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PERMITTE E/ADDRE88 (/ns'lude NATIONAL POLLU DISCHARGE ELIMINATION SYSTEM (NPIMS) ormApproved. <br /> Patlllry' Nam ation 1J diyerenl) <br /> DISCHA MONITORING REPORT (!)nIK) Approved. <br /> NAME_ MIL—CUNTIN_ENT COAL & CLKE CU (z_uII (I7-19) F - FINAL Approve/expires9-30-85 <br /> ADDRESS SUX 15A-__________—p_------ LU0000 96 �' SECT 10 BUR=IOYR24HR <br /> GAko UNUALE CO E316Z3__ PERMIT NUMBER DISCHARGE NUMBER <br /> ——————————— MONITORING PERIOD <br /> Eih�L___ ________ <br /> ————————— <br /> YEAR MO DAY YEAR MO DAY <br /> LOCATION __ FROM 0 TO MINOR <br /> ATIN: DOUGLAS b0WMAN ENV CL;OKD (20-21) (22-23) (24-25) (2627) (2X-29) (Ju.JI) NOTE: Read instructions before completing this form. <br /> (J Card On!)-) QUANTITY OR LOADING 14 Cnrd Only) QUALITY OR CONCENTRATION <br /> PARAMETER 46-33 <br /> ( ) (54-6I) Jjj�3 FREQUENCY <br /> (32-37) ( ) 146-33) (34-61) NO. OFSAMPLE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALv515 TYPE <br /> (62-63) (64-68) (69-70) <br /> PH SAMPLE <br /> MEASUREMENT [y <br /> 00400 1 0 PERMIT7�U MEEKL GRAB <br /> -EFFLUENT GkOSS VAL EQUIREMENT *# <br /> SOLIDS,. SETTLEAbLE SAMPLE <br /> MAX IML114 <br /> MEASUREMENT <br /> 00545 1 0 PERMIT REPORT 0 5 ONCE/ GRAB <br /> EFFLUENT <br /> RU VA •REQUIREMENT <br /> OIL AND GREASE SAMPLE *# >pc # * ** <br /> FREON EXTR-GKAV MET EASUREMENT <br /> 00556 1 0 PERMIT *#* *# * ##* ###* *#*###EFFLUENT EQUIREMENT REPORT 10 KEEKL GRAB <br /> FLOWI IN LONW IT OR SAMPLE * <br /> THRU TREATMENT PLANIM <br /> EASUREMENT <br /> 50050 1 0 PERMIT R PURT REPORT ****** ***# >�t##*# **** WEEKL INSTA <br /> EFFLUENT ..REQUIREMENT <br /> SULIDSq TOTAL SAMPLE <br /> UI SSOLVEU (MG/L ) MEASUREMENT <br /> 70295 1 0 PERMIT *#*# **#xw�# ### REPORT REPORT QTRLY GRAB <br /> EFFLUENT GO EQUIREMENT <br /> OIL AND VRLI♦SF SAMPLE * ### ♦ *�npc## #Ibc*# #�[**'* <br /> VISUAL MEASUREMENT <br /> 884066 1 0 PERMIT R EPORT *##### YES=1 WtEKL VISUA. <br /> EFFLUENT O EQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED <br /> �� AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN AND BASED V " TELEPHONE D A T E <br /> ON My v INQUIRY OF T INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING THE INFORMATION I BELIEVE THE SUBMITTED INFORMATION Y ^ <br /> / IS TRUE ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE SIGNIFI (�{)/ /�'_ <br /> THE PO PENALTIES FOR SUBMITTING FALSE INFORMATION INCLUDING1001 ,I <br /> THE POSSIBILITY OF FINE AND IMPRISONMENT SEE 18 USC S 1001 AND <br /> 33 USC S 1319 rYvnaln,•. urul.r rh amtur.v mns Inrllal.• /Inv.. up lu fln.urul SIGNATURE OF PRINCIPAL E CUTIVE <br /> TYPED_OR..PRINTED- - _and—m "I I Jmpn.minu.nr n/b.aL r.n 8.nnnth.and n Iva.... - - - - - - — - - -- <br /> OFFICER OR AUTHORIZED AGENT AR A NUMBER <br /> COMMENT AND EXPLANATION OF ANY VIOLATIONS (Relerenre ill utrisdnnents dele) YEAR MO DAY <br /> IF NO DISCHA►ZGt OCCURS KEPORT 'ENO UISCHA►.GE".SALINITY SHALL bE MIEA;,.AS TUS=70295 MG/L. <br /> OL G NOW 2 PRAM. NU 5FEEEN: 8406o=0t556=0.A SHtcN :84066=11' 556=GRA8 SAMPLE. <br /> .: IA Form 3320.1 (Rev. 10-79)PREVIOUS EDITION TO BE USED (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) <br /> UNTIL SUPPLY IS EXHAUSTED U0:1-/b/1006 bb-1646 PAGE 1 OF <br />