Laserfiche WebLink
PERMITTEE E/ADDRESS (Include NATIONAI 110I- 41 111- IIAI?I E 1 I IItINn PION SYSTF M�.�11/1,1f Form Approved <br /> FacdttyName/, wnifdifferent) DISCH, E MONITORING REPORT (1111R) OMB No.2040-0004 <br /> ±!^_ME—MLIi=.Wt111LIEAL_LJAL__L__LC[LE___GAJ_--- _ 12-16L _(17.11)) F — FINAL Approval expires9-30-85 <br /> A_CDREs')2Q0_I.��--------_—__---_ 4S741S St,_ SECT. 21 EFFECT AT ALL TIMES <br /> PERMIT NVMBER F I <br /> scHARCE NUMIILR <br /> -------------------- MONITORING PERIOD <br /> ITY - --- —— —- _ — <br /> —ACI LI----------------------- FROM YEAR MO TO I,I�ii <br /> Y DAY YEAR MO DAY r1Uf� <br /> LOCATION ------_ '�"8 MINOR <br /> p _ (20-21) (112-23) (24 25) (26.27) (28.29) (30-311 NOTE: Read instructions before completing this form. <br /> (3C'ardOil/),) QUANTITY OR LOADING `4 Card Onlr) QUALITY OR CONCENTRATION rRKOUENCY <br /> PARAMETER (46-53) (54-61) (,?8 as) (46-53/ (54.61) NO. of SAMPLE <br /> (32-371 — EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 62-63 (64.68) (69.70) <br /> —>< <br /> PH SAMPLE * *I"� <br /> MEASUREMENT <br /> OU400 1 0 PERMIT ** ** ** * *�o�#* �,.5 — -- - — * -9.0 M EKLYG ASS <br /> REQUIREMENT <br /> SOLIDSr,, TOTAL SAMPLE <br /> SUSPENUED MEASUREMENT --- — /+ <br /> 00530 1 V PERMIT $7C.*# *** ## %7d•** 35 — 0 ONCE/ G B <br /> UENT (z�I��_ V REOUIREMENT <br /> _ _ _ UUA__/4.Y- __—_7E)A_ _SzL <br /> OOIL(-�ANU GKLASt SAMPLE * �y.--.. * *y_ * _ _- ***- -- <br /> FREON LXIF,—GRAY MET MEASUREMENT - <br /> 005F6 1 0 PERMIT �x **## �x#�z ** ** REPORT 10 W EKLYG AB <br /> SS <br /> p( <br /> , Uf LN1 ( O REQUIREMENT <br /> IRON, TOTAL SAMPLE ���•� ���•'��� �����* <br /> {, (AS <br /> rE ) MEASUREM T ,I,, — '1 <br /> 01045 1 r 0 PERMIT * T * * * k ** *** 1.V 200 Q E/ GRAB <br /> EFFLI I REQUIREMEY T 30# A AV <br /> FLOW, IN LUNUUIT OK SAMPLE S*#* * * ** ***** <br /> THRU TREATMENT PLANI <br /> MEASUREMENT <br /> 50050 1 U PERMIT REPORT REPORT W EKLYI STAN <br /> (-� <br /> (;RUSS VAL REQUIREMENT l ST u MGD ** <br /> SCLIDS9 TUTAL SAMPLE 7a* 70[ T* kl"` * *** * <br /> UISSOLVED (MG/L) MEASUREMENT <br /> 70295 1 r✓ PERMIT ** *z� *** * �wx* ****** REPORT REPORT QTRLY GRAB <br /> EFF ULNJ GROSS A LU REQUIREMENT — 70 A y�. G/L <br /> OIL AND GKLASE SAMPLE <br /> VISUAL MEASUREMENT — <br /> 84066 1 0 PERMIT R LPORT" *#**** ES=1 ****** **** * *** * ** W EKLYV SUAL <br /> EEFLUENT -GROSS <br /> REQUIREMENT O=0 <br /> NAMEITITLE PRINCIPAL EXECUTIVE OFFICER 1 c RnFr unDHR P nALT1 or LAW THAT 1 Hw11 11"11 ALLr 1 n11 TELEPHONE D A T E <br /> _ MILIAR WITH THH INFO MATION 5—MIT-10 H—IN AIDA1w�HD <br /> �N,1✓ ��� ' SRC oM"I�o�IRr THDSH IN DIYIDDALH INMIDIAT1Lr T"I I-HIDL1 FDR ��Q ��c�^ <br /> erw Ina RMwnoN, 1 eeueve TH1 HU RMrtrHD o AnoH C <br /> IH TRIU1, AI 1 HDA ND CDM FLIT_, 1 AM AWARH THAT THHRH AR1 H a- _- 1 <br /> LHH In FDRM UTq I D <br /> "uFOHH1eII�ror rINHRAnO BMrNIsoNMCNr. 1HH 1� 4n fool ANo SIGNATURE OF PRINCIPAL XECUTIVE <br /> s (, ( �/(/ [ +:.e, y 1�1,,. IPrnalnrs under these•smnees may m</udc Jules up to SIU,000 <br /> TYPED OR PRINTED ardor nlaAarlunlmlrrlsorinlrntofhetK�e(n6monthsarldsycars) OFFICER OR AUTHORIZED AGENT AREA CODE I NUMBER YEAR MO DAY <br /> COMMENT AND EXPLANATION OF ANY VIOLATIONS (Referencc•all attachinentshere) <br /> IF NO DISCHARGE OLLURS KEPi2KT "NU UISCHARGE" ON YUUK UMK.FLLIW IS MLAS ,AS MGU=MILLIUN GALLONS PER DAY. <br /> �SyAALLI-NITY MEAS.AS TUS=70295 MG/L. 2 PRAM FUR ULG NO Si-iEEN :b40b6=0,556=0 ,A SHFEN:84066=11556=GRAB SAMPLE* <br /> F'4ir.l�t; • PREVIOUS EDITION TO III U',L D (RLPLACCS CPA FORM T 40 WHI( H MAY NOT BE USCO.) ,1 /�O n PAGE OF <br /> GGG��r!l1111 / UNTIL SUPPLY 15 LX14AUSI LD. Q 0 1,J b/0 V 2V 8o-1527 1 <br />