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PIHMITIH[ E/ADUREYII Ile.lade NATIONAI 1-01I ll DIRCHARGF. LLIMINAIION UYh11M jAPlll.l) orm Approved, <br /> f ucdiri Aam Non rI dlgrrent) DISCHA MONITORING REPORT (1)47R) IMB No.2040-0004 <br /> NAME— •_.1-00NTINENT CUAL 6 CLIKECU_--- (2-1h) (17-19) F - FINAL Approval sxpires9-30-85 <br /> AD-- COX 1 ____1 _ 00000396 [D SC 0R BA SE(;T.9 *OR=10YR2HR <br /> CAREiONDNDALE CO B 1623 PERMIT NUMBER IIHAGE N <br /> ————————————————— ———— MONITORING PERIOD <br /> EA9 16 MY————————————————————— YEAR MO j DAY IYEARI MO I DAY <br /> LOCATION FROM TO --- - MINOR <br /> ATTN: DOUGLAS BOWMANt ENV C(- RD (20-21) (zz-z3) (24-25) (2627) (28-29) (3e-il) NOTE: Read instructions before completing this form. <br /> (3 Card Onl)) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION <br /> PARAMETER (46-53) (54-61) (3845) (46-53) (54-61) NO. FREQUENCY SAMPLE <br /> of <br /> (32-37) EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS>< (6263) (64-68) (69-70) <br /> PH SAMPLE ***** <br /> MEASUREMENT <br /> 00400 1 0 PERMIT ** *** *** ** ** 6.5 ***** 9.0 W EEKL GRAB <br /> EFFLUENT 6RU SS VA L EQUIREMENT **** <br /> SOLIDS, SETTLEAaLE SAMPLE ***** ***** <br /> MEASUREMENT <br /> 00545 1 0 PERMIT ****** ***#* * * ****#* REPORT 0.5 ONCE/ GRAB <br /> EFFLUENT GROSS VAL. REQUIREMENT <br /> OIL AND GREASE SAMPLE ***** **** ***** <br /> FREON EXTR-GRAY MET EASUREMENT <br /> 00556 1 0 PERMIT ****** * **** ****** REPORT 10 W EEKL GRAB <br /> EFFLUENT EQUIREMENT ** <br /> FLOWI IN CONDUIT UR SAMPLE ***** #**# ***** <br /> THKU TREATMENT PLAN <br /> EASUREMENT <br /> 50050 1 0 i <br /> PERMIT IJE�ORT REPORT **** * ****** ****## *** WEEKL INSTA <br /> EFFLUENT GROSS .REQUIREMENT <br /> .r, <br /> SOLIDS, TOTAL SAMPLE LE_ ***** <br /> DISSOLVED (MU/L ) MEASUREMENT <br /> 70295 1 0 PERMIT ****** *** ****** REPORT REPORT QTRLY GRAB <br /> V EOUIREMENT * <br /> QQnA AV Mr- <br /> OIL AND GREASE SAMPLE **** **##* ***** **** <br /> VISUAL MEASUREMENT <br /> 84066 1 0 PERMIT R EP+URT ****#* ES=1 ****** ****** *****# **** WEEKL VISUA <br /> EFFLUENT GROSS VAL <br /> EQUIREMENT NCI=n <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 TELEPHONE D A T E <br /> AND AM FAMILIAR WITH THL INFORMATION SUBMITTED HEREIN AND BASED <br /> �`/DJ A ON MY IN OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBI F FOR <br /> V )V11 OBTAINING THE INFORMATION 1 BELIEVE THE SUBMITTED INFORMATION 7iw1 r'^ <br /> 15 TRUE ACCURATE AND COMPLETE 1 AM AWARE THAT THERE ARE SIB <br /> l.� THENIFtCANT PENALTIES FOR SUBMITTING FALSE INFORMATION U5DN INCLUOINr; <br /> THE SC Is 1 19 OF FINE AND IMPRISONMENT SEE IB USC S IOOI AND SIGNATURE OF PRINCIPAL EXECUTIVE <br /> 33 USC S 1719 rPrnnliu, ndr. rhr,r sla lun, nr iudr hn., up n� flu nru, <br /> u nun I <br /> TYPED OR PRINTED or,uuo,r /A,mr,nFmnnth,and ,.,•ur., OFFICER OR AU7 HORIZED AGENT AREA NUMBER YEAR MO DAY <br /> CODE <br /> COMMEN r AND EXPLANATION OF ANY VIOLATIONS (Reference all aria.haunts Isere) <br /> IF NO DISCHARGE OCCURS KEPORT "NU DISCHARGE". SALINITY SHALL UE MEAS.AS TDS=70295 MG/L. <br /> O&G NOW 2 PRAM.NU SHEEN:84066=01, 5:6=0.A SHELN:84066=1 „ 556=GRAB SAMPLE. !•:f A Form 3320-1 (Rev. 10.79)PREVIOUS EDDI ISON TO BE EXHAUSTED D (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.1 006 1 1V 06 �'�1�J'7 6 PAGE 1 01- <br />