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PEF,'rITTEE 'IwME/ADDR E65 I/m ILJ, NATION AI POLLUTANT DISCHARGE ELIMINATION 6Y6TEM L\'PUGdI FO/T App/BVb. <br />Fuarrn au.+rr/4ururrru++/d+rJr.rmr DIBCHA RGE MONITORING REPORT/ ) OMB ND. IUIO-0Dp{ <br />UVR <br />NAME___--_" - - Il'lol 117-191 App/onl up/eF 9~J0-86 <br />AODRE66_~ fr _ ____= ~___~__~___ ~.... ~~ <br />_-_-_ ~(~ ~__~_-____~_-`___ PERMIT NUMBER DISCwRGE NVMBER <br />FAC~uTY_(' Ic IhP ~ MONITORING PERIOD <br />-------------------- YEAR MO OAY YEAR MO DAY <br />LOCATION FROM TO ,. <br />fT7~77) I?z-?31 rzr.z31 /z6 nr c: +'~.'9r lmal) NOTE: Read instructions before completing this form. <br /> (3 Card ONY) OU ANTITY OR IOAOING N Card Only) QUALITY OR CONCENTRATION <br />PARAMETER M6-73) (38-61) (38x3) (I6-3J) (3161) NO. °v EOOr NCr 6AMPLE <br />(37.37) E% NwL rsls <br />A TYPE <br /> AVERAGE MA%IMUM UNIT6 MINIMUM AVERAGE MA%IMUM UNIT6 67631 (M6tl1 16970) <br />I <br />YL0F1 6AMPLE ~\D D1SCnil' e <br /> MEA6UREMENT <br />p ^ <br />ODDVII ~ V <br />PERMIT <br />* <br />DI~D7 i <br />IN <br /> REQUIREMENT <br /> 6AMPLE *, * <br /> MEA6UREMENT <br />5~O I D REOUIPEM6NT * * * <br />Oi/30 <br />GR <br /> <br />1RU <br />tr 6AMPLE <br />MEA6UREMENT * * * <br />1 <br />1845 ~ D REOU AEMENT * * * <br />01/30 <br />GR <br />SETT <br />SOL MEA6UREMENT * * * N <br />. U <br />545 1 0 REQUIREMENT, * * * OPThimPi 01/30 GR <br />TDS 6AMPLE <br />MEA6UREMENT * * * <br /> <br />7DLyS ~ U REQUIREMENT * * * O1/9O Gk <br />~1 <br />I <br />* <br />* <br />~ <br />/ <br />~~~JJJ MEA6UREMENT <br />/~ <br />4U0 ~ D PERMIT <br />•REQUIREMBNT <br />* <br />* C <br />E,5 <br />* <br />V.~ <br />Q~/O7 <br />GR <br />G SEG MEA6UREMENT * * <br />550 ~ U REOUEIREMENT * * <br />OPTPION <br />10- <br />Ut/07 <br />GR <br />NAME/TITLE PRINCIPAL E%EC UTIVE OFFICER I CL RTrFY UNDER PFNALTr OF Lww THAT I wv[ P[RSOn AILr EvwMwEO <br />ND AM F.MILrAR WIT <br />THE rNFORM.TION SUBMITTED H <br />REIN AND <br />.SfD TELEPHONE OAT E <br /> <br /> <br />James S. Lunan H <br />E <br />B <br />Orv M• MOUrR• OF THOSE INpvrDUALS IMMCdATELV RESPONSIBL[ FOR <br />OBTAINMG THE INFORMILION I BELICVE iNF $IIBMITfD rNFURM.TION '` <br />~ ~` <br /> <br />Manager -Permits i5 LRUC .CCVRATC .Np COMRLETC I .M AW.RE TNwT THERE .RE SIG <br />NIFKANI PEN.LTIES FOR SUEMITING FALSE INFORMATION INCLUDING (-/ <br /> THE POSSIBILRV DF FINE .ND IMPR60NMENT SEE IB <br />SE , rDDI .ND ti02 774-525s 87 07 27 <br /> D <br />33 us, +r3r9 IP <br />. <br />ramr. <br />M.• IA <br />u <br />n <br />/ <br />~ <br />e <br />n 61GNATU RE OF PPINCIPAL E%ECUTIVE <br /> . <br />. ,.,o. I„r <br />.. <br />. p.,.. .+. <br />. Iwr. <br />.ne <br />ur <br />. u <br />. <br />A PEA <br />TYPED OR PRINTED .~,...u A. L•.J.: ..rr.,. <br />u.d,+mov+.wn mrpn.r.•mrnurdl.Nr..-n GFFICER OR AUTHORIZED AGENT NuMoE6 YEAH 1.10 <br />COMMENT AND E%PLANATION OF ANY VIOLATIONS (Rrfnrnae ull mmdlmrnlF Ar/r) <br />PREVIOU6 EDITION TO BE USED IREPLACEB EPA FOR WHICH MAY NOT fiE UfiED.I <br />^NTIL 6UPPLY I6 E%HAU6TED <br />