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I PERMITTEE NAME/ADDRESS (Intlrrda , I NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) pGrmApprund
<br /> Fxrlity Namr/Lacadon 11 dlBerenl) }• f/ ' • IDIl3CHARGE MONITORING REPORT (DAIR) '
<br /> NAs_�E� ;i �l_ t= i��•r�IIl'at�GrO( .-- .: 1 1-16) 17-19) F —; F1;4AL d Yp wdaWlresal2`31R7
<br /> w°OREse '_.}uL"" .iYs— � ,1��—_ _S = - ,Lrl.ckl TANK H1Nl U�WA1'_R L—• 1` F
<br /> 1615CHARGE NUMBdR
<br /> MONITORING PERIOD 1 I c 6
<br /> CILIT7__-L LLScfZ77Jd 14� 1r ...�L YEAR MO DAY YEAR MO + DAY'
<br /> LOCATION �_LLLL----- "� -- - FRG" �y 11 Fjl TO IV
<br /> 1, :
<br /> I _ 1 (J9-71) (2Z43) ( 4- J) ( 6 ) (J6-J9).(3B-3I). NOTE: Reed In[tnletlon-bsf-rB complelinp thisIOTI.
<br /> (J Card Only QUANTITY OR LOADING (I Card Only)'? QUALITY ORS CONCENTRATION -
<br /> PARAMETER Illl (46-53) (J 61) .�(38.1J)� (16J3); _ I (Ji6I) NO. IFRkO.UENCY SAMPLE
<br /> EX ANALYSIS -TYPE
<br /> !(33)7) AVERAGE MAXIMUM UNITS MINIMU6{ AVERAGIt , MAXIMUM 31 UNITS
<br /> 1 _ - 6263) (6448) (69-70)
<br /> ro
<br /> '1: I SAMPLE >y WT1114 A70 194 111,'4
<br /> 44. 4
<br /> MEASUREMENT
<br /> I �
<br /> Ll _"gla�( a�F j,'4 4.4;e'a '+1><'•` C,1, ,s 5 ¢}av'4'.e lY': ,3•"«'a 'A:`. 0;' &: .xly.t y<'«t.:i,%�' m
<br /> NiCOVt tM(I T mx y.y e. S o- vs- ��° .Id.• +4` a,
<br /> .,mac .x, e,�a� «!& psi,°. T4fi4 a, x�" aaI «inn %`;.(1 ^k{ "cP �„),. r ••-'F,
<br /> l•..']"1 �IL'� A� SA�PLE "• Xc>r i•41M4 .Od V4 Ac r:.« ,*r9ys�F .�
<br /> l I. MEABUREME T
<br /> _ ¢ .K T .� �4.fi •+ g' .�F x
<br /> ll
<br /> I. ..i;. I «.NOY IYERI[I Tr
<br /> 'JL :1 iL; y•/:_F jt. BAMPLE � 4�4ry 44♦ >rk4•*4 _ Pt4*4 i,° _ �; ..m • � cC �. .. t
<br /> MEASUREMENT 1 ` +U ' `: O O - (•
<br /> r 'i t .\�� .,-lr rLA l/ Mlll I _
<br /> a "�1p�y n q. r� (' .a « ..®;�' C x •, F' Kati' l 1 ` H.s •4++`T� .R� yl(� c 41 R` 19m"�'p _ .i:!`� .b ,.A �f"+ ,J '\ &; �.G^ E'!' R'
<br /> L. AAQI/l W[ T' yffi�'.� �g ee sal xS# �� g.« e-;� .g' ,"_-aa".
<br /> t- ( mfl.AI A- $'. a�i�- aYys,A.+ 0 ♦ 'W(� 9 cyee. )- •.L-Ni" a .i
<br /> id:i ;-L SAMPLE � � � V*b4v i4 �+P"y A,4` N= �: :. .,1= v�- .'.�
<br /> T {n MEASUREMENT = L 1 T I a
<br /> l•I F,•� F axe MEN
<br /> rai",4i;.s'F.$ffgnGPo �wP,•'Ta'u
<br /> aY.'.«,mffi.s a'sa n eq y- m n«P. . M.k +es•!A..KrtY};\, .,i .mx'&,� 3 ' .y.�.� �'(�•^� k:�;}� ���
<br /> sn„..amI, .«a'-�, wb g.d ,iaM AT .�g� i3'. «.&^ -.%r. �,. ° •`
<br /> L:, r:/ ! I, 1. 1,Nj U 11 Um SAMPLE � of i +: x�;9 `IisiC7"! 4A>Il i#6 '> v C 7 - �M1 }::- • .1
<br /> MEASUREMEIT l "Q Y.;�
<br /> x
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<br /> P 'I .14L BALrLE :.s-a4+r�• a;, ra>ti�r - #4t-3t4.: p� N..:.�
<br /> 2LV ,Ii {i.q/L ) MEASUREME T i I - �.y� _ I ,PLC y -
<br /> q ' n n; m w e.9..' :x u 1 r�e,A• - x,°y,y
<br /> 4 e p1'Y .
<br /> RX4IIIRBt)1i1'" g°ccs. �4,V;xc « li�.,.e�«� B> �. ,-eox �'r $:r':Lt 'wg qr w �F"ems• -
<br /> as e a . k >b a-8. 1-
<br /> i L i1 0) (, i 111 - - SAMPLE Mi•O�•rr ..MEASUREMENT �I. • L4tY �'�• 1 y44',.iF4 Fla _ i _ _
<br /> ; ❑ Y: 1 +; n a _
<br /> L ;��"K; YsT} #"a ,e a4'VI'k+hxtt:rY _S z j a Po,;llx14;`,. a.�m #�d ' p . . -t� f ' =R � 'i" +PIR�9T� 'ai L•". jC L W rsrr
<br /> xRrU1RItY NY,
<br /> ga m��'�>£g :l z y z g.5- Via.< a a n. a•y '�?,'v. a ,<T;
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<br /> NAME/TITLE PR{NCI L EXECUTI E OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EAAMIN[O - 1::: _ - TELEPHONE - ♦D«A,T E
<br /> IMD AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN. ANO BASED
<br /> � l A ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR P Q 1••
<br /> li I •�� �•'� w'N OBTAINING THE INFORMATION 1 BELIEVE THE SUBMITTED INFORMATION -j ^ D :,�
<br /> 15 TRUE ACCURATE AND COMRETE 1 AM AWARE THAT THERE ARE SIG y y - ' • • 'L�T .:1� ')
<br /> i/)7 Y+ n /'1 •� ✓uL 'LIfICANT PENALTIES FOR SUBMITTING FALSE INFORMATION INCLUDING
<br /> X
<br /> / 1HE POSSIBILITY OF FINE AND IMPRISONMENT SEE IS USC 1 IWI AND IBI NATURE OF=PRINCIPAL,EXE UTIVE
<br /> 33 USC 11319 rhn.lur. .M,, Mrs lrarurr• nmr Inrludr pnr. w P•JIII,G'AI `
<br /> TYPED OR PRINTED - I and u.maximum rman•rmmrrU rd A.ru..n 6m•mlA.and.5lrcr•I y-_OFFICER.OR%AUTHORIZEr. AGENT~^ NUNBlR YEAR MO DAY
<br /> COMMENT AND EXPLANATION OF ANY VIOLATIONS (Re/erener all arfurhments here) I ,. - ,. _ ti'- I - - + ..
<br /> 41
<br /> . r L' L.iT Pram, I, 1.yLIJ,KbLT"U,•I 1JUK UMK:U1L fF.F6, L' bk A ,+vw6 42f1 ziHtLt1 .It V . . 1 ..
<br /> PA�, r,•C1AII- A „iII cN IS :ViS : '•Lf 1 :, A = $ �1 VI Si IL--„ANl¢ CIU A bfTAtk.;xA.L11T1FY l
<br /> EPAEPA Form W0-1 (RBY. 0-79)UNTIL PRlCVIOU8
<br /> EDITION
<br /> IS ETO BE lDD (REPLACLI E►A PORM V40-WHICH MAY NOT BE USED.) u`�V 1L/l'YUJC (�f�Cl PAGE 1 OF
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