Laserfiche WebLink
PERMITTEI FIADDRESS 1111014de NATIONAL PUI 4T Dls( IIA1I6I_ I I IMINATION SVSILM(MVi's) Form Approved <br /> Fac111tyName ton if different) DISCH E MONITORING REPORT 4)JIR) OMB No.2040-0004 <br /> v,%ME— H I D--LONIT N Eh11 L11AL_L_LLKE_L_l1--- (2-16) 1 i-1`) F — FINAL Approval expires 9-30-85 <br /> ADDRESS}][]X jsk------_— _— -- SECT 14 <OR=10YR24HR <br /> r r PERMI [:DISf HARGE NVMUEH <br /> ------ C_U is � � T NUMBER-- --- <br /> MONITORING PERIOD <br /> FACILITY --- -A <br /> ---�—��------------------- YEAR MO DAV VCAR MU UV <br /> LOCATION FROM O 1 TO -(� ' 1 M INUK <br /> TN; _ (20.21) (22.23) (244,' (266--27) (28-29) 130.31) NOTE: Read instructions before completing this form. <br /> (3 Card On ly) QUANTITY OR LOADING (4 Gard Onr v) QUALITY OR CONCENTRATION NO FREQUENCY SAMPLE <br /> PARAMETER (4653) (54-61) (3845) (46.53) (54-61) or <br /> (32-37) ::�< EX ANA LYSI[ TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE <br /> yyyy MAXIMUM UNITS 62-63 (64-68) (69-70) <br /> PH SAMPLE7�C�*�CJ�C ** *]IC *# *TT <br /> MEASUREMLNT ,4 a..�,y ,L �y <br /> 00/T 00 1 O PERMIT �k##**I * 6�5 * # •0 N EEKLY A6 <br /> FEEII ENTGROSS VAUlF. <br /> REQUIREMENT * <br /> SOLIDSs SLTTLEAbLE SAMPLE <br /> MEASUREMENT <br /> 00545 1 0 PERMIT ****, * *** ##�x * * REPORT 0.5 D E/ 8 <br /> REQUIREMENT <br /> EEELUHNT/ G�GREASE <br /> ' <br /> OIL►��A�ND GREASE SAMPLE �pc spl,I,c##T #TTT '�****� <br /> FrR�ELGJi,�• EXTR-6RAV ML:T MEASUREMENT (� ` y p <br /> OVS Sb 1 0 PERMIT �c�c�c�c>Fc 17k #* ** * REPORT 10 REEKE[■ AS <br /> REQUIREMENT <br /> FFFII <br /> L, <br /> 1 i'RIIS$ —._._._ _ *#>� M,yX,. <br /> MGZJ <br /> FLOW, IN LUNDUIT ^UyR1 SAMPLE * * * ** #**YT'► <br /> THRU TREATMENT PLAN MEASUREMENT -- <br /> 50050 1 0 PERMIT REPOR REPORT WEEKLYZ STAN <br /> REQUIREMENT <br /> ! �1 <br /> - .�y yy_ yyyyy yy.!,�y.!.yy j4GU-- <br /> SOLIDS/ TOTAL- SAMPLE TTT'MTT TMT'►TT * ** <br /> UISSULVED (MW/L MEASUREMENT - <br /> 70295 1 U PERMIT #### * * ***#** (�REPURL{T� REPORT Q RLY AB <br /> _ /FNT - REQUIREMENT _ *4c** _ 7�lll.l�2�.Y-- y <br /> OIL AND GkEASE SAMPLE * ** #****# ****** ****** <br /> VISUAL MEASUREMENT <br /> 84066 1 0 PERMIT REPORT **#*** ES=1 N EKLYV SUAL <br /> REQUIREMENT U` I i v- -� NO= *** <br /> SAMPLE M `l <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENTI <br /> NAMEtT'TLE PRIf CIPAL EXECUTIVE OFFICER I ` Ho n ve Nn OP LAW THAT I HAVE •rw E> M�o TELEPHONE D A T E 1 <br /> Ar.r• A 'AM ILIAR WITH 1LIE INP DR MATIDN SUBMITTED HEN[INYANDAB A!¢O <br /> Y/V ��/� OB n. III NOUIRV N� TINOSfi INDIVIDUAL! IMMEDIAT¢TY RFlEON91B <br /> V v jr) Y�r VV V NO 1H[ I U t n UN I BELI[VE TH¢ IUBMIT TED INPO <br /> N!I T In NTA�00 ROOM PLlTE. I AM AWARE HAT TH¢R[N ELUDING y <br /> EENALTI¢S LUB MIT TING PAL[¢ INPOR MATIDN• <br /> t I Eo -Ie ILIrV oP nNF AND IMI RIso NM[NC !c[ n u s c. § 0a ANo SIGNAI URC OF PRINCIPAL EXE UTIVE <br /> L uwl. (Pura'ul s undl r t/Icse smnitcs may Include lures up to$1QOu0 <br /> OFFICER OR AUTHORIZED AGENT AREA <br /> TYPED OR PRINTED anu',nr ma,o w a nl mtpn t m son lncrl t of bet 6 on dl s and 5)•curst CODE NUMBER YEAR MO DAY <br /> COMMENT AND EXPLANATION OF ANY VIOLATIONS (lfer,nceallattachmentshere) <br /> IF N0 DIS(,HARGL OCCURS KLPCRT "NU DISCNNRGE11 ON YOUR UMR.FLLW IS MLAS .MGU=MILLION GALLONS PER DAY. <br /> SALIwITY MEAS.HS TUS=70295 MG/L. 2 PRAM FUR ULG 10 SHEEN :84066=01,55b=01A SHE LN:84066=1 ,556-GRAB SAMPLE. <br /> EPA Fain 3320.1 (Rev. 10 79) PREVIOUS EDITION TO BE: USED (REPLACES EPA FORM T•40 WHICH MAY NOT BL USED i ry pU PAGE OF <br /> UNTIL SUPPLY IS EXHAUSTED. 0040``,/08 2886-1527 1 <br />