Laserfiche WebLink
NATIONAL POLL UTANT,P!SCH ARG F LLIM114ATION SYSTEM <br /> • DISCHARGF ITORING REPORT <br />.J. <br /> )-(T COAL (PF7r' <br /> IL�A <br /> t-V-H'1-if)ALE INSTRUCTIONS <br /> L co 816:?3 f 1. Provide dates for period covered by this report In npa,7c,it.a,:i,-1-1,1:110P IING PEVIOT)". <br /> J 2. Enter reported minimum, average and maxi..., values -(.t:A7.`1 1TV"w,d-(-J,Nr'F-f 111', FI t I.; <br /> 44-1 a; 117-191 In the units specified for each parameter as I)', ,-! -tij, 1,,111. <br /> ---- -- asterisks. "AVERAGE" <br /> RAGE" is Overage computedo— act,.4.1 li,,, is .;i,7"di.,j:- <br /> �IC <br /> 211 3. Specify the number of analyzed samples that -xcr,,d it,,! (,,,:� ,, as <br /> P — and <br /> "MINIMUM"are extreme values observed III'tring the I,1-,1 p, <br /> I C. <br /> PERMIT NUMBERLON..Ti,np permit conditions In the columns lubeled"No. I x.- 11 iv-o, , i�-r"I <br /> Ij — 1 4. Specify frequency of analysis for each parameter as N- nnah-,iz/N- d.,vs. (tolq, 1'I/7" i- T,i-- <br /> (20-21) 122-231 (24-26) 12647) 420.291 130-31) tent to 3 analyses performed every 7 days.) If cmilintiour (int,r-('014T. <br /> S. Specify rumple type("grab"or"—hr. composite:")as appli,n1d". 11 fnsluoncy was-nfirtw-s, <br /> el enter "NA". <br /> 7 1 p <br /> w REPORTING PERIOD: FROM -1 TO -10 6. AV, form.ropriale signature is required on bottom of this form. <br /> -A. <br /> YEAR MO DAY 7. R nove carbon and ietain copy for your records. <br /> a. Fold along <br /> dotted lines, staple and mail Cirtgitjtd to offi,Is tzl,-ifi-I h,I-:;6t. <br /> t A2-37) <br /> (3.. tonly) QUANTITY (4 card only) CONCENTRATION F.!-Q U EN1.1 <br /> PARAMETER 06-451 148-530 (111�6 11 (61-431 1 36-4W -- (M-631 <br /> MINIMUM AVERAGE MAXIMUM IINITS NO, MINIMUM AVERAGE MAXIMUM UNITS I X TYPE <br /> Ex <br /> JVJ C0,4_601T 0 0. it <br /> t PERMIT MGD --------- <br /> j CONDITION <br /> REPORTED 0 a 4 It It 4 it I* <br /> ( 71J�L EiTSC;,I I LVFf,-) KG/DAY <br /> PERMIT it <br /> 5 REPORTED TYfAL 1 , i A <br /> PERMIT KG/DAY <br /> it # li # p # # # # # # # # it 30 <br /> CONDITION <br /> fOTI%L(AS Fi'-') REPORTED It It IF 0 <br /> 6-03 0.OR <br /> KG/DAY <br /> PERMIT <br /> CONDITION <br /> `1 Ii T L 1) REPORTED 51 <br /> SU <br /> W FERMI T <br /> CONDITION 6.ft <br /> �11L 4 G:?EAS)EtVISUAL REPORTED <br /> PERMIT <br /> CONDITION VT <br /> REPORTe6 <br /> PERMIT <br /> CONDO TION <br /> REPORTED <br /> PERMIT <br /> C ON III TI N <br /> NAME OF PRINCIPAL EXECUTI OFFICER TITLE OF THE OFFICER DATE <br /> (teal I alit familiar with the information contained in this <br /> i�-� j OHN /I ppc-sibraiv r report and that to the beef of my knowledge and ballet such infor- <br /> madon Is true, complete,and accurate. SIGNAII-IRE OF PnI14CIPAL EXECUTIVE <br /> LAST FIRST MI TITLE YEAR MO DAY OFFICER OR AUTtIORIZEO AGENT <br /> EPA For.3320-100.72) ORIGINAL PAGE I OF <br /> (.'Nt IS 'ETTLFn HTNE NFATER FROM 0LJTC H CREEK ANY SINGLE GRAB CANNOT EXC <br /> F E 0 49 FO,-� TSS <br />