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NATIONAL.PO4LLITAN' FARGE E..IMINAT I ON SYSTEM �•. <br /> DISCHAR ITORING REPORT F.,m Appra veri' <br /> _ • I�r <br /> 'I O.tlI)NO.f33'; <br /> w. <br /> L <br /> 1 <br /> INSTRUCTIONS <br /> L <br /> •-t — 1 1. Procida dates fur period covered by thi report 1.spaces mad:ed"REPORTING PERIOD". <br /> — J 2. Enter repgrted minimum,.-,age end mazimwu values under"QUANTITY"ead"CONCENTRATION" <br /> in the units specified for each parwn E-,er as app,opriate. Do not enter values in b cs on <br /> eiaing <br /> o.n l <br /> — ---^ autari ak s. "d VERACE"is overage computed over aqual time di sch s:ga is operating."ti AXC1U9" <br /> el -� t and"MINIMU]t"are..•ztreme values ot::erved dorm;;the reporuag period. <br /> .. 1 <br /> 00 .b3, Spe;:ify tba n�,aber of aslyaed s mplxs that—seed the maximum(sn dror min:e,um as appropriate) — <br /> a <br /> -- -------- pc-r.it conditions il;the'cal._lnbelud' " " <br /> ST PERMIT NUMBER DIS 51[: L=ATITZOE LUHGITUL,L> ' (no enlxr O <br /> __ ._ 4. S:ecifY Irxquoncy JI analysis fur ca.h puremrt cr us No. analyses:NJ. days.(a.g.,'3.7'is agaiva- L <br /> Izz z31 I�z-xm Iza-z>I Ize-zsl Ina all Inn/ra 3 aUalyaas perfomed every 7 days.) If cc n,inuoue enter"CONT." <br /> Specify sample type('•grab"or"_It,composira")as appllcable. If freq....y.4.COg6 auoue, <br /> ^^t1 1 — note` I:A". <br /> -;J REPORTING PE FIO D: FROM /L/ I (��G lJ TO �71� V I J ' 6. App Lp rule e,W'efura is rngnired On tAtlJm OI thra fJrm. <br /> � f 7. Remove earbJn and ratnin c�q:V for your records. L <br /> {., — --- YeAF I M1iJ DAY YEAR MU — g a p------ ginal t0 office cpec:(iad in <br /> 8. Fuld alon dotted lines, tG le and mail Od Parai <br /> (J card e.1'.) - .—card ally) <br /> OUA.ttTITY CONCENTRATION FREOUENCY <br /> -� 133c•. 1.6-f31 I4�a�l id 1.6031 10.a 11 :.lt SAMPLE <br /> PARAMETER - _�.__--.i'-NO3�'ie.ae, .— ._—r:O. OF <br /> MINIM1IM AVERAGE MAXIMUM UNfI I MINIMUM AVERAGE MAXIMUM UNITS 1'r PG { <br /> EX EX ANALY515 <br /> REPORTED I t, <br /> 4 <br /> ' PEPr.nT ---__ — <br /> S'y c011-1On <br /> � � COI,CI tIJN <br /> POR - <br /> ' 1 � PERMIT <br /> ' t.M1 n CO NDI TIJN <br /> t y � I RFPOFTED `•__-- _— -- <br /> I �— <br /> RTLO <br /> PE—T I <br /> COnDI Y:Un <br /> 3 <br /> REPORTED I '---- — - <br /> S <br /> jf.`/• 1 PFFMIT <br /> ' COND'.TION <br /> i; <br /> II REPORTED <br /> ' PEP`aIT <br /> REPOPTCD <br /> I C—GI T:DN <br /> 'f E OF PPINCIPAL EXa UTIVE OFFICER - TITLE OF THE OFFICER_--_ DATE \7> <br /> f cnrtify that f am 1—diar with III,Information contained in this LL) <br /> Jcto A) f+ C 6cGU T/4E VICE Pi' S%DEN] 7 � 421- pJ,t and that m rbc 6e.r of:,.y Ano wledga and ballot au h Infor ---- <br /> } - _____ !__--- matiun 7a I—,cOmplata,and--rala. SIGNATU FE OF PRINCIPAL EXECUTIVE <br /> LAST FIRST MI TITLE YEAR M OFFICER OA AUTHORIZED AGENT <br /> EPA Farm 3320-1(10.73) PAGE OF <br /> ORIGINAL <br /> j <br /> i <br /> i{ <br /> 1 ' <br /> 1 <br />