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NATIONAL POLLt1TA^I Vi A171,E ELIMINATION SYSTEM -
<br /> DISCHARG. JTORING REPORT rm Approvod
<br /> ,WB NO. 15S-120073
<br /> r ' rt-Cf C'i1a. (>-I1 Ff" PLAI%T
<br /> ,j LiOx ISii
<br /> CAltb')I ,)ALE INSTRUCTIONS
<br /> oil 6?3 -� 1. Provide dates for period covered by this report in spaccb malted"REPORTING.1'F'RIOD".
<br /> 2. Eatcr reported minimum, average and maximum values under "QUANMY"and"CONCENTRATION"
<br /> I r•ai 1-4-161 L17-I0 in the units apvciGed (or each PDraulctcr as appropriate DO not Inter ,aloes in boxes contain,ny
<br /> -- ------------------ ---- -- ------ ---------------- es:entiks "AVERAGE" is av,:ruge computed over actual time d,>titarge is operating. "fdAXBtUM"
<br /> „ and"MINIMUM" are ext rim L nt;e values at during the reporting period
<br /> rJ �' I I I 3. Specify the number of unalyzed samples that exceed the max,mum(an Vor nunm,wn as approl,nata)
<br /> S7 — PENMI r NUMBER DIS SIC LATITUDE LONGITUDE pi:nnit cundiltons to the columns labeled"No. Ex." 1(nofw, ,w rr "0".
<br /> 4. Spey iiy &eltucney u(amity sro fu, each Parameter as No. an alysesr tin da�•s (r "3/7" re equtva-
<br /> - - -----' --- — --- -- --- - a
<br /> 12n-2II 122-t al 124-251 12a•271 tta-2DI I10• t) lent to J analyses V-Itwned every 7 days) If continuous enter"CON C "
<br /> -- --- -- - y, spealfy s:.nlPle typo("grub"or"_--tor compoatte")as ry,PlicaLly if(itquenLy wan elintinuuub,
<br /> enter "NA".
<br /> REPORTING PERIOD. FROM r '1 t I 1 TO �(' I 4 b.
<br /> MO
<br /> MO YEAR O Appropriatn signature is required on LntWm of this form.-- -�—"-"� `�-- M -�-- 7. Rem
<br /> YEAR _ DAY OAV o ve cin Lon and retain copy for your records.
<br /> H. Fuld along dotted Nine:, st,+ le and mail On•inal to ollice s rclfn d n.
<br /> P 6 P p�••,:i,
<br /> 13 a-D71
<br /> 17 0(��a..r anti, -- --t -
<br /> QUANTITY CONC.ENTRArIGNFHECUFNCY
<br /> PARAMETER 1=a a7, ua av seta a _--___-__w .•t'ie-ab, Ian-ee• -�sa n_u____ 'c<t I OF SAMPLE -
<br /> MINiMUM AVERAGE MAXIMUM UNITS rEX MINIMUM AVERAGE MAX MUM UNI iS Nfi 1 T`i Pk
<br />• E I EX I ANA,-PSIS
<br /> h`tl t REPOR fEO _u .i V-
<br /> P E RM T
<br /> -�, �." coNUl,loN w >: a It # � � # / " A ,: .;; �} +( ,>• � ,r .. i} .; a i/7 I J
<br /> REPORTED � -
<br /> f - --------- - --- --- - --- /I ,
<br /> I � 1) LJ ) PER /C Y
<br /> 'MIT ---- -- -- ------------
<br /> CONDITION # # # T( {} T} {'+ Si 1♦ -a i} •a ,} J ,`} ,} # ,f S 7i i4 4 ,} I 3R
<br /> e, L REPORTED ,i i< K i} # ,} 4 # i+ t. to t} ti sf 0 # At
<br /> /, - - - 1 v/L {
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<br /> t11_ (i•i r i )
<br /> PERMITIt 4 It it r _
<br /> •r {r ,• `J < '' ,} ��l ,� ' I Cr)
<br /> it 11 �' •E Y: {r f 1.
<br />/ k'y±' COrD1 TION '} � � iY # ,r � # .2 .} ,} {3 F•'
<br /> ,_ `,., ,'•"'. +' HerDHTCD It a 7l t• d tl ;r 1," 0 i.
<br /> I •r I' <. f ( tlfl �l)T ,rc sr I
<br /> P EAMlr �Y
<br /> it
<br /> REPOPTID
<br /> FCi„ANT
<br /> CONGI TIOri C
<br /> r I
<br /> REPORT ED
<br /> I I
<br />, ✓EPMIT
<br /> CON UI TION i I
<br /> NAME OG-PRINa_IPAL EXECUTIVE OFFICER TITLE OF THE OFFICER — DATE ;~
<br /> __ -"-.------------'"--'--'------ ---_--- -'---H------------- -- ---,---i 1 c.,•rtlly tn.,t l am &rniltar with the Io/un,intioa, contalned in this '
<br /> / r,)j Al \ !/ �' -jI rrpart anr!that best of ,,y knomlcdgend uch rn a brae(•sb,r-
<br /> - -
<br /> 'n�/ �( I to the
<br /> I I S�a,NA TU f,, C,r 1 0,-IPAL EXE..0 rIE
<br /> _ 1 matiun ra In,I, .nrly,l a•r..•. and uI•a un,le V
<br /> LAST -- FIRST - MI TITLE PEAR MG UAY UFFiI L-uH A.,TUVt<IZED AGENT
<br /> -L_.____--.____-----_____-__-__-_—_ ______-_-__
<br />• EPA Foam 3370.1(10.72) Pi,GE OF
<br /> 01(IGINAL j I
<br /> )` T. r I r{ I.;) ;^jr f_'� Fht11, L• • '1 il•;t 3 ✓ i'' 0 f y I
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