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PERMITTEE E(ADDRESS (Include NATIONAL POLL IT DISCHARGE ELIMINATION SYSTEM(NPDES) <br /> Facd(tyName/Location Ifdlfferent; DISCHAkGE MONITORING REPORT/DMR) <br /> 2.16 17-19 F - FINAL <br /> AOBRcfp�_Q U-La9A____________ 00039135 TOTAL DISCHARGE FACILITY <br /> PERMIT NUMBER DISCHARGE N UM BER <br /> ---��'� A—� -------- —��z MONITORING PERIOD <br /> FACILITY YEAR I MO DAY I YEAR MO I DAY <br /> LOCATION FROM TO ,, :9INOR PITKN <br /> A TT N: DOU G L A S W BOWMAN (20-21) (22.231 (24.23) (26-27) (28-:9) (30-31) NOTE: Read instructions before completing this form. <br /> (I Card 0n1)) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION <br /> PARAMETER (46-53) (54-61) (3845) (46-53) (54.61) No. FREQUENCY SAMPLE <br /> >< EX ANALYSIS <br /> TYPE <br /> (32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> .II, .y.A. 61-63) (64�8) (69-70) <br /> . YYYY-� YYYY'r` <br /> PH SAMPLE r•.- rY <br /> MEASUREMENT ,+ py� <br /> 00400 1 0 O PERMIT 'rT A`r�r # �3 r #; v 6. 5 YJ` 9.0 WEEAL GRAB <br /> EFFLUENT GROSS VALUeEEQUIREMENT Y �+nF MINI:= MAXIMUM SU <br /> SOLIDS, TOTAL SAMPLE v�r .�v• YM ~'�i-J <br /> SUSPENDED MEASUREMENT ! <br /> 00530 1 0 0 PERMIT Y REPORT REPORT ONCE/ GRAB <br /> EFFLUENT GROSS YALU EQUIREMENT# 1�A <br /> SOLIDS, SETTLEABLE SAMPLE Y rY,�AY YMYYY ,'k Y`rYY <br /> MEASUREMENT <br /> 00545 1 0 0 PERMIT #++ #. # - $ #Y ####�G# OPTIONAL REPORT ONCE/ GRAB <br /> EFFLUENT 'GROSS VALU £QUIREMENT vv I A <br /> OIL AND GREASE SAMPLE YYYY +,EY Y 'nFr,'JIYY# <br /> FREON EZTR-GRAY MET rEASUREMENT <br /> 00556 1 0 0 PERMIT OPTIONAL 10 WEREL GRAB <br /> EFFLOEN_T GROSS YALU eEQUIREMENT � # <br /> IRON, TOTAL SAMPLE # r #Yv�#► �#Y## <br /> (AS Fc) MEASUREMENT <br /> 01045 1 0 O PERMIT # # ####zk# ## ###### REPORT REPORT ONCE/ GRAB <br /> EFFLULENT GROSS A EQUIREMENT � # A Y <br /> FLOH, IN CONDUIT OR SAMPLE YY�iY .�•�A- ~rA- v '�f rA► <br /> THRU TREATMENT PLA NtAEASUREMENT — <br /> 50050 1 0 0 PERMIT REPORT REPORT ###### # ###$ ###### ###y NEELL INSTA <br /> EFFLUENT GROSS Y EQ INST fix <br /> U UIREMENT r•D #Y## <br /> SOLIDS, TOTAL SAMPLE <br /> DISSOLVED (MG/L) MEASUREMENT <br /> 70295 1 0 0 PERMIT ### # # #M#,�#XX REPORT #iEPOR? QTRl.Y GRAB <br /> EFFLUENT S V LUJt£QUIREMENT Y*# <br /> i' .w <br /> NAME/11TLE PRINCIPAL EXECUTIVE OFFICERJ I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED TELEPHONE D A T E <br /> AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN AND BASED ` <br /> ON My INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY Rf SPONSIBLE FOR /� <br /> OBTAINING THE INFORMATION 1 BELIEVE THE SUBMITTED INFORMATION ?/ram•� <br /> IS TRH IF ACLURATE AND COMPI FTE I AM AWARE THAT THERE ARE SIG •��///���•••///"' (/Y <br /> NIFICANT PENALTYS fOR SI'BMITTING FALSE INFORMATION INCL1IDING , / f <br /> /---+� THE PL)'ti191LJI e OF FINE AND,IMPRISONMENT SEE IB USC 4 1001 AND SIGNATURE OF PRINCIPAL EC UTIVE <br /> 33 USI I. I)19 '1'.on lU.. unde (hr.e 5(a(nlr� rr,n� ulrlwfr 11ne� up (" $/110 r <br /> TYPED OR PRINTED 'n.f�n ma unwm urrpn+"nrn.ol('d h.nr ern 6m'Inth.nnA i var.r OFFICER OR AUTHORIZED AGENT AREA NUMBER YEAR MO DAY <br /> ICODE <br /> COMMENT AND EXPLANATION OF ANY VIOLATIONS (Rrlrrenee (1ll ulhuhnu'ntl heri) <br /> IF NO DISCHARGE OCCURS 'REPORT NO DISCHARGE ON TOUR DMR. OIL 6 GREASF NOW 2 PARAM, NO SHEEN: 84066=0, <br /> -- O-i 556=0, A SbHEEN: {84066=1, 556=GRAB. SALINITT [TEAS. AS TDS. TSS,SETT.SOL, E IRON NO LIMIT PREPRINTED O <br /> E'•� il <br /> _WV (El r'T�IFUTIII RIUI l Ic�HAUST o NFPLACES EPA FORM T-40 WHICH MAY NOT BE USEEt I PAG% OF <br />