Laserfiche WebLink
°ERMITTEE ,N/A(,pMFE^/~AO,O/R~pESS~lnr~lode <br />AME_ YGlI l7 ~/US l_V/~L (,Q-~CNL~.A l~____ <br />DDREas 13U0 SOUTH_YAL_E____ ______ <br />_-- FLACSSAFF _______ AL d6GU1 _ <br />4CILT' 7-;~~ ______ <br />ACATION SL~~ ~owauc.~Cwaar~,4_©L`,------ <br />1TTN: .. N, PRESIDEN'L <br />NAl1UNAL YVLLUTANI DI)lHNN4E lLIMINAl10N 6YBTEM I NI~IJI:S I <br />DISCHARGE MONITORING REPORT I UAIR) <br />(1-Ibl (11-191 <br />l.-CL'JLU ~ uJ4 n <br />PERMIT NUMBER o1.cNAwoa Nuraaw <br />MONITORING PERIOD <br />YE R. MO DA TEA MO D/~Y <br />FROM TO <br />(70.111 (17-151 l11-191 l16-171 (18.19) (JO-ll) <br />rlisuR <br />(S U tl N H W) FDE198{fDltSved. <br />F- E I N A L OMB No. 2040.0004 <br />ll15CHAAGL R11DrDY1A4~4tF1Bilt-Y4REEK <br />r};c ~' NC UiSCHARGE ~~ ~ #{~# <br />N07E: Read Instructions before completing this lorm. <br /> (l Card Only) QUANTITY OR LOADING (4 C.rtl Only) QUALITY OR CONCENTRATION <br />PARAMETER (46-JJ) (546/) (J8-4J) (46-JJ) (5461) NO. FREQUENCY SAMPLE <br />(J1-J7) EX ANALras TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> (61e11 (14d,) (69-]Ol <br />)IL AND GhEASE <br />IISUAL SAMPLE <br />MEASUREMENT ###### ~ ( 9q) ####:~# vv4a## ###### <br />~~ <br />~ <br />~~ <br /> t <br />l4U66 1 0 0 A C5=1 '+### W L iISUAL' <br /> PE <br />. ' <br />'`~ <br />SFFLUENI' GROSS YALU QumEMErrr ` ; INS'I HAX tiU=U 3### <br /> , <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT. ~ ,~ .. <br /> REQUIREMENT ~ ~' ~ ~ "' ' <br /> SAMPLE <br /> MEASUREMENT <br />I <br /> PERMIT <br />~ ~ ~ ~ ~ ~ ~ ~' <br /> REQUIREMENT ~ ~ •~ <br /> SAMPLE <br /> MEASUREMENT <br /> <br />PERMIT ,,: ., <br />:.. <br />:..<::.: <br />.:'. <br />' <br />- _:-; ' . <br />I <br /> RE000iEMENT . <br />. <br />. . <br />~ .. .. ~ ... <br /> SAMPLE <br /> MEASUREMENT <br /> .PERMIT ~ ~ -' ~ - '. <br />~ ' ' <br />~. <br />.. .. <br /> REQUIREMENT, ..' .., ':..., ,~ . . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ -.: <br /> <br /> <br />~ ~ .S . <br />-.~: <br />.:.~. :'.:..:..y7,~.~ <br />: <br />` ~ <br /> <br />~. ~ ..-, ... ~ <br /> <br />- ~ <br /> <br />.~. <br />- <br />' ~ .. <br /> <br />~ <br /> neawREMwr --: <br />. .. , . <br /> r. , <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT..'-. .. .~.. [, :. <br />•. <br />_.. ~.~„- . <br /> <br />. <br /> <br />. <br /> REQUIREMENT ,. <br />y <br />:..... . <br />- <br /> <br />.. <br /> .a . <br />NAME/TTLE PRINCIPAL EXECUTIVE OFFICER I CERTFY UNDER PENALTY OF LAW THAT I INVE RERSONALLV ExAMrED TELEPHONE D A T E <br /> ANO AM FAMl1AR Wmi TFE 9FORMATDN SUBh1RTED NEREW. AND BASED <br />~~ <br />f l <br />~QC ON MY WOURY OF TWSE NPV[%lAL4 IMMEDIATELY RESPON9BLE FOR <br />~ <br />` <br />O <br />•i v ~J OHrANWG THE Y~FORMATgH I tfUEVE THE SUBMRTED NFORMATxJN IS <br /> TRUE ACCUrtATE AND COMPLETE. I AM AWARE THAT THERE ARE <br />f <br />~ ~~ ~~ [fir <br /> O a <br />~~ <br />~ T~ <br />P <br />TV~ <br />F FW <br />PR <br />G M <br />EE <br />IB <br />C 1 I <br />O I~ND <br />N <br />~ <br />~7 `J <br /> O ~ . <br />9BLI <br />E AN <br />I <br />EN <br />06 <br />O <br />S <br />US <br />OO <br />3J USC 1 1319 <br />(R <br />lfin <br />r Ih <br />n.Nlu m <br />iMlude f <br />u <br />to <br />M IGNATURE OF P CIPAL EXECUTIVE ( Q <br /> y <br />P <br />. <br />na <br />u <br />e <br />Re <br />mR AREA <br /> TYPED PRINTED SIOD09 .M or m.aimum impimnmenl W belrern b monlhr .nd J ye.n) OFFICER OR THORIZED AGENT NUMBER TEAR MO DAY <br />COMMENT AND EXPLANATION OF ANY VIOLATgN4 (RClertnCe Ill III.tAlllen/t Mre) <br />IIL E GREASE--SEE FOCTNUTE F/, GAGE 3. QATRLY ~AtlPLING INSTtiUCTIUNS--FUC'PtiUTI: D/. <br />FPA Form 3320-1 ( .. 9-881 P/P.VIlIIIS ediFnns may ho 16/`(I IPEPLACES EPe FnRM T- WMIf.H MAY NOT RE IISFTII - r-F .OF <br />