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NATIONAL POLLUTAN' 'HARGF_ ELIMINATION SYSTEM •�I <br /> DISCMARGOiTORiNG REPORT rnApproved <br /> 'NB NO. ISII-ROO73 <br /> t rl"Cf CiijAL (PREP PLah:T <br /> w BOX IS8 <br /> ( AItFJI)IJ.�AI'E INSTRUCTIONS <br /> L (;tl H 16?3 � � 1. Provide dates for period covered by this report in spaces marked"REPORTING PERIOD". <br /> 2. Enter reported minimum, average and maximum values under "QUANTITY"and"CONCENTRATION" <br /> 12-3) lA-1et tr7-la1 in the units specified for each parameter as appropriate. Do not enter values in boxes containing <br /> asterisks. "AVERAGE" is overage computed over actual time discharge is operating. "MAXIMUM" <br /> and WIN1NIUM"are extreme values observed duringthe reporting period <br /> 3 Specify the nuinbor of analyzed samples that exceed the maximum(and/or minimum as appropriata) <br /> Y <br /> ST PERMIT NUMBER DIS SIC LATITUDE LONGITUDE permit conditions in the columns labeled"No. Ex." if none, enter"Cl". <br /> 4- Specify frequency of analysis for each parameter as No. analyses/No. guys. (e.g., "3/7" is equtve- <br /> 120-2It I22.2et I24-2e) I2e-27t Iza-2101 450-31t teat to 3 analyses performed every 7 days.) If continuous enter"CONT." <br /> 5. Specify sample type("grab"or"—hr. composite")as applicable. If frequency was continuous, <br /> enter "NA". <br /> REPORTING PERIOD: FROM i ') ( 1 "'1 TO r-4 I-� I 6. Appropriate signature is required on bottom of this form. <br /> YEAR MO DAY YEAR MO OAY 7• Remove carbon and retain copy for your records. <br /> 8. Fold along dotted lines, staple and mail Original to office specified it;per-;,it. <br /> t iel-371 <br /> a-Cep 1e9-701 <br /> (3 eard only) QUANTITY Ncard arty) CONCENTRATION — FREQUENCY <br /> PARAMETER gas.All ua-ev _I e.-en _ .—_mz-ea;l So.As1 - -t,1e-s3_ Isn_e_ule c-i SAMPLE <br /> OF <br /> MINIMUM AVERAGE MAXIMUM — UNITS NO. MINIMUM AVERAGE MAXIMUM UNITS NO TYPE <br /> --- --_ EX EX I -ANA;_YSIS _ <br />,r <br /> r Ll t,! f N C-),•f1,1.)f 1 REPO R'r ED <br /> _ - P e HMl T <br />'�i ''., -'.i n n w ,► a +► st t+ u a cr — u is „ t. ;. <br /> � CON Uf T10 N 117 14 <br /> 1- 9 TrJ41 nA REPORTED <br /> PERMIT <br /> 7 3 CONDITION it .-k {'I (/�-- 4 11 ii -y ii # 4 S ii t} d• X I 1/1',i GR <br /> / C•,.L ii)i♦11T,,1y Jii_ Ji)r,,p REPORTED <br /> PERMIT 1 f <br /> CONOI TION ., {: ♦✓• f {.'I . '.; .r „ I J/ J co <br /> ryi ,i,. .',OTC,I t,t, F=) REPORTEDPERMIT <br /> 4 IF tr <br /> I —' --- iC.,i/i)<:Y )------ ------------ •fir ------ — <br /> ' CONDITION ' � � 3.� �• I I/'' , 0r ---- —_ _ ---- --------- f j <br /> REPORTED <br /> r .;� PERMIT <br /> C -- —_ - •71J —_—_..___ \ --.__ -_—_.-__ �li __..___) ....-____..__.___._ <br /> P . CONDITION :t i► A F.•`� �♦} 4;' r e 1 <br /> REPORTED G- ♦a w ii !r i` 'i Ir It {r(• t' i- <br /> 01 <br /> P fi RMI T <br /> . , <br /> CONDITION �► {f k �r {r � p l} rf i�I fF {Z 5: {} 1,'- t! )} � 1 i IfI�4 VI <br /> \� REPORTED <br /> CONDITION < <br /> HEPOHTED <br /> CONOI TION ' <br /> GNAME OF PRINCIPAL EXECUTIVE OFFICER TITLE OF THE OFFICER DATE — <br /> !ccrti ly That!nrn familiar trith the inforutation contained in this [4' f <br /> -=C�L- _ 1 __—_____—``''��_ ,(, ''•, - '--- ---- i` re Inrf and that to the best of nl kno n•!ed C:�L�. <br /> 11 Y ge and belief such infor- ____---- <br /> -. _I__ _._I_� __ malion is/mc, rompletc, and accurtac Si GI`ATUr.ii OF I t 114CIPAL EXECUTIVE <br /> LAST FIRST MI - TITLE YEAR MO UAY-L-_-- OFFIC¢F OR ..j Tr,ONIZEO AGENT <br /> EPA Farin 3370.1 U0.7Z --'---- <br /> PAGE OF <br /> ORIGINAL I I <br /> 1= T: `. .i?L'.Ii ;tTf: Ttii2 fkil;, L. ie .•I Ti;i 3 %I::Y Ii.;VL:_- (,?A <br /> T FXrr' 4', ,6 L F:.I• TS5 <br />