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NATIONAL POLL.IITAN HA96E ELIMINATION SYSTEM <br /> DISCHARGE iR.jNITORING REPORT I Approved <br /> OMB NO. 156-M073 <br /> r MID _ tr COAL (13t MH <br /> PO CHIC t58 <br /> cRr��euPAi� <br /> CG tit Z ` INSTRUCTIONS <br /> L I. Provide dates for period covered by this report In spaces marked"REPORTING PERIOD". <br /> 7. Enter reported minimum, average and maximum values under"QUANTITY"and"CONCENTRATION" <br /> la u) Ill 1 in the units specified for each parameter ae appropriate Do not enter values in boxes containing <br /> -- --- asterisks. "AVERAGE" Is ovatege computed over actual lima discharge Is operating, "MAXIMUM" <br /> snd"MINIMUM"are extreme values obabrved during the reporting period. <br /> O O:(� Fa{i _ 3. Specify the number of analyzed samples that exceed the maximum(and;or minimrmt an appropriate) <br /> St PERMIT NUMBER OIS iIC LATITU D! LONOITUpE permit conditions in the columns labelod"No. fix." If none,enter"O". <br /> �� —_ —ER � IS (_ — 4. Specify frequency of analysis for earl,paramlUer as No. analyses/No. days. (e d., "J/7" is aquiva- <br /> Im 111 I22-1.11 l24-16) I1e•1Tt I94-10) (So•Su low to 3 enslyseb performed etery 7 d.,ys) If continuous enter"CONT.' <br /> 5. Spe,ify sample type("grab"or"--hr. composite")as applicable. If frequency was continuous, <br /> enter "NA". <br /> REPORTING PERIOD iROM I TO n 6. App priate bilmature Ix requirwl on bottrm a(title tool. <br /> a —`� k-7�•�- �� I- 7. Rcmor•e.:arbon and reWin wIv for yYEAR MO nnY EAR _MO UAY g. Fold along dotted lines, staple and mail Original to office specified in permit. <br /> _132-3T) 3 — <br /> ( cs rd on <br /> ly) _-- (I <br /> — QUANTITY —d only) GONGENTNAfICrN FRE<rUENCY <br /> PARAMETER OR SAMPLE <br /> -_—�3e-tlm-- —�esJe w91—_— __ Is�en ___! la1•ea Ise-eei_.---- -----^i�e•a+l--- to o_en--- ----- tn1-a� <br /> MINIMUM AVERAGE IeAXiMUM UNITS ND. MINIMUM — AV13.RA sE MAXIMUM UNITS 11 IYPE <br /> EX EXX At1Al-VSI! <br /> F1--Ow aA7-Z REPORTED <br /> PERMIT <br /> CUNDI T,ON <br /> �IFL9 REPORTED <br /> PERMIT <br /> CONDITION <br /> _.--__--- <br /> �//���rJ <br /> CONDITION_ <br /> '7-6TAL (F RRPORTEO .----- <br /> l/I PERMIT <br /> CONDITION <br /> �..7a7eqL _--7-�w <br /> Pa <br /> CONO.TI TION ,-•,__ --__ _ ` - - - <br /> 7 uw r3I o ITy REPORTED <br /> P ERM,T <br /> CONDITION <br /> REPORTED <br /> Pfi RMIr�- -__---- --- <br /> CONO,no" <br /> REPORTED <br /> PERMIT <br /> CUN UI TION <br /> NAME OF PRINCIPAL EXECUTIVE OFFICER TITLE OF THE OFFICER DATE <br /> ---------------------- ---------------- — I certify that I am familiar with the Information containod In this <br /> — -- !`'7l}I motto is that to the beer re my knowlurate.edda and ball of such infor- l <br /> VE 5, J(�1.iR,r r'1 EyC[�(1�]f(Jt �(((,E ��.s=J�f�'=�� ZLL_L11� 11Z SIGNATURE 4f PRINCIPAL EXECUTIVE— <br /> _ _ motion la tole, complete,rod accurate. <br /> LAST FIRST MI TITLE — YEAR MO DAY OFFICER OR AUTHORIZED AGENT <br /> EPA Form 3310-1(10.77) — -- -- _-_`—_—.— ---"-- PAGE OF <br /> ORIGINAL <br />