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 NAME/ADDRESS (Include NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved
Paoli ' me/La if dlgerent) DISCHARC ONITORING REPORT(DMR) IMB No.2040-0004
NAME-- H (;ONT I';vt '' t ---- ( 17-19)
•xpires 2-29-84
ADDRESS i3 . 11 'rS(�X(( �i'��--------- ••��
{,Gr{tkll('Y1//4),7 PERMIT NUMBER DISCHARGE NUMBER
--------------
------- --T--------------- MONITORING PERIOD
E&9-1LII.Y--._ -------------- p YEAR MO DAY YEAR MO DAY
LOCATION
FROM TO O
�---------_____ C O
(20-21) (22-23) (24-25) ( 6• ) (28-29) (30-31) NOTE: Read Instructions befor*completing this form.
' (3 Card Only) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION
PARAMETER (46-53) (54-61) (38-45) (46-53) (54-61) NO, FREQUENCY
PARAMETERSAMPLE
(32-37) EX ANALYSIS TYPE
AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 6263) (64fi8) (69-70)
' I ! SAMPLE +
Fp LIj( f,pT MEASUREMENT rr } a t + « p r
I i ,
f►ERMI ET
17 (? t) ilBQil1I�E3MEElIT t; wk 3 9r fie xl 4€ M �' k ? A b, 'i #'
-�-��q. SAMPLE
t`1')�jd �' ^— •1 ^--•�� •�k MEASUREMENT
(C irf (: jY- ► } I MRMIT
(�i1��?s!'I IYEQV1p�Mr31VT :_ r• ,E, E » .� r « k' t �e �& �`.� .l ,. � ,�'�1,3 ( i
SAMPLE
RS(:3V i )� •^lY MEASUREMENT
PgMM I I I
y,
l SAMPLE
r3!)•• �;( if MEASUREMENT • c +.
PERMIT
() )1(:) PIEgE3II�IMlgt4l s r t x w •I n >e a ** s",e:
SAMPLE l
I)I(•, '� (!Ft F a+SS�. MEASUREMENT
i
V i 0 t Pg3tM17 /
�.}tl REQUIRKMENY * + t sAt A u t - 4 f
SAMPLE
L U1%7 U-1,!(� _ ,(l{ 1 TY F./ji!- MEASUREMENT
T U:, (r F F(; jf N T) #►tiRI1RIT
`a R&QilEiZEIeIgNT A.,
_-
- SAMPLE
MEASUREMENT
I
t ,14 i PERMIT -
E'I:E(;•t11I�tEMEN'C ,
NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED - TELEPHONE D A T E
AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN AND BASED
t`el- 1�M ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
1V Y OBTAINING THE INFORMATION I BELIEVE THE SUBMITTED INFORMATION 1
1 IS TRUE ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE SIG
t •" NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION. INCLUDING y
THE POSSIBILITY OF FINE AND IMPRISONMENT SEE 18 USC f 1001 AND SIGNATURE OF PRINCIPAL EXECUTIVE
33 US 4 1319 (Penalties under these statutes may include fines up to Slop(m) _
TYPED OR PRINTED and'or maximum Imprisonment of hetureen 6 months and 5 vears.l OFFICER OR AUTHORIZED AGENT A A NUMBER YEAR MO DAY
COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) _
IF tl ()X`�CIIQT�� Gjy(;� ?!r5 (,' i 1 t j ,•, 4a} t'il} ( a.:f' is t ,
rs
SE F-
°FW91' T FOR Lt;ITr; : t,1 jl. ," 6 : , • t r „ rT'1
:PA Form 3320-1 (Rev, 10-79)PREVIOUS EDITION TO BE USED (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) PAGE OF
UNTIL SUPPLY IN RXMAIJSTffn