&<ill',nf o-ce tt. iin : 8 N. a~ffi«~Yg..S~J. ~>E:.e•'&i v" «s ~a'ID'..'Cp~!?fi#~'~..R, « K '#w.a ~~~~s~~~~ '. 6' ~' .3 °' p~a ~'f ~:F _ X• ~°~d o-:x ~ RC F GFOSS VAT U U :REQUIRE • M Cti.T ~s ~e~ %e °e._ ,° ~x A a ~~ 8 _ °° s ° s ~ ~~~ o `a ?amx g axv.;-a °aa M . ° ~~ m z ~ ~ ° ^ ° •a i j "°' ° - , °~~ ' . vA Y _ . iNT . L #.". $x' s:, - ~ ' . « . °°°t y . my;. °e. ~w . s z.~ . ~ x f .Y Y' T m ~« ~ / x $° NAM [/TITLE PRINCIPAL Ex[GUTIYE OFFICER I CEwrIFr unDp P(HALT' OF Lww THAT I HAVE PEIFiONALLr ExAMInED AND AM FAMILIAR WITH THE IMFdIMITgN SUBMITTED H[REIN nMD BASED ~~ •" i TELEPHONE O A T E (/JC - ~ ON YY IryIX11RY Oi TMO6E INDVIDUALS IYMEOATELY Rf$PON$IBLE FOR OBTAINING THE INFORMATIONI I B[LIF VE THE SUBMITTED INFORMATION ~ / ` r ~(a ft11- I r--. n ra ~ I= TIRIE ACCURATE AND CCMRETE. I AM AWAR[ THAT THERE GItF SIG ~~ ( I _ NIFICAHT p[NALTIES FOR ~SUBMTrING FALSE INFORMATION IN~LUdNG ~ ~ ( .~,/ ~' 1 i~ ~ i h ~ ~' ~~ I I ~'• f ~,\/r r ] . fNE POf 51BN.ITY DF FWE AHD IMMISDNMEHT SEE IB USC S 1(pl AryD 3] uSC A U19 rPrn.lnr. uMn rArY uaulr. na. md/r /mr. rV V. Flu vW SIGNATURE OF PRINCIPAL E%ECUTIVE j~) ~ ;/ "'J ~' ~ I ~ ~ TYPED OR PRINTED r.tl..r nnrrmwn rnpnn..nl.llr ./A.I.«nEn..nrA. and .i .~.a•.' OFFICER OR AUTHORIZED AGENT A A NUMBER YEAR MO DAY COMMENT ANO EPFVnngIlVn VF wni •w~nlwne \nrlvrnae un uuvanmrnu nr r> .~,AET?LEASE°- SCLICS LI"1IT APPLIES O?ILY ZF <= 10-Y~, 24-N ?i?;;C'_F :YEN:' I: CL:,Z"cG. IF CL:.'_`1 .~PP~OYED 5Y F~.^.,G• TS/}.E Z3CN LINTS KILL !iCT rE ne~PLI G TG aF.rOrT?^ '?F.65L'E°:':E`~TS--S c I.9.i?, 2:, U n9D Z.e.,D, FG f,R IR[RLAOtf [-w WNICN MAY MOT f[ Of[D.I ~~[ 0I 1