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PARAMETER
<br /><J2-il )
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<br />t Cord Only) QUANTITY OR LOADING
<br />(46 154-61)
<br />(4 Card Only) QUALITY OR CONCENTR A rION
<br />(311.45) ti4 -(1 )
<br />Nc.r.r
<br />(.7(
<br />AVERAGE
<br />MAXIMUM
<br />UNITS
<br />MINIMUM
<br />AVERAGE
<br />M A X M U M
<br />UNITS
<br />+42-oit
<br />SAMPLE
<br />MEASUREMENT
<br />e 7
<br />PERMIT
<br />RrownemEter
<br />5 .t, Z—
<br />' I
<br />-i f: —
<br />---- -
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<br />SAMPLE
<br />MEASUREMENT
<br />i '
<br />7, 4 ,
<br />7, 7 4
<br />PERM T
<br />zqut R.EH ENT
<br />‘ . CTO
<br />SAMPLE
<br />MEASUREMENT
<br />1
<br />a
<br />.
<br />etRuir
<br />REQUIREMENT
<br />,
<br />4)
<br />- I 1. r
<br />SAMPLE
<br />MEASUREMENT
<br />_..,..!--
<br />t% 0 0 0
<br />144, b
<br />PERMIT
<br />AS QV I REM ENT
<br />SAMPLE
<br />MEASURMENT
<br />LI 34 0
<br />. PERMIT
<br />RotruiligmENT
<br />-
<br />. 3 2.
<br />0,
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<br />SA M PLE
<br />MEASUREMENT
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<br />a 00/
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<br />PERMIT •
<br />REQUIRE/4E4
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<br />.64i 4-
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<br />SAMPLE
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<br />REQUIREmEto'
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<br />-
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<br />00008
<br />O. 016
<br />NAME /T ITLE PRINCIPAL EXECUTIVE OFFICER
<br />1 CERT FY UNDER PENALTY OF LAW THAT I HAVE PERSONAL LY EA *MINED
<br />AND AM FAMILIAR WITH TNE INFORMATION f-tits-NutTED HEREIN AND BASED
<br />ON MY INOtoRy OF THOSE tNDIVIDuALS tMMEDsATEt Y RESPONSIBLE FOR
<br />DEIT AIN1W'.., THE INFORMATION I RELIEVE THE SUBMIT, ED INFORMATION
<br />15 TRUE ACCURATE ANC C`.4.1PI ETE I AM AWARE THAT !HERE ARE Sft...;•
<br />NIFICANT PENAL TIF5 FOR SUBMITTING FALSE INFORM A I ION INCLUDING
<br />THE POSSIBILITY OF FINE AND IMPRISONMENT SEE 16 l.. 5 C I 1001 AND
<br />i 1 310 (Penoteir. andel- (hear xt.Itcars no "'Nadi. /mot( lip fo It101100
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<br />OFFICER OR AUTHORIZE-0 AGENT
<br />3
<br />A A
<br />CODE
<br />& 2...s- 4-ecp.
<br />TYPED OR PRINTED
<br />NUMBER
<br />PERM! AIME/ADDRESS (Thelnde
<br />t Laratil14 1! different)
<br />NAME / 07.40 „L.,
<br />ADDRESS P.4›., 8.•Se
<br />2,
<br />2D T.11 &AO 4 1 , •
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<br />NATION AL POLLUT A JSC MARGE ELIMINATION SYSTEM t NPDt.
<br />DISCHARGE MONITORING REPORT (1)141?)
<br />(2 16; (17 191
<br />eo- 00
<br />PERMIT NUMBER
<br />- MONITORING PERIO
<br />Y D
<br />/-461" YEAR I MO DAY E
<br />FROM / 7 TO
<br />e ZO
<br />DISCHARGE NUMBER
<br />R MO
<br />._1_ -J
<br />Oa 2 124 2; i tf).,111
<br />ortn 4pprovec
<br />Alo, 2000-00:
<br />NOTE: Read Instructions before coroploing Ois form,
<br />lir rIC1
<br />SAN PL
<br />C-Ni" iNPE
<br />4 / ;
<br />CI
<br />/3 1
<br />7
<br />'EAR MO DAY
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