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REP43321
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REP43321
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Entry Properties
Last modified
8/25/2016 12:45:28 AM
Creation date
11/27/2007 9:52:30 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981019
IBM Index Class Name
Report
Doc Date
2/23/1995
Doc Name
1994 ARR EXHIBIT 2 PART 2
Permit Index Doc Type
ANNUAL RECLAMATION REPORT
Media Type
D
Archive
No
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HtRMITTEE NAME/ADDRESS Ilnrludr <br />l.uiliry NKmr/L9nrion i! di!&mnN <br />NAME _ _1 I ~ 1 _I .r I~~ 1 J '> <br />FACILITY -------------------- <br />LOCATION ______ _____ ----- <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION $i9TEM (NPDES) <br />DISCHARGE MONITORING REPORT (OMR) <br />(?-16) (!7-191 i'. .).1 <br />-. ~~ ~ ~ c ~ ? ~ 7 ~~ : 1 1 (° [t ~ a `7 'J. [ Form.•Approved. <br />PERMIT NUMBER PucR P6[ MVMfIF11 ~ C ~ .I n [, OMB No. 2040-0004 <br />MONITORING PERIOD ~ • '^;1 r [ 1 r ,Apprgvsteljpir'a tOC3gg94C R F. R t <br />YEAR MO DAY YEAR MO DAY <br />FROM TO . t I ~ Ak fl 11 ) .i ~'[ r7 rsiF ~ ( GpC <br />rm_lI r+1-vl a+-zsr ne-?n raa9r r1aJ1) NOTE: Read instructlona befor c mpleting this form. <br /> (J Card Only) OUANTIT7 OR LOADING (4 Cartl Only) QUALITY OR CONCENTRATION <br /> <br />PARAMETER <br />(46-S1) (54-61) <br />(J8-45) (+6-SJ) (54-6U <br />~~ FREQUENCY <br />DF <br />•AMPLE <br /> EX Y$t$ <br />NA TYPE <br />(J?-J71 A <br />L <br /> AVERAGE MA%IMUM UNITS MINIMUM AVERAGE MAXIMUM UNRS (61411 (a+b!) (69.70) <br />( l 'i (~~ i I~ i. i S F. ~I ~ ( t( 7 : :!'- <br />. ..... .....e .. .. <br />• . ': f" <br />... <br /> SAMPLE l . - . <br />It ~, MEASUREMENT <br />' r [ .-.~Tt" Y r~.7 t<;:f•?:,~.'•: .',:f,:~~r? ~r'Cr~r;: , k BF <br />RLY :~4li~T <br />'• PERMIT . . . <br />' I•!'7 ''1~ .!{75~ 01,7,77' REQUIREMENT TbST PAX '77= ) ~'IF :.`-:: <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ' <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT ' <br /> PERMIT ,'. ?.~ <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> . <br />PERMITr <br />~ <br />~ <br />~ ,1. <br />• ~ <br />V <br />'~s' <br />~~~ <br /> REQUIREMENT ~ - .,. ~ , <br />~ <br />,1 <br />,,. C . <br />. ~.-.. <br /> `I <br />~ <br /> MEASUREMENT :=T <br />: '~n <br /> ? <br />. , <br /> <br />~ r f <br />k <br />'•~7 <br /> REQUIREMENT ~ •. ~ <br />V~ <br />- - <br />> <br /> SAMPLE ~': a{ +~ ~ <br /> MEASUREMENT ~ ;~ <br /> <br /> REQUIREMENT ~ "a' .I . <br /> <br /> SAMPLE ~ ~~ <br /> MEASUREMENT ' <br /> <br />PERMIT ~ r <br />'•. ~~ ~ 'l~ <br /> <br />NAME/TITLE RI CIPAL EXECUTIVE OFFICER I CERnFV uFIDER PENALTY OF LAw THAT I HAVE PERSONAf1r Ex AMINED TELEPHONE D A T E <br />•ND AM FAMfLMR WITH THE IIJFORM/.TION SUBMITTED HEREIN: AND BASED i <br />ON MY INOURV OF THOSE INgVIOUALS IMMEDIATELY gESFONyBLE FOR 3038Z4.445~1 <br />OBTAIMNG THE INFORMATION. I BELrE VE THE SUBMITTED INFORMATION IS <br />•C~ <br />~1I!I [~ <br />VPLAND/E•"•RONMENTALARAIRS TRUE. PCCURATE ANO COMPLCTE I AM AWPRE THr.T THERE AFE I 01 i <br />SIGNIFICANT PENALTIES FOq SUBMITTING FPL$E INFORMATION INCLUDING ~ ~ ` + <br />THE PDSSIR4Tr DF FWE AND MPRI;ANMENT SEE IB u$C f IDOI AND SIGNATURE OF PRINCIPAL E%ECUTIVE <br /> J3 U$C f IJ19 (P(nYlllrf YntlC! IhtSC f1YlYICI InYY nL'IYtlC flrl[f u/1 IJ <br />TYPED OR PRINTED f10dP0 YnJ a mYfimum Impnsonmenf ul' nera¢n 6 mumhi Yud 1 /YYrs.I OFFICER OR AUTHORIZED AGENT NUMBER Y[AR MQ DA7 <br />COMMENT AND EXPLANATION OF ANT VIOLATIONS (Kererrntt all affa[Smrnfs Ortt/ . <br />..^fLF'AvLP iDLfD: LI~[L 4DPLI°: 1N7.! 1' != l""7~t~ T'l-r7 ii PI'':CiP i'VE"d" I.i 'f.'.i^DD. IF :'I,nIM APPR09P.I1fA! <br />1.~~7, ?55 ~ ',N19 '. I'7:P; •4t Ll. rt ~' ~7' qvD T°~ :~ t{cPIF. 'Ef' ~'FAS!l i1°MC'N?.--;C(~ L. 7t.14a P: 17 AV7)~T. R.1[7~ O•G 6. <br />EPA FOrm 3320.1 7RBV. 9•B7)) PrBVl016 Bdif10I15 /r13Y DB 16B1Y. (REPLACES EPA FORM T-10 WMICN MAY NOT DE USED.i I) 1~ Y 1 ~ ~ Il () 1 7 7.I], (j rl 7 PAGE Z OF <br />
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