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PE$M'TTEE N DRESS (Include NATIONAL POLLUTANT BARGE ELIMINATION SYSTEM proved. <br /> Pan6t) Nunle/A I dif)oent) A L DISCHARGE ITORING REPORT I041R) 2040-0004 <br /> NAME-- w_•= — ----------- ('-lel (17.191 e/expires 9.50-35 <br /> ADDRESS_1300,South the ----------_ <br /> Fla staff Arizona 86001 PERMIT NUMBER DISCHARGE NUMBER <br /> -----n—I',r—, -11—A, --------------- MONITORING PERIOD <br /> FACILITY--'S.L Cj. j IAL�-------------- YEAR MO I DAY YEAR MO i DAY <br /> LOCAT—ION————————————- <br /> -——————— FROM 87 07 01 TO 87 09 30 <br /> -- (10-2() (21.13) (24-13) (2617) 1.+-:91 13o-31) NOTE: Read instructions before completing this form. <br /> (3 Card Only) QUANTITY OR LOADING I(4 Card Only) QUALITY OR CONCENTRATION <br /> PARAMETER (46-53) (54-61) (38-45) (46-53) (5"l) NO. FREQUENCY SAMPLE <br /> ><� OF <br /> (3I-37) EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 61.63)I (64-68) (69-70) <br /> �j�j G' tr1S UAL SAMPLE <br /> MEASUREMENT No Dischar e <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE C� <br /> MEASUREMENT <br /> PERM ET <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> n SAMPLE <br /> • I MEASUREMENT <br /> N <br /> .__. - PERMIT - <br /> REQUIREMENT- , <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREM8NT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT - <br /> NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED i TELEPHONE D A T E <br /> AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN AND BASED ' <br /> ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br /> James S. Lunan OBTAINING THE INFORMATION I BELIEVE THE SUBMITTED INFORMATION =i��/ �� `✓i�T�Y <br /> IS TRUE ACCURATE AND COMPLETE I AM A-ARE THAT THERE ARE SIG <br /> NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION INCLUDING <br /> Manager, Permits THE POSSIBILITY OF FINE AND IMPRISONMENT SEE USC S 1001 AND• SIGNATURE OF PRINCIPAL EXECUTIVE 602 774-5253 67 10 21 <br /> 33USC $1319 •Yrna III.•. umrr tFro uamu•. mo. nlludr nnr• uv t., flllt <br /> TYPED OR PRINTED utW ur manmunr mrPru..n noon rd Mmwn n nnrn t.,and i.rc r. OFFICER OR AUTHORIZED AGENT AREA NUMBER YEAR MO DAY <br /> COMMENT AND EXPLANATION OF ANY VIOLATIONS (Re/erence ull utimOtments here) <br /> PA Form 3320-1 (Rev. 10-79)PREVIOUS EDITION TO BE USED (REPLACES EPA FORM T-AO WHICH MAY NOT BE USED.) PAGE OF <br /> UNTIL SUPPLY IS EXHAUSTED <br />