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wino AwNR andee YsUA+wIU •••••• <br />NAME ,;ll (.i111YILr-1.` R.I. ! '.',i r~'1L_ _ _ _ <br />ADDREas t:S:J.:1•LYIL'_'1'iL' .. _ •--- <br />nw nunwL rv~w, wn t utat.nwnut tLININg11UN SYS7 EM /IYYOFSI <br />DISCHARGE MONITORING REPORT (OMRI <br />(7•!61 (17.191 <br />PERMIT NUMEER DISCHARGE NUMBER <br />FDIm Approved. <br />1 - ~ I '1 A 1. OC,6 No. 2fNOdOD1 <br />Apprwel alpine a-3o-B~ <br />. °r' r. n LL .... _ _ __ 1.'_ L'iL'1 J.. MONITORING PERIOD ' <br />FACILITY <br />_ _ _ _ _ _ _ _ _ _ _ _ __ <br />FROM YEAR MO DAY •ro YEAR MO DAY <br />,. <br />. <br />r <br />LOCATION <br />_-_ <br />i <br />• <br />• <br />,. 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I•• , <br />• <br />I'li1 'r.J~g1, SAMPLE G{,:G',n}r,: y::t0r?{t'r :1 i}ft1}:};+::• .. <br />A i f F. ~ MEASUREMENT <br /> <br />{~~'I ~' 1 17 '' <br />F FfigM~ <br />lNt ,,i <br />~pltt~A~i ji <br />'' <br />;.~~~~#Kllk •F <br />YY <br />`` <br />':•Y 1:: ~ <br />E~OIOI~ILs+P ;: <br />3a~ J` ~ J7 <br />~eM:1 'I <br />:1 ;y, <br />~t.`:~i/~ <br />R u <br />,. <br />, . , EOUNIEM _ Ir <br />, " <br />F <br />1 . . s i l .x <br />• ' I 1. V Z(7N nl! I'r t~11 ~ SAMPLE rt [::;trl p•:a ~ g i,f..., :,: '. •: .y,, ;.,,; ,y..t: ;: Y:::: ~ ~ <br />I '' I' r II I: r5 T 71 L; ~J',' r t. A 11 Z MEASUREMENT <br />I,~' .1 L 11 1' !i+itiu"inELl~Nfp ;~,~p~wQ~;~'~~ 'iIAEFi:~BT H ~ ~J~~~..{" ~ ~.`,,va¢~44. '° 404!9+}' :, . i:~;; g6ltL4. N~'rrl <br />1 i' 1' ~ r ~ ' t' 1 ~ L' it ' ;Y.t l: 4•: <br />~11 1 ~~'Jrl ro'rAL SAMPLE Y,t~e'r,Y.: fi.r;:,. pl:f Gtt ¢•} r::.r .:,:F :~::r '. nY+:, ': ' <br />I ; •, . ~ 1. Y ,,: 11 1 : MEASUREMENT <br />r I • 1 'n I; PER-1T ~ <br />1S BIo6a d: <br />D <br />~ •%ip'~ b. :::xe~ ~ai7aRt+xvl ' `1'A>Ylk4~ac; <br />~ -!i•:POR i ~: ~ ~!R' Y t H <br />~I <br />, _,.. , , _ I. L EDUINEMENT 1 Q c. - .• I r ~ <br />."x C7 <br />.~ ~. ' ' <br /> <br />• 7..i~ > <br />NAMERIiLE PRINGIPAL EXECUTIYEOFFICER 1 CERTI <br />AND AM FY UNDER PENAITV OF IaW THAT t HAVE P <br />FAMILIAR WITH THE INFORMATION 6UBMITT ERSONALLY <br />ED HEREIN <br />A E%AMINED <br />ND BASED ~ , TELEPHONE GATE <br /> ; <br />ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONS <br />IBLE FOR , + <br />1 ' <br />It LIII EttkSl1401T - / <br />' '' <br />~ 097AININO THE INFORMATION. 1 BELIEVE THE SUBMITTED INFO RMATION / <br />~ <br />~F t.Nltt{ (. 1:IIV LLUIIIOll1C81 1S TRUE, ACCUMTE AND COMPLETE. 1 AM AWARE THAT THERE ARE SIO~ ~-~ <br />. 3t13 <br />U2Ji-4411 91 Ill 1 i <br /> NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION, IN CLUDING , . <br /> THE POSSIBILITY OF FINE AND IMPR180NMENT. SEE 16 U.S.G 1 <br />8 1001 AND 81GNATURE OF PRINCIPAL EXECUTIVE <br /> 71P. IPmdrle wan rArs uuem mq LwOrrY lltta ry ro t/A000 <br />~ <br />a <br />TYPED OR PRINTED Q <br />4wpHw„mrnr oJMwaeepuluW lJws/ OFFICER OR AUTHOR12E0 AGENT NUMBER YEAR Mo DAY <br />..V IY,men r l,nV l.ArlAnlt r tV n Vr Itni YI V Lw I rV Ni7 /N(Il1lIILrW tnt~flwNwO welt/ <br />i!i n({. 1'4f......1 ,. 7, '. *,1R1•h'1'1'!' F/ I'1 I'I!l~ I'I+trrr. ~.cl'1'1,'.•,! L 'I.I' rt~•I• LI. ;, .,•!1.Y' 11' Cv '1'1-ii', '- <br />1,, ,1 I•, .,. T. f I •T•'~'7., t 7 .. I, .,. ~5 17 , r. .. I,'. 7I ~ ,•1 ~ , <br />I 1.01' , I" I t I I,I r 1 II:I' <br />:Pp Form 332PT (Rs1i.9•B8) Prrr/duf a Itlonrmay Us t ' ' ' IR CES Ep RM T~0 WNICN MAT NOT eE U6ED.1 pAOE of <br />