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

:RMITTEE NAME/ADDRESS (Inciude NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM(NPDES1 Form Approved
cilityName/Location"lijer'_ent) DISCHARG'- ONITORING REPORT (U,11R) MB No.2040-0004
4 ME-__ - --_-- (2-1 17-19 -- pproval expires 9-30-85
z �•`• PERMIT NUMBER DISCHARGE NU-.ER
I + ,
--- T------------- MONITORING PERIOD
A.CIL.ITY I
' ------------- YEAR MO p9_
EAR MO DAY
DCATION ' I FROM TO _ - -
.+ (20-21) (22-23) (24-25) (26-27) (28.19) (30-31) NOTE: Read instructions before completing this form.
(3 Card Only) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE
PARAMETER (46-53) (54-61) (38-45) (46-53) (54-61) OF
(32-37) I >< EX ANALYSIS TYPE
j AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 62-63 (64-68) (69-70)
I ' SAMPLE
iMEASUREMENT
vPERMIT •�,, a '� -�; ',zu .. „,ws,;z,z, ,+ <, ;;`£,,, ,.„, F •4.
REQUIREMENT
SAMPLE .
MEASUREMENT
1 q
i' PERMIT
REQUIREMENT
.• _.11 ,» SAMPLE
MEASUREMENT '
PERMIT
REQUIREMENT i. w �`.':•, ro ,. -
r
`* > t •- SAMPLE r
MEASUREMENT
' - PERMIT + +;„,+',. ,,4,' < .i+e. i,x m✓ w .• , +
REQUIREMENT ,.• q? 'a t
r _ y
` Y SAMPLE
1:I MEASUREMENT
PERMIT ` .. ,r . 'q 4 t •ek ., „' s , ;t .,`� ., . M „, ,
t • _ REQUIREMENT • $ ,
SAMPLE
MEASUREMENT ( .y
{1 PERMIT'
REQUIREMENT w _°; •/ 3,� ,
SAMPLE
MEASUREMENT
PERMIT '�+ :#!JfS,+?.z.%°;�.:.s .;i yj.s s';•j: •�. .SOn{,' ;ri, ,
REQUIREMENT
4ME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED TELEPHONE D A T E
AND AM FAMILIAR WITH THIS INFORMATION SUBMITTED HEREIN AND BASED
ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR `
' - + OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION '
IS TRUE, ACCURATE AND COM►LETB. 1 AM AWARE THAT THERE ARE SIG-
NIFICANT FENALTIES FOR SUBMITTING FALSE INPORMATION, INCLUDING
THE POSSIBILITY OF FINE AND IMPRISONMENT. SEB 13 U.S.C. 4 IO41 AND '
SIGNATURE OF PRINCIPAL EXECUTIVE
as u.S.e• 4 1319. (Penalties under these statutes may include jives up to$10,000
TYPED OR PRINTED and)or maximum imprisonment of between 6 months and 5 years.) OFFICER OR AUTHORIZED AGENT CODE REA NUMBER YEAR MO DAY
IMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
'A Form 3320-1 (Rev. 10-79) UNTIL SUPPLY IS EXHAUSTED D )REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) PAGE OF