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PERMITTEE /ADDRESS (llulmle NATIONAL P01I IJT DISCHARC.F ELIMINATION SYSTEM 1•`l'lyl.1) Form Approved. <br /> Faala) Name Ion 0 diYerenl) DISCHAR ONITORING REPORF (I)NIR) 48 No.2040-0004 <br /> NAME_ M1.J—CUNTINENT_I LIAL_& LLIKE Cu (. r (17-19) CF — FINAL pprove/expires9-30-85 <br /> ADDRESB_BUX_158 8 _62 — — 1,o 0003yb 0`�=� SELT 11 f<OK=10YR24HR <br /> CARBGNDALE CU V 162� PERMIT NUMBER DISCHARGE NUMBER <br /> ------------------------- MONITORING PERIOD <br /> FACILLY--------------------- YEAR MO DAY YEAR MO DAY <br /> LOCATION FROM TO 8§ 14 ; M I NUR <br /> ATTN: DUUbLA:. BOWK0 LNV CUORO (20-21) (22-23) (24-25) (2(,21) (2X-29) (I0-31) NOTE; Read instructions before completing this form. <br /> (3 Card Only) QUANTITY OR LOADING 14 Card Only) QUALITY OR CONCENTRATION <br /> PARAMETER (46-53) (54-61) (3845) (46-53) (54.61) NO. FREQOUFNCY SAMPLE <br /> (3137) EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS>< (62-63) (64-68) (69-I0) <br /> PH SAMPLE <br /> MEASUREMENT <br /> 00400 1 0 PERMIT ****** *�x *** *** 6.5 ****** 9.0 WEEKL GRAB <br /> EFFLUENT -RG VALUEREQUIREMENT * * <br /> W W-A, MAX INLIM RLJ <br /> SOLIDS 9 SETTLEABLE SAMPLE * ** ***** •* <br /> MEASUREMENT <br /> 00545 1 0 PERMIT ****** ****** * ****** REPUKT 0.5 ONCE/ GRAB <br /> EFFLUENTREQUIREMENT <br /> OIL ANV GREASE SAMPLE * ** ** ** <br /> FREGN EXTR-6RAV MET EASUREMENT <br /> 00556 1 U PERMIT ****** ** ** * ****** REPORT 10 WEEKL GRAB <br /> EFFLUENT EQUIREMENT ** <br /> FLOWS IN CONDUIT Ok SAMPLE ***** ***** ***** <br /> THRU TREATMENT PLAN <br /> EASUREMENT <br /> 50050 1 0 PERMIT R REPORT ****** ****** ****** *** WEEKLY INSTA <br /> EQUIREMENT <br /> SOLIDS* TUTAL SAMPLE * * # ** ***** <br /> DISSOLVED (Mb/L ) MEASUREMENT <br /> 70295 1 0 PERMIT �**�** ****** *** ****** REPORT REPORT QTRLY GRAB <br /> EFFLUENTEQUIREMENT QnnA AV <br /> ** <br /> OIL AND GREASE SAMPLE ***# *** * *** * ***** <br /> VISUAL MEASUREMENT <br /> 840b6 1 0 PERMIT REPORT ****** ES=1 ****** ****** ****** **** WEEKL VISUA <br /> F F UENT .REQUIREMENT <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 THE INFORMATION SUBMITTED HEREIN AND BASED <br /> .F ON MV INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR (yam <br /> J ©��v/ �U�S OBTAINING THE INFORMATION I BELIEVE THE SUBMITTED INFORMATION / <br /> 15 TRUE ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE SIG <br /> NIFICANT PENALTIES FOR SUBMITTING FALSE IN ORMAlION INCLUDING <br /> THE POSSIBILITY OF FINE AND IMPRISONMENT SEE 18 USC S 1001 AND SIGNATURE OF PRINCIPAL EXECUTIVE <br /> 33 U S C S 1319 IPrna III- und.•r Ihv.r era lr.u. nm1 ulrlud.• l...... up to 111U — <br /> TYPED OR PRINTED and or maumum Imp...nn .vu..r OFFICER OR AUTHORIZED AGENT AREA NUMBER YEAR MO DAY <br /> COMMENT AND EXPLANATION OF ANY VIOLATIONS (Relervare all allachnlenly heir) <br /> IF NU DISCHARGE UCCURS KEPURT "NU UISCHARGEn.SALINITY SHALL bE MEAS.AS lDS=70295 MG/L. <br /> OEG NOW 2 PRAM.NU SHLEN:8406b=0955tj=0 .A SHEEN:84U66=1 :556=GkAb SAMPLE. <br /> I'A .'wrltr 3.i 1 10-79)UNTIL SUPrr)IT ON PLY IS TO HE TEDD (REPLACES EPA FORM T-40 WHICH MAY NOT DE USFD.1 UU64tt/100686-1b46 PAGE 1 OP <br />