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NATIONAL POLLUTANT PJSGdIJWE ELIMINATION SYSTEM I <br /> ` DISCHARGE, WING REPORT <br /> 3loved <br /> 58-f20079 <br /> INSTRUCTIONS <br /> 1. Provide dates for period covered b this p y report to spaces marked"REPORTING PERIOD". <br /> J Z. Enter reported minimum, average and maximum values under"QUANTITY"and"CONCENTRATION" jq <br /> I +2:-113 ++•Im I17•1a) in the units specified for eacb perammer as appropriate. Do not enter values in boxes containing <br /> asterisks. "AVERAGE" is average computed over actual time discharge is operating. "MAXIMUM" <br /> _ O r N O n and"MINIMUtd" are extreme values observed during the reporting period ti <br /> CO-075—OYR 7 000285 _ 39 11 52 107 17138 & Specify the number of analyzed somplme that exceed the maximum(and/or minimum as appropriate) - <br /> -'—� permit conditions in the columns laheled"No. Ex." If none,enter"O". <br /> P <br /> PERMIT NUMBER DIS SIC LATITUDE LONGITUDE 4. Specify frequency of analysis for each parameter as No. analyses/No. days. (e.g., r'3/7"la a of va• <br /> lent to 3 analyses performed eve 7 days.) I[continuous enter"CONT." ( g q <br /> Izo•xu Izx-xsl +xe•ael Ixe•zn +xe•xvr +so•su Y P every Y ` <br /> "'- S. Specify sample type("grab"or"_hr. compoeile")as applicable. It ft'equency was continuous, """ 1: <br /> enter "NA". <br /> REPORTING PERIOD: FROM 7 6 1 0 0 1 TO 7 7 D 1 (> 1 6. Appropriate signature to required on bottom of this form. <br /> J- I` <br /> 7. Remove Garb?n end retain copy fcr your records. <br /> YEAR MO DAY YEAR MO DAY <br /> S. Fold along dotted lines, etep[a and mall Original to office specified in permit. G; - <br /> ua•an we•eer tee.Tol `� <br /> - (7c■rdonty) QUANTITY (ec■rdonly) CONCENTRATION <br /> FREOUHNCY s,l <br /> PARAMETER _ Ise-eel _ +,e•esr leaeu lex•asl lae•esl lee•ea lee•sn �� lex•es OP SAMPLE <br /> 1 MINIMUM AVERAGE MAXIMUM UNITS NO, MINIMUM AV ERAOE MAXIMUM UNITS NO. TYPO <br /> �— EX ANALYSIS I' <br /> I: <br /> r—i REPORTED F' <br /> PERMIT <br /> CONDITION ' <br /> REPORTED fl:' <br /> PERMIT <br /> CONDITION NO REPORT D DISCHARGE DURING REPO TING PERI OD' <br /> REPORTED ` <br /> fi <br /> PERMIT �45 <br /> CONDITION <br /> REPORTEDr. <br /> PERMIT �';j t' <br /> CONDITION t; <br /> RaPORTaO <br /> t <br /> PERM.T <br /> 1{� <br /> CONDITION <br /> REPORTED <br /> CONDITION <br /> REPORTED <br /> f I <br /> E <br /> PERMIT <br /> I` <br /> CONDITION t <br /> REPORTED p " <br /> PERMIT <br /> t <br /> CONDITION <br /> f <br /> NAME OF PRINCIPAL EXECUTIVE OFFICER TITLE OF THE OFFICER DATE i <br /> —'� f certify that I am familiar with the inlomtafion contained in <br /> repoel and that to the best of my knowledge and belief such <br /> REEVES, JOHN A. EXECUTIVE VICE PRESIDENT 7 7 0 1 3 1 motion is true, complete,and accurata sl NATURE OF PRINCIPAL EXECUTIVE <br /> LAST FIRST Mt TITLE YEAR MO DAY OFFICER OR AUTHORIZED AGENT (+. <br /> EPA Fs 3320-1(10.72) . <br /> PAGE OF <br /> ORIGINAL <br /> f <br /> I: <br />