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PARAMETER <br />((1 <br />(3 "ard Only) QUANTITY OR LOADING <br />(46 (54 <br />(4 Cord Oily) QUALITY OR CONCEN <br />(38.45) (46 (5441) <br />NO <br />EX <br />2 <br />FREQUFNC. <br />OF <br />ANALYsts <br />0 N) <br />SAMPLE. <br />TYPE <br />k(St 70) <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS <br />I Len <br />SAMPLE <br />MEASUREMENT <br />c f <br />rERMIT ' <br />Rtputnametst <br />.3 ...1 2— <br />- <br />---'''---- <br />P AI <br />11 <br />34 <br />17 <br />sAmpLE <br />MEASUREMENT <br />\ 1 <br />,. <br />7, 7—r <br />7, 6 <br />0 . 0 2.__ <br />0 <br />PERSIST <br />REQUIREMENT <br />- <br />Ihit14/ <br />0; / f ‘Fr eiok re__ <br />SAMPLE <br />MEASUREMENT <br />1 <br />19 <br />PERMir. <br />REQuIREMIts <br />t <br />, ,i.f <br />, , <br />\ , <br />SAMPLE <br />IM EASURME E <br />i <br />4.004 <br />,„i b <br />6'44 <br />, 44 MIT <br />..... <br />. . ...„ <br />SAMPLE <br />MEASUREMENT <br />---* <br />...---- <br />0.4-1_3 <br />6 • 1.72- <br />I <br />2-/ <br />JO <br />MANIC <br />ReOUIREMENT <br />. <br />, <br />4:s.i . 2 2- <br />SAMPLE <br />MEASUREMENT <br />0* 10 0 0 ei <br />0. -- <br />.1 ,9 tf <br />2 <br />1 6 <br />PERMIT <br />REQUIREMENT <br />' <br />Pi <br />SAMPLE <br />MEASUREMENT <br />O0 P 0 <br />,.-..*-• <br />,--- <br />mutat, <br />ftiotiollt04.147 <br />NAME/TITt E PRINCIPAL EXECUTIVE OFFICER <br />I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED <br />ANO AM FAMILIAR VAIN THE NFORMATION SUBMITTED HEREIN AIR RASED <br />ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONS OLE FOR <br />OBTAINING THE INFORMATION i RELIEVE THE SUBMITTED INFORMATION <br />TS THERE <br />TRUE ACCURATE AND COMPLETE I AM AWARE THAT ERE ARE SIG <br />NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION INCI-LICANG <br />THE POS OF FINE AND IMPRISONMENT SEE 18 USC 1 1001 AND <br />33 usE 11319 'Arm1 nd.. under these statutes May whale (mos up to 110 RV <br />and or rnox1MorM4ffinnoonment 91 hrtInon 6 months and 5 yours I <br />_ . <br />TELEPHONE <br />DATE <br />/e, 1- 4. Lirol..-r <br />3413 <br />WA FA <br />?..zr — 1-6' 00 <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />OFFICER OR AUTHORIZED AGENT <br />TYPED OR PRINTED <br />NUMBER <br />YEAR <br />MO <br />DAY <br />PERMITTEE /ADDRESS I1fl(ltolt <br />Faso/UV Natx■x/- deggrrnr) <br />MAX <br />ADDRESS Pd • 3 irli_Afr <br />jc) A2 7 <br />faca-Lu_ L E:74-y_-414•14...4 . _--___4 u z■ - <br />LOCATION _7 , <br />COMMENT ANO EXPLANATION OF ANY VIOLA IONS r creme. all Wu( (rictus IlFrt <br />NATIONAL POLLUTANT HARGE ELIMINATION SYSTEM INFOLV <br />DISCHARGE MONITORING REPORT (putty <br />(2 16) (17-191 <br />60- P,24,2"1 <br />PERMIT NUMSER <br />MONITORI <br />YEAR I MO DAY <br />raom g r z <br />(26 <br />111:21; <br />(3471T) <br />Q PER100 <br />TO <br />OISCHAFIGE NUMSEH <br />YEAR MO <br />12.rj — ()6.101 <br />DAY <br />IAD/ <br />Fora proved <br />011 No. 2000-0011 <br />NOTE: Read instructions before completing title form. <br />