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(lncfadr FarifUr A'amr/Lacalion if Diffcrrntl <br />NAME ; SRN FUELS <br />ADDRESS NCIR F ZOPV i"! I NE <br />I; O`-. Ij c v <br />_ II'7 <br />FACILITY I'jOftl LCfJ i`1'11V.F <br />LOCATION ,_A <br />t Gh}i-F LlQT}~. <br />'~ ' ] 4~4 <br />MThiF M14!.' ..=R <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM ((NPDES) <br />DISCHARGE MONITORING REPORT (DA4R) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br /> <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION N~, FREQUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE ~ /, <br /> <br />MEASUREMENT] ? <br />_ .. . , <br />' <br /> PERMIT r ~ - I~'.l~C ~F*.: i~ Y _ <br /> REQUIREMENT' 30I3A Ft`i~~ iJAILY i`?X .. <br /> SAMPLE ~ <br />~ <br />~ <br />~ ~ ` "'^• <br />~ <br /> MEASUREMENT -' =~ . ' - <br /> <br /> REQUIREMENT ~'(.Jt-IA AVl% i.•r4lLl (•i' i;'~ i <br /> SAMPLE r <br /> MEASUREMENT f ~ J ~~ ~ %~ <br /> PERMIT - :, ;< r ~ _ <br /> REQUIREMENT :SODA AVM= -. "'1 "f .. . <br />• SAMPLE <br />f~ r - <br />f~ <br /> MEASUREMENT p <br /> PERMIT Flit#¢st ~' -F->-:~•~:.. - ,'~i•##•'~ , I i <br /> REQUIREMENT iDA AV> iir~, i t ~' <br /> SAMPLE - I <br /> ~ I `J <br />I " <br />i r:i_.t_ ! L-.:.~~%_: MEASUREMENT ~ . <br />`•: `~' PERMIT -y.s r - ~.Y _ ~: <br /> REQUIREMENT ~ ~-"~ AVG: DA I l_ ' <br /> SAMPLE I j.. <br /> MEASUREMENT - - <br /> PERMIT .~ ., __ _ r_ <br /> REQUIREMENT `.. ~+ AVG DF <br /> SAMPLE ~ ~ 1 ~/ A <br />` <br /> <br />MEASUREMENT <br />V b _ <br />t( ~ <br />. <br /> PERMIT : =a x > .. - -. r !_. -. - _ <br /> REQUIREMENT ~ `' ' D~"~ _ ,.,~ <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I ccrtif~ under prnalty of Inw thnt thi. durumrm alld all uUrehmrnt+werr <br />prepurril under m~ dirMinn or +upeni+fun in accurilanar with a .~+tem drsi>tnrd TELEPHONE DATE <br /> h, ac+urr that yuuliRrd prrconnrl pruperl~ y~ther and c. nluate the iafurmauna <br />- _ +uhmitlad. Ra.+cd un m. inyuin of the perwn ur pervxl. wbu mnn~•r the c~slrm. - _ I - <br />• ~ <br />- <br /> <br />- or th~r+r pcr+nns dirar'Ih rr+prnt+i Mc (nr I:athcring thr informntien, the infol-matlon <br /> <br />to the tw+t ..! ms knowtrdFr anil t+rlirf <br />trur <br />acrun4 <br />and rlxupkta• <br />bmiu <br />+ <br />d i+ "- .' , <br />~ _ <br />~' ~ <br />J, ~ / <br /> , <br />, <br />. <br />. <br />. <br />. <br />u <br />I am aware tlult there are +iltni(icunt penal6ir hrt +uhminin>` falx inGlrmatiun. SIGNATURE OF PRINCIPAL EXECUTIVE <br />~ <br /> <br />TYPED OR PRINTED <br />IOCludlnK t11r p1t+11h1111\ UI r'ml• and Impfl+UOillrtll for Il11UNln~; riolation+. OFFICER OR AUTHORIZED AGENT AREA <br />CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLAT-ONS (Heterence an anacnmenrs Here/ <br /> <br />~~~'°r.~'.i / i~[TI'I5 35 $ ~{-})~Ci 10r-Ill. PAGE OF <br />