Laserfiche WebLink
RMITTEE NAME/ADUMt!l~nnuUF ...... .. ... ... _. .... ..... ~.... ~._.. ~.:.. ,_,.. , ... ..~ I <br />rl/Iry Nlme Lorulon I! fferrnrl DISCHARGE MONITORING REPORT r l7MR) <br />uwe ~EAUU OAL CG_(~Et+EC~l,~Ij____ (z•ld) rn-19) i'IiNUN <br />aDRESe 13UJ TB YALE-_-_-_-___ __ ~_ CUUJUUZG ~C4 d (SUNK NYj FoppgpplpYed. <br />FLAGSTAFF AZ E3oG01 PERMR NUMBER nI.cRAn.a RUR.xn F - FINAL OMe No. 2040.0004 <br />----------------'---~--- MONITORING PERIOD uA~l.unnwn z.v°r+<+a-ay-r avr• vncc~n <br />CILRY <br />_ <br />----- -- - ------- YEAR MO DAY YEAR MO DAY <br />' '7r;7~ <br />KATgN ~~~4Ln~~~4.ffSCt~__ __- FROM TO ~'~v NU L'15CAAAGE ' <br />~ <br />NOTE: Read InsUuctlons before completing this form <br />LT T Ei : ~; <br />;: "' ^ "'"° ° "" ^ •' <br />F A ES I D E N T <br />FII <br />11 <br />1+ <br />IJ <br />ld <br />17 <br />f <br />19 <br />O <br />II <br />. <br />, <br />. <br />- <br />- <br />) (1 <br />- <br />) (J <br />- <br />) <br />(X <br />I ( <br />-IJ) r <br />) r <br /> (J Cud Only) GUANTRY OR LOADING (+ Cob Only) QUALITY OR CONCENTRATION <br />PARAMETER (16-JJ) (fldl) (78.15) (16-1)) (S1fil) NO. FREDDENCV SAMPLE <br /> E% ANALT615 TYPE <br />(JI-J7) <br /> AVERAGE MA%IMUM UNn-9 MINIMUM AVERAGE MA%IMUM UNITS !/)dJl (61-0!) fdP70) <br />d SAMPLE ~ >C ii ~ ~ ~ r~~'k: ~ ~ ~ ( I2j }~ ~ ~ <br /> <br />MEASUREMENT ~ - <br />O <br />v ~ ~~ <br /> <br />00400 1 0 U ~' <br />MIT. : <br />, •. <br /> <br />~~~ U <br /> <br />.. ~ . ~+~ o ; <br /> <br />.a . , . <br /> <br />weaaL <br /> <br />caA~ <br /> <br />EFFLUENT GROSS YALU PER <br />u~~+T~ _~ <br />' ` <br />° .~~~~ <br />###t <br />lfItlI811d' <br />^ <br />~ ' '' ~ ~~ ..- <br />~ tlAYItlOl1 <br />SU <br />'I'' ~ <br />~ <br /> .. ~ ,,,,. , : .+ . <br /> SAMPLE <br /> MEASUREMENT ' <br /> } <br />EMIT '` <br />REQVIREMLI.1 <br /> <br />n <br /> <br />" <br />F: <br /> <br />4. <br /> <br />9y <br /> ~ <br /> SAMPLE <br /> MEASUREMENT <br /> :... -..: <br /> <br />FeRMn .. I. ...-.. <br />s,y~. <br />'~ _ <br /> <br />,, <br /> RGGUIREMENT: <br />:' <br />' . t` <br />,., <br /> <br />_r' - - <br /> SAMPLE <br /> MEASUREMENT <br /> PERMR .r' r <br />~ .' ~ ~ '; <br /> RHCUUiEMENT i .r <br />' ~ d - :.~ . <br /> (, <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT :.. <br />'R[OWRBMENT rA,'Yv> ;P.-:. <br />J,i>~r,.~. _ <br />- .. <br />- - _ . <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ..: ' .'::. ': ~ <br />" . ~ .. <br />. <br /> REGUeiEMENT r :1 <br />r~ i-~ <br /> <br /> SAMPLE <br /> MEASUREMENT ' <br /> PERMR' - ~ I. ... <br /> REOUIRlMENT - . ' .. - .. <br />NAME/TITLE PRINCIPAL E%ECUTIVE OFFICER I rERTFV HOER PENALTT OF LAW THAT I HAVE PERSONALLY ExAMwED TELEPHONE D A T E <br /> AM1D AM FAM4MR KTFH TFE WFORIAATON $U9.rITTED HERE W: AND $ASED <br /> <br />( <br />L <br />V S ~~~ ON My WDURT OF THOSE wDIVWALS AwEDIATELV RESFVNSBLE FOR <br />OHTANiNG THE pFORMATgN I ELEVE THE SURLVTTED wFORMATIDN IS <br /> 1 <br />h <br />(~ <br />/ <br />TRUE ACCURATE AND COMPLETE I AM AWARE TyNT TIERE ARE <br />TIES FOR <br />MItTwO FALSE wFORIMTION INCL <br />D <br />NG <br />~F PENA ~~ <br />{ <br />j ~ <br />oU/O rte <br />Lr7 ~ ~ I <br />L <br />6UB <br />U <br />AiE POSSIBIITY of FwE AND MPfILANMENT SEE I. usc. t 1001 AND <br />f 131p <br />y <br />33 <br />hi <br />Ih <br />(fi <br />M <br />Nd <br />SIGNATURE OF INGIPAL EXECUTIVE yo <br />r ~y~ <br />/ <br /> ( <br />rn. <br />f v <br />rr <br />rx RHUrrr mry rnr <br />ner uy rP <br />USC. <br />e AREA <br />TY PE OR PRINTED fl01JLd .M a muimum impriwnmenr o! Der.trn 6 nramAr rAi J yrx:/ OFFICER O AUTHORIZED AGENT NUMBER YEAR MO DAY <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS (Rr)ertnrr Ill alDrhmrnrt hrR) v <br />OIL E GAEASE--SEE FOOTNOTE F/, FAGS 3. 46TNLY :iAt7YLING 1NSTitUCTIUN3--FUU'PNUTE D/. <br />(REV. 9-88) P2vious Edi7ionS r113y 6E IbRd. IREPIACES EPA FORM T-AO WHICH MAY NOT BE USED.1 ~ ~~ T r ~ . l i ~ 7 ~'. r ~ ~ '{ PAGE ~OF <br />