ML12012A220
| ML12012A220 | |
| Person / Time | |
|---|---|
| Site: | Sequoyah  |
| Issue date: | 01/09/2012 |
| From: | John Carlin Tennessee Valley Authority |
| To: | Waits D Office of Nuclear Reactor Regulation, State of TN, Dept of Environment & Conservation, Div of Water Pollution Control |
| References | |
| TN0026450 | |
| Download: ML12012A220 (8) | |
Text
Tennessee Valley Authority, Post Office Box 2000, Soddy Daisy, Tennessee 37384-2000 January 9, 2012 Ms. Dana Waits State of Tennessee Department of Environment and Conservation Division of Water Pollution Control Enforcement & Compliance Section 6 th Floor, L & C Annex 401 Church Street Nashville, Tennessee 37243-1534
Dear Ms. Waits:
SEQUOYAH NUCLEAR PLANT - DISCHARGE MONITORING REPORT FOR DECEMBER 2011 Enclosed is the December 2011 Discharge Monitoring Report for Sequoyah Nuclear Plant. If you have any questions or need additional information, please contact Brad Love at (423) 843-6714 of Sequoyah's Environmental staff.
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations.
a n Si e P sident S*equoNuclear Plant Enclosures cc (Enclosures):
Chattanooga Environmental Field Office U.S. Nuclear Regulatory Commission Division of Water Pollution Control Attn: Document Control Desk State Office Building, Suite 550 Washington, DC 20555 540 McCallie Avenue Chattanooga, Tennessee 37402-2013
PERMITTEE NAMEIADDRESS (Include Facility Name/Location if Different)
Name TVA - SEQUOYAH NUCLEAR PLANT Address P.O. BOX 2000
-(INTEROFFICE OPS-5N-SQ_)
SODDY - DAISY, TN._.373.._84_..
F..ac_.
.A
- SEQUOYAH NUCLEAR PLANT Location HAMILTON COUNTY ATTN: Brad Love NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
DISCHARGE MONITORING REPORT (DMR)
PERMIT NUMBER DISCHARGENUMBER MAJOR Form Approved.
(SUBR 01)
OMB No. 2040-00 F - FINAL DIFFUSER DISCHARGE EFFLUENT NO DISCHARGE NOTE: Read instructions before completing this form.
104 I
MONITORING PERIOD FmYEAR I MO DAY oYER M
From F 1 1TI12 01 1 To [-1 1 12 131 PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO.
FREQUENCY SAMPLE
,_EX OF TYPE AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS TEMPERATURE, WATER DEG.
SAMPLE 27.8 04 0
31 / 31 RCORDR CENTIGRADE MEASUREMENT 00010 1
0 PERMIT Req. Mon.
DEG. C.
CONTI CALCTD EFFLUENT GROSS REQUIREMENT DAILY MAX NUOUS TEMPERATURE, WATER DEG.
SAMPLE 13.1 04 0
31 / 31 MODELD CENTIGRADE MEASUREMENT 00010 Z
0 PERMIT
- 30.5 DEG. C.
CONTI CALCTD INSTREAM MONITORING REQUIREMENT DAILY MX NUOUS TEMP. DIFF. BETWEEN SAMP. &
SAMPLE 1*04 0
31/31 CALCTD UPSTRM DEG.C MEASUREMENT 00016 1
1 PERMIT DEG. C.
CONTI CALCTD EFFLUENT GROSS REQUIREMENT DAILY MX NUOUS FLOW, IN CONDUIT OR THRU SAMPLE 1683 0331/31 RORR TREATMENT PLANT MEASUREMENT 50050 1
0 PERMIT Req. Mon.
MGD CONTI RCORDR EFFLUENT GROSS REQUIREMENT DAILY MAX NUOUS CHLORINE, TOTAL RESIDUAL SAMPLE 0.025 0.039 19 0
10/31 GRAB MEASUREMENT 50060 1
0 PERMIT 0.1 0.1 UG[-
FIVE PER CALCTD EFFLUENT GROSS REQUIREMENT Mo AVG DAILY MAX WEEK TEMPERATURE - C, RATE OF SAMPLE 0
62 0
31 /31 CALCTD CHANGE MEASUREMENT 82234 1
0 PERMIT 2
DEG CONTI CALCTD EFFLUENT GROSS REQUIREMENT DAILY MX C/HR NUOUS SAMPLE MEASUREMENT PERMIT REQUIREMENT NAMEITITLE PRINCIPAL EXECUTIVE OFFICER I Certify under penalty of law that this document and all attachments were prepared under my TELEPHONE DATE direction or supervision in accordance with a system designed to assure that qualified personnel John T. Carlin properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the I e Vice President information, the information submitted is, to the best of my knowledge and belief, true, accurate 423 843-7001 Site Vice President and complete. I am aware that there are significant penalties for submitting false information, SI NTR OF PRINCIPAL EXECUTIVE including the possibility of fine and imprisonment for knowing violations.
OR AUTHORIZED AGENT AREA NUMBER YEAR MO DAY TYPED OR PRINTED CODE COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
No closed mode operation. Veliger monitoring data is included as an attachment.
EPA Form 3320-1 (REV 3199)
Previous editions may be used Page I of I
Mean # of Water Mean# of Water SUB NOTES: %
Sample Date ZM~m3
% Settlers Temp. ('C) Sample Date Asiatic Temp. ('C)
LOCATION LOCATION Gravid Asiatic COLLECTED BY TCamsm3 T
CClam 12/07/2010 12/14/2010 12/22/2010 12/29/2010 01/04/2011 01/11/2011 01/18/2011 01/25/2011 02/02/2011 02/08/2011 02/15/2011 02/22/2011 03/01/2011 03/08/2011 03/16/2011 03/23/2011 03/30/2011 04/06/2011 04/08/2011 04/20/2011 May 2011 June 2011 July 2011 August 2011 Sept 2011 October 2011 11/20/2011 11/29/2011 12/06/2011 12/13/2011 12/20/2011 6
0 0
0 0
0 0
0 0
0 0
20 00 22 0
0 18 45 21 100 0
0 0
0 0
0 0
0 0
0 100 0
0 0
0 0
100 100 100 23 10 10.5 26 13 22 9.5 23 10 9
23 10 11 11 11 11 12 15 15.5 16 12/07/2010 12/14/2010 12/22/2010 12/29/2010 01/04/2010 01/11/2010 01/18/2010 01/25/2011 02/02/2011 02/08/2011 02/15/2011 02/22/2011 03/01/2011 03/08/2011 03/16/2011 03/23/2011 03/30/2011 04/06/2011 04/08/2011 04/20/2011 11/20/2011 11/29/2011 12/06/2011 12/13/2011 12/20/2011 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0
.23 10 10.5 26 13 22 9.5 23 10 9
23 10 11 11 11 11 12 15 15.5 16 1-25-545 1-25-545 1-ISV-24-1234 1-25-545 1-25-545 1-25-545 1-ISV-24-1234 1-25-545 1-25-545 1-25-545 1-25-545 1-25-545 1 -ISV-24-1236 1-ISV-24-1236 1-ISV-24-1234 1-ISV-24-1234 1-ISV-24-1236 1-ISV-24-1234 1-1SV-24-1236 1-1 SV-24-1236 PB RS WE WDT PB RS CR WDT PB MJW MLW PB PB WE MLW MLW MLW HMW WAW/PB PB No Samples Collected No Samples Collected No Samples Collected No Samples Collected No Samples Collected No Samples Collected BC PB PKS PB 0
0 0
0 0
0 0
0 0
0 14 14 12 25 12 18 0
0 0
0 14 14 12 25 12 1-ISV-24-1236 1-25-545 1 -ISV-24-1234 1-25-545 1-ISV-24-1234
PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different)
Name TVA - SEQUOYAH NUCLEAR PLANT Addrtess P.O. BOX 2000
.IJNTEROFFICE OPS-5N-SQN)_
SODDY-DAISY TN 37384 Faciity.
TVA -SEQ.UOYAH NUCLEAR PLANT Locaiobn HAMILTON COUNTY NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
MAJOR For DISCHARGE MONITORING REPORT (DMR)
(SUBR 01) 0a1 TN0026450 II 101 T F - FINAL PERMIT NUMBERI DISCHARGE UMBER BIOMONITORING FOR OUTFALL 101 m Approved.
lB No. 2040-0004 Iv~f~
RA^K lre *pKl.2 rfpoctiL~in 1
EFFLUENT ATTN: Brad Love I YEAR I MID DAY I
YE MO_
DAY. I NO DISCHARGE 0 1 NOTE: Read instructions before completing this form.
PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO.
FREOUENCY SAMPLE
,___EX OF TYPE AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS IC25 STATRE 7DAY CHR SAMPLE Monitoring CERIODAPHNIA MEASUREMENT Not Required 23 TRP3B 1
0 PERMIT 43.2 PERCENT SEMI COMPOS REQUIREMENT EFFLUENT GROSS MINIMUM ANNUAL IC25 STATRE 7DAY CHR SAMPLE Monitoring 23 PIMEPHALES MEASUREMENT Not Required.
TRP6C 1
0 PERMIT 43.2 PERCENT SEMI COMPOS EFFLUENT GROSS REQUIREMENT MIMINUM ANNUAL SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I Certify under penalty of law that this document and all attachments were prepared under my TELEPHONE DATE irection or supervision in accordance with a system designed to assure that qualified personnel John T. Carlin p
-ropery gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the iceSPresident information, the information submitted is, to the best of my knowledge and belief, true, accurate, 423 843-7001 12 01 09 Sequoyah Site Vice President and complete. I am aware that there are significant penalties for submitting false information, SIl(A U 0
PRINCIPAL EXECUTIVE TYPEDORPRINTEDincluding the possibility ofIfine and imprisonment for knowing violations.
FEW
, AUTHORIZED AGENT AREA NUMBER YEAR MO DAY TYPEDOR PRNTEDCODE COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
Toxicity was not sampled in December 2011.
EPA Fonn 3320-1 (REV 3199)
Previous editions maybe used Page 1 of I
PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different)
Namee TVA - SEQUOYAH NUCLEAR PLANT Address P.O. BOX 2000 I-NTEROFFICE OPS-5N-SQN).
SODDY_- DAISY TN 37384 Facility
_ WTA - SEQ.UOYAH NUCLEAR PLANT Location HAMILTON C O U N..N..TY NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
MAJOR Form DISCHARGE MONITORING REPORT (DMR)
(SUBR 01)
OMBI TN06450 IZ 103 G F-FINAL PERMIT NUMBER J
DISCHARGE NUMBER LOW VOL. WASTE TREATMENT POND MONITORING PERIOD EFFLUENT Approved.
No. 2040-0004 ATTN: Brad Love I YEAR I MO I DAY I I YEAR I MO I DAYDISCHARGE From L 11 I 12 I 1 Tol 11 1 12 131 NOTE: HRGa is NOTE: Read instructions before completing this form.
PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO.
FREQUENCY SAMPLE EX OF TYPE AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS PH SAMPLE 7
8 12 0
12/31 GRAB MEASUREMENT 00400 1
0 PERMIT 6
9 SU THREE/
GRAB EFFLUENT GROSS REQUIREMENT MINIMUM MAXIMUM WEEK SOLIDS, TOTAL SUSPENDED SAMPLE 8
8 19 0
2 / 31 GRAB MEASUREMENT 00530 1 - 0 PERMIT 30 100 MGIL TWICE/
GRAB EFFLUENT GROSS REQUIREMENT MO AVG DAILY MX MONTH OIL AND GREASE SAMPLE
-<6
<6 19 0
2/31 GRAB MEASUREMENT 00556 1
0 PERMIT 15 20 MGIL TWICE/
GRAB EFFLUENT GROSS REQUIREMENT MO AVG DAILY MX MONTH FLOW, IN CONDUIT OR THRU SAMPLE 1.083 2.062 g03 0
31/31 RCORDR TREATMENT PLANT MEASUREMENT 50050 1
0 PERMIT Req. Mon.
Req. Mon MGD SEE RCORDR EFFLUENT GROSS REQUIREMENT MO AVG DAILY MX PERMIT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I Certify under penalty of law that this document and all attachments were prepared under my TELEPHONE DATE direction or supervision in accordance with a system designed to assure that qualified personnel John T. Carlin properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the President information, the information submitted is, to the best of my knowledge and belief, true, accurate, ice P 423 843-7001 12 01 09 Sequoyah Site Vice President and complete. I am aware that there are significant penalties for submitting false information, SIdA E F PRINCIPAL EXECUTIVE including the possibility of fine and imprisonment for knowing violations.
0 OR AUTHORIZED AGENT AREA NUMBER YEAR MO DAY TYPED OR PRINTED 0CRAUHRZEODET AEA NME YAR O
DY COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
The L-Valve (Outfall 103) was closed on 12/13/2011 at 2040. The L-Valve (Outfall 103) was re-opened on 12/16/2011 at 1000. There was zero discharge from Outfall 103 on 12/14/2011 and 12/15/2011.
EPA Form 3320-1 (REV 3199)
Previous editions may be used Page I of 1
PERMIT-EE NAME/ADDRESS (include Facility Name/Location if Different)
Noae
_TVA - SEQUOYAH NUCLEAR PLANT Address P.O. BOX 2000
.(I-NTEROFFICE OPS-5N-SQ_)-
SODDY - DAISýf, TN. 37384_
Faci!y TVA - SEQ.UOYAH NUCLEAR PLANT Location HAMILTON COUNTY ATTN: Brad Love NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
RMJOR DISCHARGE MONITORING REPORT (DMR)
(SUBR 01)
PERMI NUMBER DISCHARGE NUMBER RECYCLED COOLING WATER MONITORING PERIOD EFFLUENT Form Approved.
OMB No. 2040-0004 Fo I YEAR I MO I Y
I YEAR I MO IDAY Froml r111 1=1 l
T 1 2 1 31 NO DISCHARGE
_Xj NOTE: Read instructions before completing this form.
PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO.
FREQUENCY SAMPLE EX OF TYPE AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS TEMPERATURE, WATER DEG.
SAMPLE 04 CENTIGRADE MEASUREMENT 04 00010 1
0 PERMIT REPORT DEG C CONTIN CALCTD EFFLUENT GROSS VALUE REQUIREMENT DAILY MX UOUS TEMPERATURE, WATER DEG.
SAMPLE 0******
CENTIGRADE MEASUREMENT 04 00010 Z
0 PERMIT 30.5 DEGC CONTIN CALCTD INSTREAM MONITORING REQUIREMENT DAILY MX UOUS TEMP. DIFF. BETWEEN SAMP. &
SAMPLE 04 UPSTRM DEG.C MEASUREMENT 00016 1
0 PERMIT 5
DEG C CONTIN CALCTD EFFLUENT GROSS VALUE REQUIREMENT DAILY MX UOUS FLOW, IN CONDUIT OR THRU SAMPLE TREATMENT PLANT MEASUREMENT 03 50050 1
0 PERMIT Req. Mon.
MGD CONTIN RCORDR EFFLUENT GROSS VALUE REQUIREMENT DAILY MX uous CHLORINE, TOTAL RESIDUAL SAMPLE 19 MEASUREMENT 50060 1
0 PERMIT 0.1 0.1 MGIL Five per CALCTD EFFLUENT GROSS VALUE REQUIREMENT MO AVG DAILY MX Week TEMPERATURE - C, RATE OF SAMPLE CHANGE MEASUREMENT 04 82234 1
0 PERMIT 2
DEG C CONTIN CALCTD EFFLUENT GROSS VALUE REQUIREMENT DAILY MX uous SAMPLE MEASUREMENT PERMIT REQUIREMENT NAMEMTITLE PRINCIPAL EXECUTIVE OFFICER I Certify under penalty of law that this document and all attachments were prepared under my TELEPHONE DATE lirection or supervision in accordance with a system designed to assure that qualified personnel John T. Carlin properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the I
Vice President information, the information submitted ist, to the best of my knowledge and belief, true, accurate, 423 843-7001 12 01 09 Sequoyah Site Vice President and complete. I am aware that there are significant penalties for submitting false information, SI E (*= PRINCIPAL EXECUTIVE I
including the possibility of fine and imprisonment for knowing violations.
0 R
R AUTHORIZED AGENT AREAI NUMBER YEAR MO DAY TYPED OR PRINTED CODE COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
No Discharge this Period EPA Form 3320-1 (REV 3199)
Previous editions may be used Page I of I
PERMITIEE NAME/ADDRESS (Include Facility Name/Location if Different)
N.ame "rVA - SEQUOYAH NUCLEAR PLANT Address P.O. BOX 2000
-INTEROFFICE OPS-5N-SQN.)
SODDY - DAISY TN 37384 F..act TVA - SEQUOYAH NUCLEAR PLANT Loction HAMILTON COUNTY ATTN: Brad Love NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) MAJOR DISCHARGE MONITORING REPORT (DMR)
(SUBR 01)
TN0 0
1110 T
]
F-FINAL 7
PERMIT BE
[DISCHARGE NUMBER RECYCLED COOLING WATER MONITORING PERIOD EFFLUENT Form Approved.
OMB No. 2040-0004 SYEARI MO 1
DAY o
EARI M
DAY From 1 11 _I12 011 To 1 11 1 12 31 NO DISCHARGE
[K
- j NOTE: Read instructions before completinq this form.
PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO.
FREQUENCY SAMPLE EX OF TYPE AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS IC25 STATRE 7DAY CHR SAMPLE 23 CERIODAPHNIA MEASUREMENT 23 TRP3B 1
0 0
PERMIT 43.2 PERCENT SEMI COMPOS REQUIREMENTMIMU EFFLUENT GROSS VALUE MINIMUM ANNUAL IC25 STATRE 7DAY CHR SAMPLE PIMEPHALES MEASUREMENT 23 TRP6C 1
0 0
PERMIT 43.2 PERCENT SEMI COMPOS EFFLUENT GROSS VALUE REQUIREMENT MINIMUM ANNUAL SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I Certify under penalty of law that this document and all attachments were prepared under my TELEPHONE DATE direction or supervision in accordance with a system designed to assure that qualified personnel John T. Carlin properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the e
President information, the information submitted is, to the best of my knowledge and belief, true, accurate, 423 843-7001 12 01 09 Sequoyah Site Vice President and complete. I am aware that there are significant penalties for submitting false information, SIGNATURE OF PRINCIPAL EXECUTIVE including the possibility of Fine and imprisonment for knowing violations.
OFFICER OR AUTHORIZED AGENT AREA INUMBER YEAR MO DAY TYPED OR PRINTED I
CODE COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
No Discharge this Period EPA Form 3320-1 (REV 3199)
Previous editions may be used Page 1 of 1
PERMIITEE NAME/ADDRESS (Include Facility Name/Location if Different)
Name TVA - SEQUOYAH NUCLEAR PLANT Address P.O. BOX 2000
_-[NTEROFFICE OPS-5N-SQN.)
SODDY - DAISY TN 37384 Facii TVA-SEQUOYAH NUCLEAR PLANT Location __._HAMILTON NTY ATTN: Brad Love NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
DISCHARGE MONITORING REPORT (DMR)
PERMIT NUMBER DSHRENME MONITORING PERIOD YEAR T
MO YEAR IMO DAY From 1 12 01 1 To[ 111 31 MAJOR Form Approved.
(SUBR 01)
OMB No. 2040-0004 F - FINAL WASTEWATER & STORM WATER EFFLUENT NO DISCHARGE
[ j NOTE: Read instructions before completingi this form.
PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO.
FREQUENCY SAMPLE
_________EX OF TYPE AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS OXYGEN, DISSOLVED (DO)
SAMPLE MEASUREMENT 19 00300 1
0 PERMIT 2
MGIL TWICE/
GRAB REQUIREMENT EFFLUENT GROSS MINIMUM WEEK SOLIDS, TOTAL SUSPENDED SAMPLE MEASUREMENT 19 00530 1
0 PERMIT 100 MGIL TWICE/
GRAB EFFLUENT GROSS REQUIREMENT DAILY MX WEEK SOLIDS, SETTLEABLE SAMPLE
- DAILY****25 WEEK MEASUREMENT 00545 1
0 PERMIT MUL ONCE/
GRAB EFFLUENT GROSS REQUIREMENT DAILY MX MONTH FLOW, IN CONDUIT OR THRU SAMPLE 03 TREATMENT PLANT MEASUREMENT 03 50050 1
0 PERMIT Req. Mon.
Req. Mon.
MGD ONCE/
ESTIMA EFFLUENT GROSS REQUIREMENT MO AVG DAILY MX BATCH SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I Certify under penalty of law that this document and all attachments were prepared under my TELEPHONE DATE
-direction or supervision in accordance with a system designed to assure that qualified personne John T. Carlin
/properly gather and evaluate the information submitted. Based on my inquiry of the person or
[persons who manage the system, or those persons directly responsible for gathering the Q1" a
Vice President hinformation, the information submitted is, to the best of my knowledge and belief, true, accurate, 423 843-7001 Sand complete. I am aware that there are significant penalties for submitting false information, b4*AJRE OF PRINCIPAL EXECUTIVE I
including the possibility of fine and imprisonment for knowing violations.
OFFICER OR AUTHORIZED AGENT AREA NUMBER YEAR MO DAY TYPED OR PRINTED N
RCODE COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
During this reporting period, there has been no flow from the Dredge Pond other than that resulting from rainfall.
j" Form 3320-1 (REV 3199)
Previous editions may be used Page 1 of I