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PERM ITT CE LIADDRESS (In(lude NATIONAL POl' IT Ells(IIARGI 1111.1INA Elr)N Sv•,I I P-t(NN)0/ form Approved <br /> Facility Name, nlfdlllrrent) DISCH E MONITORING REPORT 11,1110 OMB No.2040-0004 <br /> tiAM¢—M ► l_I I N 1 I N LU 1 ►`_1 t A I _f,-(_L((_-_jell_____ _- _ -_'1—_ (1_ 1. _ ---_ F — FINAL Approve!expires 9-30-85 <br /> ADDREYat[IA 1 58 -------- ----- Ll.L2-11.3y,�--- --- U1� _. StGl .15 <0R=10Y14HR <br /> PE RMIT NUMBER UIsc.ARGIL NUMULIt <br /> MONITORING PERIOD <br /> FACILITY <br /> —__—.----------------- YEAR I MO I DAY YEAR MO DAY <br /> LOCATION ----- -- FROM L y L r11 TO 1' 31 M I NUR <br /> (20-21) /22-23) (2a--z5/ (26.27) (28�vT (303i) NOTE: Read instructions before completing this form. <br /> cam— — <br /> (3 Card Only) QUANTITY OR LOADING (4 Card Onll) QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> PARAMETER 7 (4b 1.?) (54-61) (3845) (46-53) (54.61) or <br /> (32-371 EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 62-63 (64.68) (69-70) <br /> PH SAMPLE # ak ## (1 **IK V e_� % <br /> MEASUREMENT v7'C gS 2 O wC \i� <br /> � i� <br /> 00400 1 0 PERMIT #***## #***aka tk,�k 6.5k*#** 9.0 W EKL.YG A8 <br /> IIENI CV411 11 <br /> REQUIREMENT - <br /> # MINIMUM MAX I MUM t I <br /> M l� <br /> SULIDS, SFTI LEAbLI: SAMPLE Xt* # • / P I O / I N vr-> <br /> MEASUREMENT <br /> 00545 1 0 PERMIT ,�,�>�**,� ***%*�Ic #Ike t� ****** REPORT 0.5 0 CE! G AS <br /> !-NT (;R,jRS VA IREQUIREMENT <br /> OIL AND GkEASE MEASAMPLE <br /> SUREMENT <br /> FREUN EXTR—IiRAV MLT <br /> 005 56 1 0 PERMIT * ,� ## *# > >� # * * #*** RL NORT 10 W EEKLYG AS <br /> r-FFI ( REQUIREMENT <br /> FLOW, IN LONW I`(y UR SAMPLE <br /> r �T-�N <br /> THRU TREATMENT LAN MEASUREMENT W�1 .�^ <br /> 50050 1 0 PERMIT R U NGKT REPORT **##** ##***# ****** * ## W EKLYI STAN <br /> REQUIREMENT <br /> SOLIDS, 16TAA/L SAMPLE �� �� <br /> DISSULVFU (MG/L MEASUREMENT — C/JLI�V v <br /> 70295 1 0 PERMIT * #** *�* * Sk## #** �o* REPORT kEPURT Q RLY GRAB <br /> _- ,l L' `` REQUIREMENT wy � <br /> UIL AND GKL-ASE SAMPLE I O AF aiL*#aX �V YF�P ## * #akV - <br /> VISUAL MEASUREMENT --</L�r� .4 <br /> I \ <br /> 0 4066 1 O PERMIT KI ►"URT # �! YL_S-1 �' T # WEEKLYV SVAL <br /> I REQUIREMENT YJ �y <br /> L j•tA_ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I vaNnrr "Nola Pl Nn T DP LwW T.wr I .wve Pew sonw ur ! MINCD TELEPHONE D A T E <br /> AND AM IT.P MILIwR W T.! INFORMATION {UB MIT TlD H •IM AN <br /> DABwt.. <br /> J,1 INOUIRr Or T.Of• INDIVIDUAL• IMMlDIw Ttl LT RC�rONf FOR <br /> pN� '};y■/ . T.! INr ATION. I AILILVC T.� 6"RM,TTLD IN.•O TION �63•_ <br /> —1' I L'A^P YY A NIN ACCUR A TfiO ND COM PL6T L. 1 AM AWwRi TN AT T.... AR. <br /> PI<ANT NALTIE9 ArOR SUBMITTING FAIL■ INroRMwTlO N, INCLUDING �E <br /> *d- <br /> ....... Iry ar .—Iso NMCNT, aS. 1• Us C. 4 loos ANo SIGNATURE OF PRINCIPAL EXECUTIVE tl�,�ralnrs under these slatules may Include files up to$10,000 <br /> TYPED OR PRINTED and/or nla.iur:unl flllpnsnnnu'nt of hctUccn6nlortth5 and 5}'earsJ OFFICER OR AUTHORIZED AGENT COEAj <br /> AR DE NUMBER YEAR MO DAY <br /> COMMENT AND EXPLANATION OF ANY VIOLATIONS (Rt'ferenee all ally L)IIIICIII]here) <br /> Ir NO UISi► ARGL ULCURS kLPUkT "NO U15CriAKGL11 FLLW IS MEAS. AJ MOO=MILLIUN GALL. PER DYA. <br /> EPA Form 3320-1 (Rev. 10-79) PREVIOUS EDITION TO RE USED (REPLACES EPA FORM T-40 WHICH MAY NOT UE USED.) PAGE OF <br /> UNTIL SUPPLY IS EXHAUSTED, <br /> C/:U��t�/Ut�2i�t�G-1527 1 <br />