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NATIONAL. POk-t-UTANT t-: 1014 SYSl EM
<br /> DISCHARGE TORING REPORT
<br /> i.
<br /> INSTIZucrioNs
<br /> 1. Provide dates for period covered by this repo.(in :.page-,1 .1 11"11-1, 1 1 1')1)"
<br /> 1 3 2. Enter reported minimum, average and riaxinium ini,l,, -., , ,- ,''t , , I : ; I I I'll
<br /> 417-191 in the units iqircified for each puraniel- w, iqq-,Ijr-It- i- 't 1�,!;,, ". I,, . , ,
<br /> --- asteri,lis. "AVERAGE" is average r.....ptit�d-- u,1-0 1.,), 1 1! 1
<br /> and"MINIMUM" are extreme values oh,,eive-1 di-ilp,lite I,I, i-
<br /> !'1 a tiLf FT3. Specify the number of analyzed samples that ex(--vil Ih v i ( ,' fi,
<br /> permit conditions in the columns labeled-No I %- 11 1 .'",
<br /> PERMIT NUMBER sic LONGITUDE 4. Specify frequency of analysis for each puramit,' .",N- i- I 1 0 7"
<br /> (20.ail (22-41j (24 291 116-171 (2a-19) (30-30 font to 3 anolysos perfonned every 7 days J, It,-1Ij,ni-,, oJ I
<br /> 5. Specify
<br /> ("grab"sample type(" ,ab-or".—hir. -mil""te") h. - - "vl �nl- j
<br /> .ril "N A".
<br /> REPORTING PERIOD FROM TO 6. Appropriate signature Is required on bottom of It,, f,,on
<br /> V, 7. Rv1nov amade, bon and retain copy for your record,
<br /> Y CAR MO DAY YEAR 8. 1. i..'
<br /> _MO DAY Id along dotted line., skapla and aw Onvl-d toldfi, 1', 1 ...
<br /> (42-31)
<br /> (J card nly) (4 cntd only)
<br /> QUANTITY CONCENTRATION
<br /> I"r,jq
<br /> (1:-451 (40�53, Idir-e 11(38-.51 1 (54-61)
<br /> PARAMETER -------- -- ----- ---- ---- 11 F
<br /> .NO
<br /> MINIMUM AVERAGE MAXIMUM UNI rs MINIMUM AVERAGE MAXIMUM U14,T'�
<br /> Ex A:)A L
<br /> HEPOR I ED 14 41 A # # u # # iF of 4
<br /> -------- - --
<br /> I'MI T
<br /> N 01 T.0,
<br /> L T REPORTED it
<br /> L V;-, KU/DAY
<br /> PENMIT Ill 111 4F is # 0 Ill, it it 0 it it. 4% It it,
<br /> C)NDITION
<br /> f 1, 11,T'L REPORTED
<br /> KGILYAY
<br /> PI,AMIT it ir, 41 J� 4 0
<br /> ONDIT.ON
<br /> A 1,P 0 R T C(I A 4 'a 4--d-41L
<br /> K /DAY
<br /> OP401 TkON 7,
<br /> RENOkTtO 14 it III
<br /> C;u
<br /> PERI.IT
<br /> It
<br /> K U-1 Y CONOIIION f,
<br /> PA E REPORTD
<br /> 0 4 it
<br /> PF .IT
<br /> "E.P�R I L6
<br /> C
<br /> R-T
<br /> tLPO-11 LO
<br /> PE."'T
<br /> CON UI
<br /> ONO,T.ON
<br /> NAME OF PRINCIPAL EXECUTIVE OF FiCCH 1*11 LE OF THE OFFICER DATE
<br /> I certify Islas!I am familiar with 11tv Oilamistilon contained in Ilas
<br /> Jell N PR c--,;io,:�Ivr d that to silo ties(of lily knowledgil and belies such into,-
<br /> 4,L report all
<br /> ma,licin 1.true, eumpl.to, And Strwiltili, of P111W il'I L I F C :T1 I
<br /> LAST FIRST TITLE DAY U1 I 1iLH ON AU I 1,,-,1,1 D ,T
<br />• EPA F-,.3330-1 110.72) ORIGINAL FAGE-� 0 F
<br /> Y-1,P(, )'. 1)1S-TP1HtITFL) A WZA RUNOFF F r2O H COAL PREPARATUM PL
<br /> dlli- i'--:y Si; (L'- CANI'jO L-X( E:FD 41, MG/L FOR TSS
<br />
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