Laserfiche WebLink
A <br /> NATIONAL POL1.UTAt>1,T�%!�" E ELIMINATION SYSTEM"' +'�DISC�IARG �ING REPORT <br /> �pHllo I � <br /> y j on <br /> c , <br /> ' INSTRUCTIONS <br /> I. Provide dates for period covered by this report In spaces marked"REPORTING PERIOD''. <br />;�•� II(// 2. Enter rrportrd minimum,average and mrwlmam values tinder"QUANTITY"and"CONCENTRATION" i It•L Ipal i 11T•Irl In the units uprclfled for ouch parnmetor as appropriate. Do not enter values In boxes containing <br /> aster)sk s. "AVERAGE"to average computed over actual time discharge Ir operating, "MAXIMUM" <br /> O'O7�J-OYR--2"DOl)Z Pj Q r u r R and MIN MUM"are extreme values observed during the reporting period Y : <br /> _ 1O7 �.'� 38 P9.1� <br /> 01 52 3. 9Prcify ehe number of an„IytcJ aomplea that exceed the maximum(and/at minianum to appropriato) i <br /> Ply F[RMIT NUMOER DIS SIC . prnnil cendlllona In Ihr columns IabrlcA"tin. ftx." If none,roleLATITU DF GITUDE a, Specify frryucncy of analysis for each parameter satin. analyses/No. days. (e.g., A equl va• <br /> enter 'NA". <br /> t <br />'.� 12e-211 122.231 Imam Ita-2T1 12a•241 I—3n - lent to 3 analyses portnmred every 7 days.) If continuous enter"CONT." + t <br /> S. Specify sample typo("grab"or"_hr. Composite")as applicable. If frequency was continuous, f" <br /> •- <br /> REPORTING PERIOD: FROM TO 0 6. Appropriate signature Is required on bottom of this form, ft, <br />,M1 YEAR MO DAY YEAR MO DAY 7. Remove carbon and retain copy for your records. <br /> [ <br /> 8. Fold along dotted!Ines, staple and mail Original to office specified In permit. <br /> (3—d Imly) _._.__., Iaraal lag-T01 i <br /> QUANTITY (lcerdsnly) CONCENTRATION 1 1 4 <br /> IYkAM tsa-am _�2e•am reran IA-N /srsN FREQUENCY -.. <br /> �Nf flg 1R)PP Yf PARAMETER ut0. 1 ra-4m Ia2-aa OF [AMPLE e <br /> MINIMUM AVERAGE MAXIMUM UNITS EX MINIMUM AVERAGE MAXIMUM UNIT[ NO' TYPE Rd,. <br /> nepon TRO EX ANALYSIS ff <br /> 1 PERMIT <br /> CONDITION �.. <br /> REPORTSO <br />� PERMIT <br /> tCONDITION <br /> I1 AA� REPORTED � - �+ c� <br />.Ir�rl lr PERMIT <br /> 1. <br />+{ �; CONDITION NO RF1 ORTEn _DT.CHARGE DIM ING RFPOT TIN(; TIM On <br /> I REPORTED - - '- <br />} i PERMIT <br /> CONDITION <br /> I ' REPORTED t <br /> 1 <br /> t , �!t, PfiRM1T <br /> CONDITION <br /> REPORTED <br />'Ir�lrr PERMIT - - ........ r <br /> CONDITION t �1rIMMh <br /> REPORTED 1 l <br /> i <br /> i PERMIT <br /> V <br /> r CONDITION 1 { I <br />{ REPORTED _— _ <br /> PERMIT <br /> ' CUNDI TION �� <br /> 1 � <br /> NAME OF PRINCIPAL EXECUTIVE OFFICER TITLE OF THE OFFICER DATE <br /> I certify that I am familiar with the information contained In this <br /> Reeves, J.A. EXOClltiVO Vice President 7 6 ? report and that to the beat at my knowledge and belief such infor - - <br /> Italian is true,complete,and accurate SIQNATURE OF PRINCIPAL[XECUTIVC <br /> LAST FIRST MI TITLE YEAR MO DAY OFFICER OR AUTHORIZED AGENT ' FF <br /> EPA Form 3220•1 00.74 � <br /> PAGE OF + 1' <br />