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°ERMITTEE NAME/ADDRESS//n~'/ude <br />F~TIl6y Nam / , i ! I? (I <br />NAME_ ~~~i~1~1p ~aL CU_(~eNECd 11~____ <br />4ODRE68 13Uti SOUTH YALE __ <br />___ FLAGSTAFF -_-----_AZ dbt:01 _ <br />FACILfrY /_~ _________ <br />ACA710N Y~~ ly)Ci4t~ ~bV~Q~_ _ _ _ _ _ _ <br />ATTN: N, FRESIUEN'J <br />..,. ~ s I ~n~ I . ..J I <br />w..,.~ .... ~.. ~..~.... ~..........__ ......w....... ~..~ <br />DISCHARGE MONITORING REPORT r l)MR1 <br />(7-161 (17-191 <br />CU(r L' [i U 4 A <br />PERMR NUMBER °nc~w.°a .ur,aw <br />MONITORING PERIOD <br />YEAR. MO DAY YEAR M OAT <br />FROM TO <br />r70-zll rzz-vl r14.zs1 rzb-z11 rzA-z91 rJ0-JI1 <br />IYaNUH <br />(5 U b u ti ~) FoFrQl~fyfiDved. <br />F - FINAL oM8 No. 2oao-oooa <br />DISCHARGE MvfeieR4~lYBPI~~A'~&EER <br />~'~'~ NO DISCHARGE ~ _~ ~"~=~ <br />NOTE: Read Instructlona before completing 1h15 lorm. <br /> (l CIrtI OIIIy) QUANTITY OR LOADING (4 Cold Only) QUALITY OR CONCENTRATION FREDIENCY <br />PARAMETER (46-y11 (54-bll ()8-45) (46-SJ) (y4~1) EX ac <br />NALYSIS STYPEE <br />(J7-JJ) AVERAGE MAXIMUM UNAS MINIMUM A <br />V <br />ERA <br />G <br />E MA%IMUM UNITS (67lJ1 A <br />x646 <br />11 169-]0) <br />V .S, 0 9AMPLE >a><F %d LI L:Y J}`#ik ~ ~~ <br />\\ <br />~ <br />y <br />~.[ ~ ( I9) 22 <br />~~ <br />/ !! <br />~ <br />SUSPENDbU MEASUREMENT . l./ <br />CI . V .JIJ UVas <br />0053U 1 0 U ~~:_ .-..:.. uv#:. ,~aal> #~Y ~,~~.. . 3 ~ <; -. _ "~.70 ~~ ': ~ ONCE ~ GRAB <br /> <br />EFFLUENT GROSS YALU cul~rrt+er,T. ~`; = <br />t <br />~ <br />~~ ~oazl <br />~~ 30 DA AYG tl <br />UAILY;' HG/L -pOHY <br /> ... , <br />:;..; <br />.;s.: . <br />caH ~ 1} -. >r~J ~} ;t yl - ~~ ' v ( 19) <br /> SAMPLE <br />EASUREMENT ~'~ { <br />/ <br />FREUN EYTn-GRAY NET „ <br />00556 1 0 U F f#4>:a firiAr%~# qI,O 4 ~ 10 COtlTI GEAR <br /> PERMIT . - <br />, ~`' <br />,..... . <br />~ <br /> <br />• <br />., <br />EFFLUENT GROSS YALU aeQUwEMmvT <br />' ... ~' <br />:; =~~~ :;.. ~.~~. . , , ~; ~ <br />• .'INST. 1!A NG/L ~ GEEI2' ~~~~~`::.. <br />INDb SAMPLE ID IOq#V #~~1?;1 /f ##.1 ak >;• 77 <br />D <br />S /~ <br />~5 ( 19~ /.}~) I/ <br /> <br />~ TOTAL ELCOVERABLE <br />MEASUREMENT <br />' ^ <br />`~ ~ <br />LJ ? <br />~J <br />G09tiU 1 U 0 <br />' <br />' ~#~~ .0 ONCE . GEAR <br /> PERMIT <br />.: -:a ': ,.. <br />r <br />EFFLUENT GROSS YALU REQUIREMO4T fi:lir 30D6 AYG DAILY tl NG/L !lONT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT.'. ~.. ',.- <br />~ <br />~ <br />= <br />~ <br /> REQUIREMENT ~i... <br />:: ~ <br />~.;~.-t: .. ~ .. <br /> SAMPLE <br /> MEASUREMENT <br /> .:~ PERMR' ... :. ... _- ..... ~_ <br />.....: ':. ~, r;,'.::. <br />. . <br />" .. <br /> REQUIREMENT. <br />.. - <br />,_ ..::., ~..: y.. <br />„ <br />.. 4'.-... :, .;.. " <br />~, <br /> <br /> <br />.: , .. <br />-t,~ . <br /> <br /> <br />. '. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT :. .~ .., : ; ..,. ' ~ ... .. ~. <br /> REMEJiT ~ .. ~, . :. ~ - - . <br /> SAMPLE <br /> MEASUREMENT <br /> <br />.. <br />PERMIT :'.,' .J .. .:.i]: ~. :'.c .. <br />-,..,. <br /> <br />~ ~ . <br /> REQUIREMeNT <br />~ <br />^ _ <br />NAME/TREE PRINCIPAL EXECUTIVE OFFICER LAW THAT I RAVE PERSONALLY ExAMINED <br />I CERTIFY UFIJER <br />PENALTY OF TELEPHONE D A T E <br />~ ~~`` ( <br />I/L~M~ \t O ~~ AND AM FAMLYIR WRN TYE INFORMATgN SUBMITTED HEREN. AND BASED <br />~YNFORMATION'I BE~VE TNME ED4IBMTTED mFORM~ATIDN~15 <br />TANR <br />` OB <br />G <br />TRUE ACCURATE AND COMPLETE I AM AWARE THAT TKRE ARE <br />~a ` /~ / I <br />J X1 SIGNFCµT PENALTIES FOR SUBMITT,IG FALSE INFORMATgN INCLUD,af- <br />THE POSSIBLRr OF FNE AND MPRISONMENr SEE le usc. / loDl AND <br />SIGNATURE OF PR CIPAL EXECUTIVE 7~ ;Z76 370 ~ <br /> <br />TYPED O RINTED 33 USC / 1310. (h,alin uMCI rhea Ya(uln mIy IIICIUdt lion uY 10 <br />fI0A0D aM w matimum impu°nmanr of bclRnn 6 monlN and J ytan) <br />OFFICER OR NORIZED AGENT <br />RE'1' <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENT AND E%PLANATON OF ANY VIOLATgN4 (ReRrtn[e ,II ,R,Cllmenb Otrc) <br />OIL E GhEASE--SEE FOOTNOTE F/, PAGE 3. UHTHLY SAPIPLING INSTRUCTIOnS--FUOTNUPE L`/. <br />e()IIId15 R12y AE used. IREPL AGES EPA FORM <br />WNICH MAY NOT BE USED.1 I, I. „~ 1i ~, .1 7_ ~ /I ~ ~ <br />IOF <br />