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'4 • NATIONAL POLLUTAr 'NARGE ELIMINATION SYSTEM - <br /> DISCHARG�IITORING REPORT Approved <br /> 1� <br /> a NO. ISS•ROO73 <br /> j P-C CrAL (PRI P PLINT <br /> 10 hox 159 <br /> �AP8 r, AL F <br /> ' - INSTRUCTIONS <br /> L C0 9 16'3 -� 1. Provide dates for period covered by this report in spaces marred"REPORTING PERIOD". <br /> + - Y. Enter reported minimum, average cud maximum values under"QUANTITY"and"CONCENTRATION" <br /> Ir•M lA-met 1t7•191 in iha units specified for ouch parameter as appropriate. Da not enter values in beaee containing <br /> asterisks. "AVERAGE" Is average computed over actual time discharge is operating. "MAXIMUM" <br /> �� and it condition are extreme value observed during the reporting period <br /> 1 0 396 121 1 3. S ecif the number of anal p ( appropriate) <br /> ( " ; P y y-.ud samples that eased the maximum and/or minimum u <br /> �T PERMIT NUMBER DIS SIC LATITUDE lONtiITUDE Permit conditions In the columns labeled"No. Ex." If none,enter"O". <br /> 4. Specify frequency of analysis for each parameter as No. analyses/No. do a. (e.g., 113/711 Is equive- <br /> Ir0-111 Ir'--rb: I24-25t (2e-27) Ire-rat 130-811 lent(a 3 analyses parfommdJ every 7 days.) If continuous enter"GONT." <br /> S. Specify sample type("grab"or"_hr. compoclte")as applicable. If frequency was continuous, <br /> enter"NA". <br /> REPORTING PERIOD: FROM l;1f <br /> D�A <br /> 1TO 6. Appropriate signature fs required on bottom of this form.YEAR MOY YEAR NO DAY 7. Remove carbon and retain copy for your records. <br /> — 8. Fold along dotted lines, staple and mail Original to office specified in permit. <br /> 1 er•a71 .. _ ___ _ 104-ee1 Ue.70I <br /> (9 card only) QUANTITY (1 card°nly) CO N CENTRATION FREQUENCYT — <br /> PARAMETER Ie8.4 I I4e-etI _�s4-eu 1e1-e7 ue-4R l40-ps)- - is.-Oil I0a-er OF SAMPLE <br /> MINIMUM AVERAGE MAXIMUM UNITS NO. <br /> MINIMUM AVERAGE - MAXIMUM UNITS HO. TYPE _ <br /> EX ANALYSIS <br /> ' 1 f-Y,1 REPORTED Q' O !7 �— <br /> �_;.': IN C 1 11UIT � 'Z.-4 ♦ # l► # # # # # # # # # � I t�i. lu <br /> PERMIT MGD <br /> CONDITION +� +' ++ # # # # # # # # # A # # # # ii # # 1t # # # 1/7 IN <br /> TnTnL DTSS RePonTeD <br /> (''I�;5'.LV -,;� --'----- KG/DAY - - MG/L <br /> CON ---- <br /> PfiRI41T _ 1/9.0 GR <br /> • ,r -1 i! DITION 4 1t # 11 # it � # # # # # # ff # # # # # # # # # ti' <br /> 1LI059 T( TaL. SUSP REPORTED t # # 1r # .# # # R <br /> PERMIT <br /> KG/DAY -- MG/L ---. _. <br /> CONDITION # # • {t # # C # x # # q # i0 # # # # # # 30 1/90 — CO <br /> • ,,.TOTAI.(AS Fi) REPORTED # # u # # s a # # # # u #. o,Zz O l f9a co <br /> ':►f PERMIT KG/DAY — <br /> l'1=4�� CONDITION # # # # # # # A # # # # # # # 3e5 Tan 1/90 CO <br /> I�r!0 f I:`.11) REPORTED # ♦7 ;i 11 # # # # li # # ♦T 8. i # If <br /> SU # # 8•a/ (� 1 <br /> - _ <br /> •{ i/ CONDITION # # # # # # # # # # # fJe0 * # # O — 9e(; SU . <br /> _ 1/90 GR <br /> 71 <br /> ]L N GRE S REPORTED # # # 4 # If # * # # # # # {S' Y # '1.. .�VISUt1 _ O � � i�`10 �T � <br /> PERMIT — - <br /> '� If 10 1/90 VI <br /> REPORTED <br /> 1 PERMIT _ <br /> '•`., -- CONDITION <br /> REF OF'rF <br /> , <br /> !` PERMIT <br /> CONDITION <br /> 1 <br /> NAME OF PRINCIPAL EXECUI IVE OFFICER TITLE OF THE OFFICER DATE <br /> _ — I certily that I am familiar with the Information contained in this <br /> �Gl,�m�� Jpf(ILl �. t{�l�r�T— % report and that to the beef of my know/edge and be!!.I each Iniar _ <br /> ration is true, complete,and accurate. SIG ATURE OF PRINCIPAL EXECUTIVE <br /> 9 LAST — FIRST MI TITLE YEAR MO DAY OFFICER OR AUTHORIZED AGENT <br /> EPA Form 3330.1110.71* <br /> ORIGINAL - PAGE 1 OF 1 <br /> ? 6115 IS SFTTLEII MIHF WATER FROM LESS IMOD MINE 43 ANY SINGLE GRAB CANNO <br /> T EXCEED 45 MG/L FUR TSS <br />