1987-12-01_PERMIT FILE - C1981017 ‎(145)‎

• Permit No: C1981017
• IBM Index Class Name: PERMIT FILE
• Doc Date: 12/1/1987
• Doc Name: 1987 Annual & Hydrology Report ‎(part 22)‎
• From: Mid-Continent Resources
• To: DRMS
• Media Type: D
• Archive: No

PERMITTEE NAM DRESS (Include NATIONAL POLLUTA ' ISCHARGE ELIMINATION SYSTEM(NPDE$) orm Approved
Far-ilityName(Locati fferent) I DISCHAR ONITORING REPORT(DAIR) MBNo.2040-0004
NAME � (2• 17-19 ,
--- t.------------- — Approval expires 9-30-85
ADIiRE§8' j I '
--------------------
• y
PERMIT NUMBER DISCHARGE NUMBER
I
--'— __'f"'------------ MONITORING PERIOD
FACILITY
— ---•T—i-• —^------------ YEAR MO DAV YEAR MO DAY
LOCATION
I FROM TO r
)' (20.21) (22.23) (24-25) (26.27) (28.29) (30-31) NOTE: Read instructions before completing this form.
I (3 Card Only) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION
PARAMETER 46-53 NO FREQUENCY SAMPLE
(32-37) >< ( ) (54-61J (38-45J (46.53J (54-61J EX ANAOF
LYSIS TYPE
AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 62-63 (64-68) (69.70)
i SAMPLE
MEASUREMENT
y + PERMIT 1- ./ T, :$•°••, ow . 1
t ,1 REQUIREMENT 1 '
SAMPLE -
' MEASUREMENT '
+. PERMIT °, . „� _ v •, ,S>w,' +.Y ., :{+
REQUIREMENT ;;r z•, "'`'� -
SAMPLE o
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MEASUREMENT
PERMIT
REQUIREMENT
4
SAMPLE - -
MEASUREMENT
PERMIT
r _ _ REQUIREMENT
1
-" •• 1 r- SAMPLE
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PERM) .F-r `a z. r3'i..:,•, 'as. :'i.r,I,F, . ice`,»+'.$,. i, + '^,:+
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i I I •�t'.,fT..�:: SAMPLE ' - , 1 -
MEASUREMENT
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.t. REQUIREMENT
NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIPY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED TELEPHONE D A T E
AND AM FAMILIAR WITH THE INFORMATION SUOMITTED HEREIN AND ■ASED '
ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
a t OETAININO THE INFORMATION, 1 BELIEVE THE SUBMITTED INFORMATION
I. TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIG- '
NIPICANT ALTIES FOR SUBMITTINQ FALSE INFORMATION. INCLUDING
__ -_�•.�•,___ THE Fo as IBILITY of FINE AND IMPRISONMENT, sEc n U.S.— $ Im1 wND SIGNATURE OF PRINCIPAL EXECUTIVE
)] u.s.c. § I S19. (Penalties under these statutes may include fines up to$10,000
TYPED OR PRINTED andJor maximum imprisonment ofbetween 6 months and 5 years) OFFICER OR AUTHORIZED AGENT AREA NUMBER YEAR MO DAY
CODE
;OMMENT AND EXPLANATION OF ANY VIOLATIONS (Referencc all attach mentshere)
--PA Form 3320-1 (Rev. 10-79) PREVIOUS EDITION TO 'IE USED (;t GF'L:,�LS EPA :=0:?f.5 T-10 I,HICH MAY NOT LE USED,; PACE GF
UNTIL SUPPLY IS EXHAUSTED.