ML17157C436

Forwards NPDES Discharge Monitoring Rept for Jul 1993.... & PA Dept of Environ Resources Monthly Facility Rept.Informs That During Month of Jul,Sewage Treatment Plant Outfall 079 Total Suspended Solid Sample Exceeded Monthly Average

ML17157C436
Person / Time
Site:	Susquehanna
Issue date:	08/16/1993
From:	Fields J PENNSYLVANIA POWER & LIGHT CO.
To:	Crowley K PENNSYLVANIA, COMMONWEALTH OF
Shared Package
ML17157C437	List: ML17157C436 ML20056E305
References
PLE-17125, NUDOCS 9308230147
Download: ML17157C436 (14)

Text

ACCEI ERA D DOCUMENT DIST UTION SYSTEM REGULA<

Y INFORMATION DISTRIBUTI SYSTEM (RIDS)

,4 ACCEc3sjON NBR:9308230147 DOC.DATE:.93/08/16

'NOTARIZED:

NO DOCKET FACIL:50-387 Susquehanna Steam Electric Station, Unit 1, Pennsylva 05000387 50-388 Susquehanna Steam Electric Station, Unit 2, Pennsylva 05000388 AUTH.NAME AUTHOR AFFILIATION FIELDS,J.S.

Pennsylvania Power

& Light Co.

RECIP.NAME RECIPIENT AFFILIATION CROWLEY,K.

Pennsylvania, Commonwealth of

SUBJECT:

Forwards "NPDES Discharge Monitoring Rept for Jul 1993...."

& PA Dept of Environ Resources monthly facility rept. Informs that during month of Jul,sewage treatment plant Outfall 079 total suspended solid sample exceeded monthly average.

DISTRIBUTION CODE:

IE23D COPIES RECEIVED:LTR I

ENCL ]

SIZE:

TITLE: Environmental Event Report (per Tech Specs)

NOTES:

RECIPIENT ID CODE/NAME PD1-2 LA CLARKgR INTERNAL: ACRS NRR/PMAS/ILRB EG FI%

Ol EXTERNAL: NRC PDR COPIES LTTR ENCL

,3 1

1 5

5 1

1 1

1 1

1 RECIPIENT ID CODE/NAME PD1-2 PD NRR/DRSS/PEPB OGC/HDS2-RGN1 NSIC COPIES LTTR ENCL 1

1 1

1 1

1 1

1 1

1 NOTE TO ALL"RIDS" RECIPIENTS:

PLEASE HELP US TO REDUCE WASTE! CONTACT THE DOCUMENT CONTROL DESK, ROOM Pl-37 (EXT. 504.2065) TO ELIMINATEYOUR NAME FROM DISTRIBUTION LISTS FOR DOCUMENTS YOU DON'T NEED!

TOTAL NUMBER OF COPIES REQUIRED:

LTTR 17 ENCL 17 gj~/

0

~ ~

August 16, 1993 Pennsylvania Power 8 Light Company Two North Ninth Street ~AIlentown, PA 18101-1179 ~ 215/774-5151 Ms. Kate Crowley Water Quality Regional Manager Bureau ofWater Quality Management Pennsylvania Department ofEnvironmental Resources 90 East Union Street, 2nd Floor Wilkes-Barre, PA 18701-3296 SUSQUEHANNA STEAMELECTRIC STATION DISCHARGE MONITOMNGREPORT - JULY 1993 NPDES PERMITNo. PA 0047325 CCN 741326 FILER9-8A PLE-17125

Dear Ms. Crowley:

Pursuant to Part A, 3.b.(1) ofNPDES Permit No. PA 0047325, enclosed is the Susquehanna Steam Electric Station discharge monitoring report for July 1993. Also enclosed is Pennsylvania Department ofEnvironmental Resources'onthly Facility Report Form (01-112).

There was one noncompliance in July. During July, the Sewage Treatment Plant (Outfall 079) total suspended solid (TSS) sample exceeded the TSS monthly average of30 mg/1. This TSS sample was recorded at 38 mg/1. Normally, additional samples for TSS are taken in order to meet the monthly average.

To ensure compliance procedures are being developed to ensure collection ofadditional samples when necessary to meet the monthly average TSS limitof30 mg/1.

Ifyou have any questions, please call me at (215) 774-7887.

Respectfully yours, iJP~

J ome S.Fields S

'or Environmental Scientist - Nuclear Enclosures

<300 ~g Copies to:

EPA Region III NRC'DocumentControLDesla NRC Region I Mr. R. J. Clark, NRC Sr. Project Manager 9308230i47 9308ih

)~tr32t~g6)

PDR ADOCK 05000387

-~R PDR

I 01-11?

t ATTACHMENT 1 PA OEPARTMENT OF ENVIRONMENTAL RESOURCES Month July 1993 MONTHLY FACILITY REPORT pate Prepared 8/17/93 Facility Name Sus uehanna Steam Electric Station PWS IO NO.

24pp994 Box 467 Facility Address Berwick PA 18603 NPOES Permit No.

PA 0047325 Municipality Salem Townshi County Luzerne Incinerator Perm)t Number(s)

N/A Telephone Number (215) 774-7889 Person Completing Form Jerome S. Fields P int Name Signature Y

)

Title Sr. Envh tJnmental Scientist 1.

Total Hours Incinerator Operated 2.

Type of Fuel 3.

Total Fuel Usage 4.

Supplier of Fuel 5.

Estimated Amount of Sludge Incinerated N A N/A N/A N/A 6.

Incinerator Ash Disposal N/A (a)

How Much (Tons)

(b) Where (c)

When (Last ccurrence (d) Hauler (e) Receipts:

es no 8.

Other Wastes (Gr1ts, Barscreen1ng, etc.)

(a)

How Much (Tons)

(b) Where (c) When (Last ccurrenci (d) Hauler (e) Receipts:

es o

9.

Septic Tank Masts Accapten:

Yes Ro 7.

Sludge Disposal Water Treatment a)

How Much (Tons) b)

Vh Jh (c)

Mken (~st ccurrence I~egg (d) Hauler (e) Receipts:

Yes No

• Republic Environmental Systems

Hatfield, PA

10. If yes:

(a)

Volume (b) Hauler(s Percent

(%) Hauled 11.

Analys1s Performed to ensure tank waste conta1ns no 1ndustr1al waste a)

Yes (o) It yves, requency 12.

Addit1onal Cotancnts:

2,000 allons of septic tank waste taken offsite and treated at the Hazl eton Sewer Authority (Permi t PPA0026921)

rERMITTEE NAME/AODItESS i/nt/tdt ocf/ltyI/tntt/Locetbn gdm'tran//

uzi

~2LQR.'O'iZtLLH WUl "~

ccccl FACILITY LOCATION ATTII:

R ~

L ~

DOZY SUPV OP" R TECHNOL MONITORINGPERIOD YEAR MO DAY VEAR MO

'DAY FROM TO

/ 02II

/22.2 I

/

/ /

~ I /

NATIONAI.POLLUTANTDISCHARGE ELIMINAYIOHSYSTEM /NPDI/5/

DlscHAItoa MONITOItlNartcrortT /D)f/t/

216 IF/9 (I7 5

07 A

PERMIT NVMSCR otacHARos NUMSXR Form Approved.

(SU BR 02)

OMB No. 2040-0004.

F <<FINAL Approval explrese-30-91.

SERV AND ADNIH BUILDING SUMP

'rF

~

HO DATA I

I NOTE: Read Instructions before compietilr!Ithis form.

'PH PARAMKTKlt (524F)

SAMPLC MEASUREMENT AVERA4K MAXIMUM n trt(t(>>II<<"v (5 Cord On/i)

OUANTITY OR LOADIN4 (dtM5)

(5Af/)

UNITS (d Conf Only)

(5645)

MINIMUM

7. QO AVKRAOK MAXIMUM

a. 20 DUALITYOR CONCCNTRATION (4W5)

($4@i)

VNITS

( 12)

NO.

EX FttEOUSNCY OF ANALYSIS (6d48)

SAMI'LC TYPE (69-Fe)

00(IUO 1

0 0"

UE GROSS VALU SOLIDSF TOTAL SUSPENDED 00530 1

0 0

H GROSS VALU OIL AND GREASE FREOII EXTR"GRAV NET O0556 1

O O

U,IIT G

OSS VALU FLOIIF I N CONDUIT OR THRU TREATNEIIT PLAN 50050 1

G 0

U SAMPLE MCASURKMKNT SKKCINRNkgeTi ":">q'~ y~~e, X'~, pic; I(>> Vg"'c~;<~cic'",cu 8AMPLK MEASUREMENT

-".':" S<<IRMCT.:", '."

'RKCIVIRESCIIKTI q>>'c'sc~C++Qgtttt>>c

~'c')rtlrtggg+4c SAMPLE EASUREMKNT Q, Q3.10 O.O > IO

-;:.,'PKRMiT!.:, j"'".;REPORT-';

"; "'.-REPORT SAMPLK MEASUREMKNT

";P,PERMIT,-...:,","-,.Ald+I(ttt",,q. /F',.',.;l)ICP~t)'4:,

c tc Avd Aa c

Ac l($

c gA>>c

e'.;IIc4$4!+(~$

~n-OC:O'tr gc>>30,O Q, crc<<wNcc,.c>>

<<W50)r V

t~g>$ >> 0'>>t>>n ~c tv+<<

0"QO "r<<t Q c "v'c

',,<Qn Irtt/t55rd i<<,

I 1"0;9~,0;:,'g:~."((ll

".<<8 HG L

3.Q

( 19)

-20 S,0,8~ 'c 5 ~r

'.."<<O'i 2'8X HG/L

@;.'Qs~gttt/Y+

NKXISHf8+ SU

( 19) c ccc+

6: >>..r SCE/;"

.NOHT 5'(i SC>> E/j:

n>> $:i808 H

Q

~1 )t/

RIB";

j""

ESTXH r<

" rl (nERMET:"':i.'".r, RCOVtRKSd CRT."

SAMPLE MEAS UR EMKNT

+. '+<<t >>," ci~iccc" C <<M" SAMPLE MEASUREMKNT

'"" 'tc NAMC/TlTLKPRINCIPAL EXECUTIVE OFFICER 8 W2.Aa SV,.

5it P Nuc.~ha.

OPa~zeVX'YIrKD OR PRINTED I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PEttSONALLY EXAMINED AND AM FAMILIAR WITH THC INFORMATION SUSMttTED HCRftN. AND SASKD ON MY INCWIRY OF THOSE INDIVIDUALS IMMEDIATELY RKSPDNSISLE FOR OSTAINYIG YHK INFDRMATIO'4. I SKLIEVE THC SUSMFIYED INFORMATION IS TRUE.

ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARC SIG.

taFK.'ANT PfNALTIKS FOR SUSMITYING FALSE INFORMATION. INCLUDIN YHK PDSSiSILITY OF FINK AND IMPRISONMENT SKC te USC l IODI 33 USC I 53IS. IPrnaltirr ucutrr thrrr

~tatutrr may tnrtudr /tnrr up lu dttt.

and vr marimum tmpnrccnmrnt u/INturrn d mccnthr and I yrarnt 4

AT OF PRIN IPAL EXECUTIVE OFFICER OR AUTHORIZED AOKNT TKI.KFIHONK'ATE MO

'f -3a&

NUMSER

~

YEAR DAcr OMMENT AND EXPLANATIONOF ANY VIOLATIONS (Rtltltntt ou ouvahmtntt trt)

FLOii AND PH SHALL BE IIEASURED DAILY IIHEII DISCHARGIHG ~

.PA Form 3320-1 (Aev. 048) PIE Yious editions may be used, (REPLACES EPA FORM T do WHICH MAYHOT ~ E USED.I 00573/930611 1/)25

~AOE Ot'

~cRMITTcc NAMEIADDRcss ffncrttdd ocdlty /rdntd/cocctbn lfdlfftront/

me ~>JU~M~~~~~JLS~M~

JiQ.HZ'>'LH ~RP'LMX~l Form Approved (SUBR 02)

=

OMBNo.2040-0004.

F FINAL Approvalexplrea6-30-91.

COOLING TOilER BLOMDOMN 0(I7 07 A

PERMIT NUMSER otacHARoc HUMaclt MONITORINGPERIOD HATIDHALPDLLUT*NTDISCHAIICC CLIMIHATIDHSYSTEM (P(PDE5/

DIICHAltOCMONITOIIIN(3ltCPOItT fDhlR/

216 11/9 HAJOR rACIUTY

-OCATION ATTN-R ~

L ~

DOTY SUPV OPER TE HNOL YEAR FROM MO DAY VCAR MO

'DAY TO 1

1 l

1

/

NO DATA NOTE: Reed instructions before completlnIIthis firm.

PARAMETER (5My)

AVERAOC MAXIMUM (5 Cord Only)

OUANTITY OR LOADIN4 (4M5)

(5Afl )

UNITS MINIMUM AVCRAOC MAXIMUM (d Cord Only)

DUALITYOR CONCENTRATION (5')

(dtw5)

(5461)

UNITS NOr EX FIICDUCNCY DP ANALYSIS (6dnre)

SAMPLE TYI K (69-10)

SAMPLE MCASU RKMKNT 8

8.80

( 12)

/35 Qpihg 00(IOO 1

0 0

R SS VA U

<<+PKIlhtt'i;~~;,.

~+~8' 8

f48 P%~4~p~'k;;~-,'~".',<,"'4 1895'";-

S U 3P:.

'AXL'X':;.Rk:5/iY ZINCF TOTAL (AS ZIi) 01092 1

0 0

N G 0 VALU

~AMPLE MCASU R CMCNT YhX~g+);,

,.~>~h~,t r-8 t,

¹¹¹¹¹

¹¹¹¹¹¹

):¹td¹

o. oP, RSRliY,O5&

".A;~V~W/gM ~M$fKM'n~H~"CÃ It' '-'IG L t5Wn W~';".Z(k:~;;,~su-4"'4'LOMF IN CONDUIT OR THRU TREATIIENT PLAII 50050 1

0 0

CHLORINE, FRFE AVAILABLE 50064 1

G 0

r O

V SAMPLE CASURKMENT "O'rKRM st,r:3'5'>'ICK4UlRKCCKNT,',

SAMPLK MEASUREMENT

> ",1 SIKRMH'l~

'KOLltRKMKNT SAMPLE MEAS UR KMENT I t). 7'P>

>~, tl

¹n.¹¹¹¹

cj;,"882,OR+".;;;.';-",,'RBj308T:3

( 03)

¹¹¹¹¹4 0~ ~'p.~jyi"j,.

( 19) 3</>>

R.(J3F ()R

)46~

XXL'Yh",RCOR9 FCm Owg(1)

"..'.j'=,,,'EE.W ':I ~R'AS'.""

"'""SrKRMIT~-

RKOUIREMKNT.,

SAMPLE MEASUREMENT

<<ih i "'PERMIT. c'.".;

.'~RKOUlRKMK)ctI SAMPLE MEASUREMKNT

"'SrCRMht.":="r'.

'RCOUlRKMKNT NAME/TITLEPRINCIPAL EXECUTIVE OFFICER

g. Cy

~

8'tg,Atrt SP.,

V t',

gI/~g, CIPCg+mLC)III'(r TYPED OR PRINTED I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMWCD AND AM FAMILIAR WITH THE INFORMATION SUSMtlTED HCRCIN. AND SASCD ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RCSPONSISLE FOR DSTAWWC THK WFDRMAYIOV.

1 SELIKVE THE SUSMITTCD WFDRMAYIDN IS TRUE.

ACCURATC AND COMPLETE.

1 AM AWARE THAT THCRC ARC SIC-taFICANT PENALTICS FOR SUSMfYTWC FALSE INFDRMATON. WCLUCNNC YHK PDsststLFIY CF FINc AND tMPRtsDNMENT sKc ls Usc I 1001 AND 33 USC I 1310. Iprnaltirr anarr thrrr rlatrlrr may tnrltrtr /mrr ap lo Stajttrt ancf or marimam nnpnronmrnl ol hrtorrn d month r and 5 pram l TKI.KPHONK ~

hers SIONA U C 0 PRINCI AL EXCCUTIVC OFIFICCR OR AUTHORIZED A4ENT 7I7 S'D-Sm 79 NUMSER YEAR DAT C MO DAY (RCPLACCS CPA FORM T dO WHICH MAYNOT SC USED.I

=QMMcNT AND cxPLANATIDNoF ANY vloLATIQNs (Rrlrrrnca au anachmrntl rra)

CI) U~to: 6 0 W~< A3F O'LSCC t tLtt'r FREE AVAILABLE CHLORINE SHALL BE TAKEN DAILY BY GRAB DURING CHLORINATION~

9QQBQ30$ tc,g 9+081+

PDR ADOCK 05000387 R

PDR

-:PA Form 3320.1 (Rev. MS) Pilous edtVons may be used.

PACE 00570/930611" 1625 10F

acRMITTCK NAMEIADDRCSS /Indudo YodlltyIIotns/Loartbn tfd+crontI 3LSMZDXb

'~DRCSSZRQ ~iLKSi12LT~~'DiEETDL.&101 I ACILITY LOCATION TII:

R ~

L ~

DOT Y SU P V OP ER T ECHIIOL I

I I I

I I I I

NATIONALteOLLUTANTDISCHAROC ELIMINATIONSYSTEM IIIPDESI DISCHAltOL'ONITOlalNOIKL'PORT IDII(W 2 Id IyIp II OtaCHAROC NUMactt PERMIT NUMSCR MONITORING PERIOD YCAR MO OAY YEAR MO DAY FROM TO Form Approved, (SUBR 02)

OMB No.2040-0004, F

FI NAL Approval expires 6-30-91.

l2 TURBINE BLDG MASTE SUNP NQ DATA NOTE: Reed Instructions before coml)lettlIIIthla fore'ARAMETER (5241)

SAMIaLE MEASUREMENT AVERAOC MAXIMUM (5 Cord Onttt)

OUANTITY OR LOADIN4 (66e55)

(SAfl )

UNITS MIN I MUM AVERA4E

¹¹¹¹¹¹ MAXIMUM (6 Cord Onttt)

DUALITYOR CONCENTRATION (ISA)

(6645)

(SAfl)

UNITS

( 12)

Noe EX 62nrl)

FRKOUKNCY Ole ANALYSIS (6645)

SAMPLE TYPIC (dtt.re)

OOII00 1

'0 0

G OSS V

U htcn) tREMCIA',

<pi~~=,Cjstttes?e";/WE

>+4¹¹IICPIIe'.na'. rr¹ g6

<~+

iaah Ai "nr 4¹~i>

4-S Qg 0>>

AX'I'1r',g,8AS,',

SOLIDS, rOTAL SUSPENDED 00530 1

0 0

N V Ll OIL AND GREASE FREON EXTR".GRAV NET j00556 1

C 0

SAMPLE MEASUREMENT mi >

ee imere e e SAMPLC MCASURKMCNT

<<ega "i,"n r

6) P PSSCM (TP:"~'at ItttaMIREM~<:

¹rjt¹r r,¹

¹¹¹¹¹¹

¹r J¹

¹~¹

~¹¹¹ etV¹¹¹¹ rrrcri' r Ir¹¹ e

ig8pj+Qtts+Ilteret+ 'er gati/'V,'0',

%$'py,y hQ 0 go'+g'$@jph

( 19)

( 19)

QQQ'gIP ddt" I O

Rkae~+'

e'e +~+5

<<(

RA 8",:ey

FLOIIF Iti CONDUIT OR ZHRU TREATIIENZ PLAN

,50050 1

0 0

U" SAMleLE MCAS U R KMKNT

",""~~.<PERMIT,>>.

't4UlREMENT SAMPLC MEASUREMENT

--'-'<<"3tEPOR'ZP

',:.::" 'AR'RCPORT o3) r r e ¹r

¹¹:c"¹¹¹

.'~~$QQQPQ$ -.;,.- "->';",lt:s)I4rggg

+'j~Qg+ggP:>> ¹¹¹ M e': e.a'"r~t"er<<

,k,ILYy: STIGMA

'ne"'rtthiIfT

CCOUI REM CNTrr SAMPLt MEASUREMENT I"I i:tthletTrnr '<<'i>>

,:lltCIUIREM047'"

SAMPLE MKASURCMCNT

~e'i<e PERMCT,>>

RCOUlREMEN'T.

~ NAMC/TITLCPRINCIPAL EXtCUTIVC OFFICER R. ('SIC.Ae

~P V P lVV~pg. DPaA.A-WICl(25 TYPED Oh I'RINTtD I CERTIFY UNDER PCNALTY OF LAW THAT I HAVE PERSONALLY KXhhttNCD AND AM FAMILIAR WITH THE INFORMATION SUbMITTED HKREIN. AND SASCD ON MY tNOUIRY OF THOSE INDIVIDUALS ttatafutATELY RCSPONStbit'OR OSThtNINtr THE tNFORMATIDN. I SELIEVE THE SUbhtlTTKD tNFDRtaATION IS TRUE.

ACCURATE AND CDtaPLKTC I AM AWARE THAT THERE ARE SIC rartCANT PENALTtES fOR SUbtalTTINO FALSE INFORMATION. INCLUDtNG THc PosstbCITY DF Ftnc AND IMPRtsontaKNT sEK lb Usc I IDDI AND 33 USC h 13IQ. tprnattirc tenner them atatatra may enrteatr nenra ap ln gtntttat and eer mazimam empnaemmrnt nr hrtarrn 6 month a and 8 scarlet Sl AT R

OF RINCIP L EXCCUTIVK OFFICER OR AUTHORIZED AOCNT TELKleNONC'ATE NUMSCR.

YEAR MO DAY

-OMMCNT AND EXPLANATIONOF ANY VIOLATIONS (Rclcrcncc vll vuvchtncnts herc)

FLOII AIID PH SHALL BE tlEASURED DAILY lIHZN DISCHARGING':PA Form 3320-t (Rev. (HIS) Previous edt'lions may te used.

(RCPLACCS CPA FORM TAO WHICH MAYHOT SC USCD.I 005B1/930611 1625 PAOC OF

uERMITTCE NAME(ADDRESS (Jnt(ttdt otdltyHatnt/Local(ctn (fdlfftrtntJ rem ~~~~~~~~JLSMJQM JiQEZfLZ)LZX2iWLRKZ~

wZZ0191 Form Approved.

(SUBR 02) 0MB No. 2040-0004.

F FINAL Approval explrea6-30-91.

Ii TURBINE BLDG MASTE SUMP 073 A

7 2

PCRMIT NUMSIR cttaCHAROE NVMSER MONITORING PERIOD NATIONALPOLLUTANTDISCHARGE ~ LIMINATIONSYSTEM (Hy()ESI DISCHAIIOKMONITORINOItCPOItY (D)(JIJ 2 Jd JW9 MAJOR

~ACILITY OCATION A

N:

~

L ~

DOTY SUPV OPER TRCHNOL YEAR MO DAY YEAR MO

'DAY FROM TO

(

J (2

~

J

~

J J

(

J NO DATA NOTE: Reed InstrUCtlons befor compIstlrrlltlilsfirm.

PH PARAMCTCR

($142)

~AMPLE MEASURCMCNT AVCRAOK 4 L'Itl nC <~ ~

MAXIMUM (J Cord Only)

QUANTITY OR LOADINO (4M))

(f All

)

UNITS MINIMUM AVCRAOC I) gt>cA MAXIMUM (6 Card Only)

DUALITYOR CONCENTRATION

(&42)

(dtMS)

(SAfl )

UNITS NO>

CX (12)

FREDUENCY OF ANALYSIS (6648)

SAMPLE TYPC (69.10) 004(J0>

1 0

0

'<'",jg" "'j'""(hE":;)~;- au(res>rh(P'(gal 4'ghtcyjjEys)ly'4/ ~~/ I UBH GROSS VALU ++Urt'.(~:5%'~~>>::.";"'Ã8 ~"'.k~~,;" ~>-.:,::/l 0:0"~C:

XIIX Itj'fN XXI'X'AB';-'-

SOLIDSF TOTAL SUSPENDED 00530 1

0 0

F.

SS V

U OIL AHD GREASE FREON EXTR-GRAV MET 00556 1

0 0

G SS VA U

SAMPLE MEASURCMCNT SAMPLC MCASURKMCNT IIKQUIIIKMKNT'>c tr:

Fr "A

,>>uu>>";1+Vg+Q IsCQI>Ch Fr vent>:tr'Sn t(cl~gt(ct"

"".v F.g I'c

<'3-'59.0g~F""."'j'." ',4'(I u':,0'.,.'<5;4

( 19).

MG L

( 19),

MG L SC,,Ef;i Rk

.1'508'

.4~~ +>>> 'I;h9 ltCEfg RASE'~

ago FLOli 6 I N CONDUIT OR THRU TREATMENT PLAN 50050 1

0 0

SAMPLE J6EASUREMENT

".:."'IIIRtMPITt::;;. ':,'"'. REP,OR X!

SAMPLE MEASUREMENT

( 03)

MGD IIntrchFPrctIK'XLES ESTXH

," jnIlAlIT.'i RI(OUIRKMKgt>'AMPLE MEASUREMENT SAMPLE MEASUREMENT

. PIRMlT",

'I%'OUIRKMKNT I ic ',

NAME/TITLEPRINCIPAL CXKCUTIVKOFF ICCR P. &.

Gqlt.ASA

~a.

VP Alu'c.L2=rhtt.

OP EIt.h T(we TYPED OR PRINTED I CKRttFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXANtHED AHD AM FAMILIAR WITH THE tHFORt>IATIDN SUStatttED HEREIN. AHD SASED ON MY INQtttRY OF THOSE atDIVIDUALS ttataEDIATELY RKSPONSISLE O'DR OSTAIHIHG THK IHFDRMATIDH. I SELtEVK THK SUSMITTKD ItlfQntaATIDN IS TRUE. ACCURATE AHD COMPLETE.

1 AM AWARE 'tHAT THERE ARE SIG NtfICAHT PEHALTIKS FOR SUStattTING FALSE IHFDRtaATION.

INCLUDING YHK POSS18nttY Of FINE AND tMPRISDHtaKNT SEK 1S USC I IDDI AND 33 USC I 1319.

tprnattira tvvtrr thrrr

~tat tra may tart>vtr />lira ap tu sto/stat a>vt ur masimum tmpnrunmrnt ufhrtvrrn 6 muntha and 6 >rarni

~

r

/o>

SIO ATU I OF RINCIP L EXECUTIVE OFFICER OR AUTNORIZEO AGENT TCLKPNONC

'Q-3gb NUMSCR YEAR DATE MO DAY

=OMMENT ANO CXPLANATIONOF ANY VIOLATIONS (Rr(rrrnct au auvchtnrnts trt)

FLOII AHD PH SHALL BE MEASURED DAILY IIHEN DISCHARGING'PA Form 3320-1 (RSV.048) Plsv(ous ed(lions mey Jle used.

(REPLACES CPA FORM T 60 WHICIIMAYNOT ~ C USCO.I 00576/930611-1625 PAGE OI

PERMITTEE NAMKIADDRKss /Include YadlltyFamc Jlocotbn lfdlffcrcntJ use ~~ ~~~~~2SMJikI U'KKSZJM~LL'8

~UL~~~ L18101.

FACILITY

'CATION ATTN:

R ~

L ~

DOZY SUP V OPER TECHNOL MONITORING PERIOD YEAR MO DAY YEAR MO

'DAY FROM TO

/ 0.2IJ

/2

~ I J

I I I

NATIOHALPOLLUTANTDISCHAROC ELIMINATIONSYSTCM /IIPDESJ DISCHAICOR MONITOItlN4)%RPOItT /DJI/RJ 216

/2.//I 0

7 079 A

PERMIT NUMSER DtaCHAROC NVMSCR Form Approved.

(SUBR 02)

OMB No. 2040-0004.

F

-.. FINAL Approval expires 8-30-91.

SEIIAGE TREATHEIIT EFFLUENT l(0 DATA t

)

NOTE: Read instructions before completin(I this Air(IL PH tAIIAMETKIC

()242)

SAMPLE MEASUREMENT AVKRAOK MAXIMUM

+ittYOn On.

(I Card On/y)

OUANTITY QR LDADINO (4M))

(5'/)

UNITS MINIMUM

7. 90 AVERAOK AgAQgA MAXIMUM

7. e5 (d Card Only)

DUALITYOR CONCENTRATION (JILL)

(4642)

(Sdcrl)

UNITS

( 12)

Nbr EX FRKOUCNCY OF ANALYSIS (ddnra)

SAMtLK TYPE (69-10) 00400 A

0 0

S N

E T

PRCS CHPL SOLIDS TOTAL SUSPEllDED 00530 h

0 0

~s RRCtUCRRMRNT~

SAMPLE MEASUREMENT

'CRQUNRMRNTA

'c <, A+psst Istgirt<~

r~t"t(:~n".

-,"',;:,4CS):$04~';

AOAles

( 26)

( 19)

,AXXil;$

'I3 I ICjlfj',

KOHTH Csr t-8

-FLOQF IN CONDUIT OR THRU 1REATHT.NT PLAN 50050 A

G 0F'I PL CIILORINE, FREE AVAILABLE 50064 h

0 0

SAMPLE MEASUREMENT

'ItRCIU(RRMRICT; SAMPLE MEASUREMENT

'.; rtKRMIT;,".

'RCtU)RRMRNT Q

Gt'l>

o, o>54

( 03)

HGD

,+r~~,gQPL'IIX' 6.>5 slt+ncgtit c

~~ ~rIi+a'.~ IsCQ+C$

"4 <'">'v "s2) "en 'Pc

~ '

19)

'; ~, '"LREPORT;;l,4-'.>REPORT':,

';,I)","

J3I trLOIIUD kXL'Y$

3 l /pi Ql'ng

'OLIFORIIF F BCAL

,'- GENERAL

'74055 A

1 0

QODF CARBONACEOUS 05 DAY, 20C 80082 A

0 0

~AMPLE MEASUREMKNT

'" ", taRRhICT" i'; '~.

CUIR K)SENT,"

SAMIIILK MEASUREMENT

'Cta U IRRMRAT'AMPLE MEASURKMKNT

'v." >> PERMIT/

'jltax)UlRKMRNTq X",'a',,'y6+gh)t);)st >~

I. 50

,'r ',", Issfscgggtsttrt DORIC

C:0

( 26) 4I AAAA pv wT'n O9084 Cc

'05 o:O,.F;: 'I~'~".>>;,:,"'4":j>9p/Iieet)II4ih' 13)

( 19)

G L C~".

~fIC$1.',.

'yflO

')/a Rk;B>>::-'CAPI/;j

<<0 OIISd/,8

~/p I

~II

, NAME/TITLEPRINCIPAL EXECUTIVE OFFICER g, Cp 8 q(C.~

Sa.

~IIEET.At LO Q(s TYPED Olt PRINTED I CCRYIFY UNDCR PCNAI.TY OF LAW THAT I HAVC PCRSONALLY EXAMINED AND AM FAMtLIAR WITH THK INFORMATION SUSMITTCD HCRKIN. AND SASCD ON MY INOU1RY OF THDSC INDIVIDUALS IMMEDIATCLY RCSPONSISLC FOR OSYAININO THK INFORMATIOY. I SCLIKVE THC SUSMITtED INFORMATION IS TRUE. ACCURATE AND COMPLETE. I AM AWARC THAT THERE ARK SIO tarcANT PKNALTICS Fon SUSMITTINO FALSC INFORMATXW. INcLUDINo THC POSSISILITY OF FtNC AND lMPRISONMCNT SEC IS USC I lOOI AND 3S USC I 1$ 1S. tPrnaltirs sndrr shear ttatstrs may snrlsdr /tars ap la Stttlsst and sc masimsm tmpnsvnmrnt s/hrtsvrn S mnntha and S swrs.t SI A

R 0

IsRINCI AL EXECUTIVE OFI'ICKR OR AUTHORIZED AOENT TKLKIsNONR ~

I7 878-BaPa NUMSKR YEAR DATE DAY OMMKNTAND EXPLANATIONOF ANY VIOLATIDNs (Rc/crcncc vtl vuvchmcnts crc)

=CPA Form 3320.1 (Rev. Ms) Ptevlous ed/Vena may be used.

(RKPI ACES KPA FORM TWO WHICH MAYNOT SE USED.)

00584/930611 1625 PAOK OF

PERMITTEE NAME/ADDRKss ((nc(udc 8'acdlty I(amcllocatbn (fdlffcrantI LLSQ9~~

ADDR~XQCL3KB~JkXliT~ST~ZT

~M3233)3 Form Approved.

(SUBR 02)

OMB No.2040-0004.

F -- FINAL Approvalexplres6-30-91.

RADNASTE TREATMENT EFFLUENT PCRMIT NUMSCR c>lacHAR44 HU>a ~cn MONITORINGPERIOD NATloNALPOLLUTANTDlscHARoc ELIMINAYIDHCYCTcM (NPDErl DISCHARGE MONIYOltINOItKI>OItY(Dh(RI 2.16 MAJOR I'ACIUTY I OCATION "CHN YEAR MO DAY VCAR MO

'DAY FROM V

TO (20.211 (22.2 1 (

I 1

(

~

1

(

1 ¹¹¹ NO DATA NOTE: Read Instructions before completlnIItlsls form.

PARAMETER (1247)

AVCRAOE MAXIMUM (S Card Only)

QUANTITY OR LOADINO (4M))

(sdar)

UNITS MINIMUM AVERAOC MAXIMUM (d Card Only)

QUALITY OR CONCENTRATION (NAS)

(ddt),

(Sddll)

UNITS NO.

CX 6243)

FRCDUENCY OF ANALYSIS (dd48)

SAMPLE TYPE (69-70)

SOLIDSF TOTAL SUSPENDED 00530 1

0 0

SAMPLE MEASUREMENT

".;4> PERMIT.n.. 4

¹¹¹¹¹¹ 3-

"¹ISK -44¹"

~

. ".'~'"'$(r g~'"+~r)c,';30 4'.0';:";.,,@',:.'3;"",00'h",0,~;"'".I,",',"

( 19)

CyrLIs8

.4::"

'tICE/;:.

BIB;"'*'~.'LOM a

1N COIIDUIZ OR THRU TREATMENT PLAN 50050 1

0 0

SAMtLK MCASU R EMCNT

~marks'V4'.',L""-R8POgkj '=~,gRg PORT;"

;,'AMPLE MEASURKMCNT

( 03)

¹¹¹¹¹¹ g6/~,

kX,LV',4> ST

>.g~~>;~ 0

'>"...;>r a'>i"."rr SAMPLC M CASU R KMCNT RKQS)IISOECSSTc'r'",,".~~;i..i'."r>""'q>,:

'Wq~~~."'>'j~'> 4'g:."'d',

SAMPLE MEASURCMKNT SAMPLE MEASUREMCNT SAMPLE MKASUREMENT NAME/TITLEPRINCIPAL EXECUTIVE OFFICER R.6 Bwp.~

Sg.

VP N~C OPGLM'1 W5 TYtKD OR tRINTKD I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED AND AH FAMILIAR WITH THE INFORMATION SUS>a>TFED HKREIN; AND CASED ON MY INQIRRY OF THOSE n>DIVIDUALS IMMEDIATELY IIKSPDNSISLE FOll DSTNN>HG YHC n>FORMAT>OY.

I SELCVE THE SUS>a>TYED INFORMATION IS TRUE ACCURATE'HD CDMPLCTC I AM AWARE THAT THERE ARE S>C.

taF>CAHY PEHALT>ES FOR SUS>a>TT>NG FALSE IHFDRMAT>OH. IHCLUDIHO THE PDSS>S>LITY OF FINK AND IMPR>SDHMKHT SEC IS USC S 1001 AHD 33 USC S 1310.

>t>rnattirr andrr thrrr rtatrtrr may >nrlrdr finrr ap to staler>

and or mariman>>n>pnn>nmrt>t o(h> >arm a mon>ha ands tram>

COMMCNT AND CXPLANATIONOF ANY VIOLATIONS (Rc(crcncc au attachmcntt crc)

FLON SHALL BE MEASURED DAELY MHEN DXS'HARGING~

TCLKtHONC

~

7(7 ~f(g-324o )5 NUMSKR YEAR SIO AT R

0 RINCIP EXECUTIVE OFFICER OR AUTHORIZED AOCNT DATE S

If MO L

DA.Y o

-PA Form 3320-t (Rev. 048) Previous edillona may be used.

IRcPI Aces KPA FDRM T.40 wHlcH MAYNoT sc UscD.I 00586/930611 1625

~ AOC Olr 1

>ERMITTEE HAMc/ADDftcss /lncltlda aa/tlsy Nama/Locct lan (Idl//erontJ um MULES.XLS~~~~MJLSJKM~

LDDRCSS FACILITY

'CATION ATTN:

R ~

L ~

DOZY SUPV OPER TECHNOL NATIDNAI PDLLUTANTDtscHARoE ELIMINATION%TOTEM /JVPDESJ DISCHAR4K MONITORING RCPORT /Dtt/RJ 2.16 J>t Jlt 0047325 271 A

PERMIT NUMSCR DtacHnnoc NUMaan MONITORINGPERIOD YEAR MO DAY YCAFI MO

'OAY FI%OM I/

TO

/

21/ /2r2/

l

~

J /

~

J

/

Form Approved.

(SO B R 02)

OMB No. 2040-0004.

F - FINAL Approvalexplres6 IIASTE FILTER BYPA'SS NO DATA NOTE: Read Instructions bsforicompIatIIIlItIIlsfirm.

PARAMETER (1247)

SOLIDSF TOTAL SUSPENDED 00530 1

0 0

FLUEN GROSS VALU

~AMPLE MEASUREMENT AVERAOC n:n.y>:u:I>"-0 MAXIMUM Frt ">II>:I>:n-4 3<'.~Mr'iTS~I';:;,'~>>>+>k,'~k (J Card Only)

QUANTITY OR LOADINO (6tws)

($64/)

(6 Cord Only)

(Ndf)

MINIMUM

" F 4 I(tQ~

AVERAOK MAXIMUM QUALITY OR CONCENTRATION (6642)

(SAf1)

UNITS

( 19)

MG L NO>

KX FRCDUENCY OF ANAIYSIS (66'/a)

'N,CE'j~',

$HOSf H SAMPLE TYPE (69 10)

OIL AND GREASE FREON EXTR-GRAV MET 00556 1

0 0

U"N GRO VALU FLOIIa IN CONDUIT OR THRU TREATMENT PLAN 50050 1

0 0

V G

0 V

LU

~AMIILC MEASUREMENT QA Nywt SAMIrLK MKASUREMKNT SAMPLE MKASURKMCNT I;:grh>>a~+i

> +>ragr>uatqg" SAMPLC CASUREMKNT

~ I>IA >I 4I>)

( 03)

MGD dg 4(At>t4 A

),,~',n,',.Qg5

'j~+ tX~i;".>;. I'>ht'I',.'a~ gp>lpga

".>,.'t '.%g',

~r>"rt 19)

MG L NOPE,'j, FNOHTH AXJjX;-;.',INg'

">'; '.L,t aA:BPVR

,r'()IH SAMPLK MEASUREMENT

',RCQUIRCMCSCT>

t:; ~>., 's~'v".'"~i:.,q SAMPLE MCASUREMCNT HAMKJTITLE PRINCIPAL EXECUTIVE OFFICER R..

Cr.

$3@,~

S('P g Vu~A-Oft.Ih<<ogg TYPED OR PRINTED I CERTIFY UNDCR PENALTY OF LAW THAT I HAVE PERSONALLY CXAMOIED AND AM FAMILIAR WITH THE INFORMATION SUOMITTED HCREIN. AND SASCD ON MY INDIXRY OF THOSE INDIVIDUALS IMMKKXATELYRKSPONSISLE FOR OSThotatth THK RIFDRMATIO'4. I BCLTEVC THE SUSMITTED INFORMATION IS TRUE.

ACCURATE AND CDMPLETc I AM AwARE THAT THcRE ARE sus.

taFICANT PENALTICS FOR SUSMITTVIG FALSE RIFORMATION.

VICLUDING THE Possto>LITT oF Fate AND IMPRtsDNMKNT sKE Ie Usc I tool AN 33 USC I I3IO. tyrnatticr u>utrr thrrr rlatutrr may inrtudr />nrr up I>> Sttt/urt and u> matimum tmpnrnnmrnl u/hrturrn 6 mnnlhr units

>rara I SIO A

R OF PRINCIP EXECUTIVC OFFICER OR AUTHORIZED AOENT TELEPHONE

'/

7 ~tr - 5golZ)

NUMSER YEAR DATC DAY

OMMENT AND CXPLANATIONOF ANY VIOI.ATIONS (Rctcrcncc au attachments herc)

FLOII SHALL BE IIEASORED DAILY IIHEN DISCHARGING'.PA Form 3320.1 (Rsv. 048) Plsvtoua ed/I/one may be used, (REPLACES CPA FORM? 60 WHICH MAYHOT ~ C USCD.)

00588/930611-.16 25 PAGE OF

FERMITTEE NAME/ADDRE55 /Indudc Yoct/ttyI/ctnc/Local/on /Idlfjcrcntl

~M M~~UJIM~?~~T ADDR~ZXO 2LK~3DJkZH SZ~LX

<<<<<<II<<

PCRMIT NUMSCIE Dtvcknnoc HUMscn MONITORINGPERIOD NATIONALI<<OLLVTANTDISCHAROC ELIMINATIONSYSTSM /IIPDESI DISCHARGE MONITORING REPORT /DIdRI 2/6

/7 /tt Form Approved.

(SU BR 02)

OMB No. 2040-0004.

F -, FZ HAL Approval expires 6-30-91.

NEUTRALIZATION BASIN DISCHARGE I'ACILITT

'LOCATION TT i:

R ~

L ~ 'OZY SUPV OPER TECHNOL YEAR

~'ROM

/20 2/I

/22.2 I

~ I I /2

~ I /

MO DAY YEAFI MO 'AY TO

¹¹¹ HO DATA I

I NOTE: Reed lnttructlons before completl(I((this form.

I ARAMSTER (3247)

AVCRAOC MAXIMUM (3 Card Only)

OUANTITY OR LOADINO (dtW3)

(5'/)

UNITS MINIMUM AVCRAOC MAXIMUM (d Cord Only)

DUALITYOR CONCCNTRATION (3aA5)

(d6>>53)

(5Afl)

UNITS NO.

CX FRCOUCNCY OF ANALYSIS (6C48)

SAMPLE TYPE (60rre)

SOLIDSF TOTAL SUSPENDED 00530 1

0 0

OIL AHD GREASE FREON ZXTRGRAV MET 00556 1

0 0

(I U

SAMPLE MEASURCMKNT

.",~%3PCRISITL ';<<

'IEKEIUIRKMKIA';

SAMPLE MCASUREMKNT

< 'rt<<<'KRrtIT<<~<<'d rtCElllrRKMK/dTr

',<<(,,n ggtcltgptvr~<<v

>>r>> <<'<<;"4Q$ ¹QQ'q) j r;:I(ttg~

¹¹ "):

J J J

~ n n

~

¹<<¹¹L ¹n

, '~+K<<,'(FOP',((IIWEILY,'x 8

(3 or 0 5,"~jO'i~gj

(.5

( 19)

MG L ICE/.",~

<<808 5/~ I SC;83/'.3 FLOMF IN CONDUIT OR ZHRU TREATMENT PLAh 50050 1

0 0

SAMPLC MEASURCMCNT

<<4 rrCRMIT.>>'i RKEIUIRKM~'AMPLE MEASUREMENT G. I)(Q

> ""REPORT"r,", -"~'-'REPORT>>

( 03)

MGD

<<>>¹¹ J 7'

ErJTI Pr(/)

,AXIIY:~

'(c~<<PC/Mt(IT/'

R~EQUIRrKMKNT-'.

SAMPLE MEASURCMENT CUIR 3 3(3 SAMPLK MEASUREMENT SAMPLE MCASU REM CNT

'>>'>>~<'"tPKRMiTN';

UIRKMKNTC IECEI vS NAMC/TITLEtRINCIPAI EXECUTIVE OFFICER g, G, ~IRa~

SR.

YP Nu(:~9 Of'a9,/T-E %OS) S I

TYtCD OR thlNTCD I CERTIFY VNDCR PENALTY OF LAW THAT I HAVC FCRSONALLY CXAMtNCD AND AM FAMILIAR WITH THC INFORMATION SIISMITTCD HCRKIN. AND SASCD OM MY INQIRRY OF THOSE INDIVIDUALS IMMEDIATELY RKSFONSISLC FOR DSTAINNG THK RIFDRMATIOM. I SELltVK THC SUbMITTED IMFQltMATION IS TRUE ACCURATE AND CDMFLETE I AM AWARE THAT THERE ARE Slo ICFICANT FCNALTIKS FOR SUSMITTINO FALSC INFORMATION. IMCLIIDINO THC FOSSIbtLITY OF FINE AND IMFRISDNMENT Stt Ib USC I 1001 AND 33 USC I 1315. IPrnvltirv vrvtrr thrrr Itvtvtrv mvp tnrtvdr /tnrv vp ln ltotttvt vrvt nr movimvm tmpnvunntrt<<t <<>/hrtvrrn d mvnttlv cnit 53rvrv I SIONAT R

OF RINCII A EXECUTIVE OIFFICCR OR AUTHORIZED AOCNT TELEPHONE

'I 7 ZQ-3

NUMSCR, DATE YEAR MO D/IV

=OMMCNT AND CXPLANATIONOF ANY VIOLATIONS (Rr/rrrncc all auuchrncntc crc)

FLOM SHALL BE MEASURED DAILY MHEH DISCHARGIHG ~

¹EM ~

FLOM SHALL BE MEASURED DAIL'Y

¹HEN DISCHARGIHG ~

THERE SHALl BE H¹ DISCHARGE OF POLYCHLORIHATED BIPH¹llYL COMPOUHDS ~

SEE PERMIT FOR.O'I'H 0

8) Ptsvtoud ddltlons may be used.

(RCFLACCS CPA FORM 7 de WHICH MAYNOT ~ C USED.)

PAOC OF 00593/930611 1625 1

>cRMITTcc NAME/ADDRcss (lnc(vdt Yoc(l(ty/(otnejlocot(an Ifd(ffcrcntJ

~~LkSYJJfJ'd~?~~

- cglSQ933~

\\ODRCSS~i PERMIT NUMSCR cnacHAR46 HUMaaR MONITORINGPERIOD NATIDNALPOLLUTANTDISCHARGE ELIMINATIONSYSTEM (I(PDE5/

DISCHARGE MONITORINQ RCPORT /DHRI 2./6 I7.19 r

N AJO R Form Approved.

(SDBR 02)

OMB Nor 2040-0004.

F -. FINAL Approvalexptres6-30-91..

~

IIASTE FILTER EFFL'DENT FACILITY

'CATION UP YEAR MO DAY YCAR MO DAY FROM TO (20 2II (22.2 I ( d.

I(2 I

(

I NO DATA NOTE: Road Inctructloiss before compl ettlsII wIIIS fortran PARAMETER (5247)

AVERAGE MAXIMUM (5 Card Only)

QUANTITY OR LOADING (dtw5)

(5dnll )

UNITS MINIMUM AVERAGE MAXIMUM (6 Card Only)

QUALITYOR CONCtNTRATION (5%45)

(dtS45)

(5Afl)

UNITS 62'))

FREDUKHCY OF ANALYSIS (664')

SAMI'LK TY PC (69-10)

SOLIDSF TOTAL "SUSPENDED

• 00530 1

0 0

I OIL AND GREASE IFREON EXTR-GRAY MET

'00556 1

0 0

SAMPLE MEASUREMENT SAMPLE MCASUREMENT A 'hydr

"'Qpgttogg~l:$,++0 ~g>>gv, =20 4'0$ : 4'.s'~"

( 19)

( 19) na.4 ')CE//:;

O H,eE/'.

Rj Br.';.,

<<<Vrtr Wi", Lr IFLOWF IN CONDUIT OR

'HRU TREATIIEtlT PLAt)

50050 1

0 0

SAMPLE MCASU REM CNT

)SITS

.;;,Q4',~ RF,PORT,~4>>

<<ADREPORT;":

2> Lrr

( 03) h"C:SIC:(I

LOX,tID SAMPLE MEASUREMENT

~ltegUSRKgKNg '.Sr4"<g>~~".+

Xe'gr-+'P'AM PLC MEASURthlENT ISCQUIRKMKNI;y.'!'. ".O'"".",~;;~";"~Y~'. r")+'4'"d

>rd<'+j~'"

gc',q(n",r@ ",q SAMPLE MKASURtMCNT SAMPLE MKASUREMCNT

, r,,rq<<,

re It>N RCQUSREMCNT l j I NAMC/TITLEPRINCIPAL EXECUTIVE OFFICER l CERTIFY UNDKII PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED AHD AM FAMR.IAR WITH THC INFORMATION SUSMITTED HCRKIN. AND CASED ON MY NOU1RY OF THOSE NDIVIDUALS IMMEDIATELY RKSPOHSISLE FDR OSTANNG THC NFDRMATIOV. I SCLIKVC THE SUSMITTED IHFDRMAYON IS TRUE.

ACCURATE AHD COMPLETE.

I AM AWARE THAT THCRC ARE SIG taFICAHT PKHALYICS FOR SUSMllTNG FALSE INFORMATION. NCLUDIHG THK Possl&LITY of PINE AHD IMPRICDHMKHT scc Ie Uac S IDDI AND

$ 3 USC

$ lolo. tyrnattirr andrr three

~lalalrr may <nrtrdr /inrr ap ln ltv/am and ur marimam tmpnvmmrnt n(hrtarrn 6 menthe and I yearn.t

. A ~ &iG'tRASI 5p gP H'44IRA(L 0f'~

TYPCD OR PRINTED OMMENT AND EXPLANATIONOF ANY VIOLATIONS (Rt(erenee att vnvehrntnlc here)

FLOII SFALL BE MEASURED DAILY IIHEN DISCHARGING ~

SIO A U C

I'RINC AL KXCCUTIVC OFFICER OR AUTHORIZED AGENT Fa

~ Qcr TCLKPHONC '

I7 Wg-3oQ NUMSER DATE 8

YEAR MO DAY

-:PA Form 8320-1 (Rev. 948) P(svtous edl(lone may be used.

IRCPL*CCS CPA FORM T 60 WHICH MAYNOT ~ C USED,)

00595/930611-1625 F'AGC Olr

FcRMITTEE NAMEIADDRcss (lnclttdr "acdlfyJfdrnr/Cocefbn lfdfffrrrnt/

mu ~~Jf~~M~~ZSMXUM ODR~

FACILITnF I OCATION ATTN:

RE L

DOTY SUPV OPER TECHNOL MONITORINGPERIOD YEAR MO DAY YEAR MO

'DAY FROM TO I 02IJ (2

~

J

~

J I f I

HATIDHALPOLLUTANT DISCHAROE ELIMINATIONSYSTEM iNPDESJ DISCHARGE MONITORINO RCPORT ID)fRI 2 Id I1./9 P

5 PERMIT NUMSCR DNCHAROS HUM San Form Approved.

(SU BR 02)

OMB No. 2040-0004.

" FI NAL Approval expires 6-30-91.

571 CIRC IfIIATER PUNPHOUSE SUHP NO DATA ).

)

44'~I NOTE: Read Inetructlons before complstIIIIIXIIIIform.

PARAMETER (5241)

AVKRAOE MAXIMUM (5 Card Only)

OUANTITY OR LOADINO (4M5)

(545l)

UNITS MINI MUM AVKRAOE MAXIMUM (d Card Only)

DUALITYOR CONCENTRATION (W45)

(4145)

(Seal )

UNITS NOr KX FRCDUENCY OF'NALYSI~

(dolt)

SAMPLE TYPC (d9.10)

SOLIDSF TOTAL SUSPENDED 00530 1

0 0

SS VA 0 OIL AND GREASE FREON EXTR 'GRAV tlET I00556 1

0 0

V 0

I F LOIIa IN COIIDUIT OR 1HRU TREATHENZ PLAN 50050 1

0 0

~AMPLE MCASVREMENT SAMPLE MCASUREMtNT SAMPLE MEASUREMENT wKKIUIRtrdc)dt;"

SAMPLK MEASUREMENT 0 ""ifEP.QR'f,,

A+I% n goal Q. 6'9Q

( 03)

~;r"',.884'OR/:;:.'GD 4 lit>iIlr"44 1,7 I.7 i60a 0'-",4~

O'Q'2.'O'II Qj'~gW~-

C-'r:Ir'~I)'I(t 6

'I~)

C ~~53

( 19)

BCE/,I Rk H

L

'R".;,,;595TH V<A,l~Yg'".4 Q

>/gI h'XX"Y',I,

%OX'EQUIREMENT,';:

'>>";;,',,',<<,:; ',s

'AMPLE MEASUREMENT

,r:.

PKRblrT'KOVIREMILNT,,

SAMPLE MEASUREMENT

'RCC}UlRKMCNT, SAMPLE MEASUREMKNT

, RKOUIRCMCIIT;;

NAME/TITLEPRINCIPAL EXCCLITIVKOIPFICKR 8 (In S.~1I.W~

SI. Vf' NIJ~o,g

&P~A-r(clue TYPED OR PRINTED I CERTIFY UNDER PENALTY OF LAW THAT I HAVC PKRSONALLY EXAMINED AND AM FAMILIAR WITH THC INFORMATION SUSMITTED HKRCIH. AND SASCD Ott MY INDUIRY OF THOSK INDIVIDUALS IMMCCXATELY RKSFONSISLC FOR OSTAININC YHC INFDRMATID'N. I SCLIKVE THK SUSMITCED INF'DRMAYION IS TRIIK. ACCURATE AND COMFLCTC I AM AWARC THAT THERE ARE SIC NIFIC*NT PCNALTIES FOR SUSMITTINO FALSE INFORMATION. IHCLIIIXNQ YHK PDSSIStLITY OF ABC AND IMPRISONMENT SCC IS USC I IDDI AND 33 VSC I ISIS. IPrnaltirr arvfrr thrrr rtatatrr may tnrfrdr finn ap ln dltlfrr and nr rnarimarn tntpnvrtntrnt nfhrtarrn d manthr anif 5 lraral SIO A VR 0

PRINCIP L EXECUTIVE OIFFICCR OR AUTHORIZED AOENT TELEPNONC

~

7/

egg-ega NUMSCR DATE YEAR MO n DPrtf OMMCNT AND CXI'LANATIONOF ANY VIOLATIONS IRrlrrrnrr au vttvc manta rrr)

FLOII SHALL BE IIEASURED DAILY IIHEN DISCHARGING'

~

-:PA Form 8320 1 (Rev. M8) Pfsvtoua &If(onemay I)e uaed.

(RtPI ACES CPA FORM T dO WHICH MAYNOT SC UatD,I 00599/930611-1625

~AOC OF