ML17158A028
| ML17158A028 | |
| Person / Time | |
|---|---|
| Site: | Susquehanna  |
| Issue date: | 10/31/1993 |
| From: | Saxton C PENNSYLVANIA POWER & LIGHT CO. |
| To: | |
| Shared Package | |
| ML17158A027 | List: |
| References | |
| NUDOCS 9312080143 | |
| Download: ML17158A028 (10) | |
Text
I
'ERMITTEENAME/ADDRESS(Include
. ~
Facility ¹me/Loon(ion ifdifferent)
NAME 2ZRHS XL3UUIZJlM~I =~QOERtUL ADDREss~ ~ OBLI NI~
t3 TBEET JLLLKHTGioi MA 18101 FACILITY LOCATION ATTN Ro Lo DOTY SUPV OPER TECHNOL YEAR MO FROM DAY YEAR MO DAY TO NO DISCHARGE (26.27)
(28-20)
(30-Jl)
NOTE: Read instructions before completing this form.
(20-Zl)
(ZZ-23)
(Z4-2$)
NATIONALPOLLUTANTDISCHARGE ELIMINATIONSYSTEM (NPDES)
DISCHARGE MONITORING REPORT ( DMR)
(2-(6)
IAJOR h
~SUBR. 02)
Form Approved.
PERMIT NUMBER FINAL OMB No. 2040-0004 MONITORING PERIOD COOLING TOil~ 5$ 6Ilr $5VfP PARAMETER (32-37)
AVERAGE MAXIMUM (J Card Only)
QUANTITYOR LOADING (46-$3)
($4<i )
UNITS NO.
EX MINIMUM AVERAGE MAXIMUM UNITS (6243)
(4 Card Only)
QUALITYOR CONCENTRATION (38<5)
(46-$3)
($4@i )
FREOUENCY OF ANALYSIS (6448)
SAMPLE TYPE (69-70)
'OIIOO 1
0 0
L S
V "ZINCa TOTAL (AS ZN):
01092 1
0 0
F LU NT G
OSS V
U FLOlI a IN CONDUIT OR THRU TREATHENT PLAN 50050 1
0 0
EFFLUENT GROSS VALU SAMPLE MEASUREMENT PEP.MIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT
%~400'v vvO'Owe REPORT.'0 AVG-'
~44~C4 4
A 4 QQgA v~004v 4 REPORT Y
'; 5GD B. I:
6oO A4 4 AA 9 ~ 0 1 ~ 0' 12I 0
( 19). g EEKL'Y AIL Y
"..'AB OHP-.G CORDR CHLORINEa FREE AVAILABLE 50060 1
0 0.
E E
T SS SAMPLE MEASUREMENT
~ PERMIT REQUIREMENT, SAMPLE MEASUREMENT v~4%004
<<It(NO>>
- oe "0 420-'19)
'ERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT 9312080143 93 PDR ADOCK 05000387 1119 R 'DR NAME/TITLEPRINCIPAL EXECUTIVEOFFICER I7,, 8yrarn Sr V
( a.r 0 hara.borI 5 TYPED OR PRINTED I CERTIFY LPIDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMNED AND AM FAMLIAR WITH THE INFORMATION SUBMITTED HEREtk Atto BASED ON MY utCsARY >OF THOSE utCIVOUALS IMMEDIATELY RESPONSIBLE FOR oBTANING THE INFoRMATloN, I BEUEYE THE sUBMITTED utFCRMATIQN Is TRUE ACCURATE AND COMP(ET E.
I AM AWARE THAT THERE ARE SIGNFICANT PENALTIES FOR S(auntITatG FALSE ~CRMATICt4, INCLUDnsG THE PossIBLITY cF ~E AND FAPRIsoNMENT. sEE IB Usc.
9 tool AND 33 Usc.
9 (319.
(prosit/es under thrse ststutts msy include nnss up to
$(0()00 snd or masimumimprfsonmen(of hrtuuen 6 months snd $ tears)
SIGNATURE OF RINCIPALEXE TIVE OFFICER OR AUTHORIZEDA ENT TELEPHONE 7(7 S/t(g-3otot AREA DATE g3 ll YEAR MO DAY cf coMMENT AND ExPLANATloNoF ANYvloLATloNs (Reference all altaehmenls here)
(I i SOVl nyIQC FREE AVAILABLECHLORINE SHALL BE TAKEN DXILY BY GRAB DURING CHLOBENATION EPA Form 3320-1 (Rey. 9-88) ltrevious editions may be used.
(REPLACES EPA FORM T.40 WHICH MAYNOT BE USEDJ I
0056II/93093.0-0922 PAGE OF
PERMITTEE NAME/ADDRESS(Include Fsci%ty Nsmt/Location ifdiffennt)
NAME REJECT YIJULM.IAM~I ~QURItIkh ""
'DDRESSTMQ MMLUi HItLTX.STREET.
MLLESXOJLN 'k 1B101 FACILITY LOCATION
'ATTN Ro Lo DOTY SUPV OPER TECHNOL (SUBR 02)
Form Approved.
F 'FINAL OMB No. 2040-0004 SERV AND AOtPRi8vab9%%58$
SUNUP PERMIT NUMBER MONITORING PERIOD YEAR MO DAY YEAR MO FROM TO enscHAnot Normen DAY NO DISCHARGE I
- j NOTE: Read instructions before completing this form:
(ZDZI) (ZZ-Z3) (24-2S) 9'26-22)
(ZB-Z9) (30-Jl)
NATIONALPOLL.UTANTOISCHARCE EI.IMINATIONSYSTEM (NPDES)
DISCHARGE MONITORING REPORT ( DMR)
'".'44 (2-I6).. 'll-I9)-.i ttAJOR
.I PH PARAMETER (32-31)
SAMPLE MEASUREMENT AVERAGE MAXIMUIrL AQQQA UNITS (3 Card Only)
QUANTITYrOR LOADING (46-SJ)
(544 I )
I'INIMUM q5'VERAGE MAXIMUM (4 Card Only)
QUALITYoR coNcENTRATIoN (JBAS)
(46-$3)
(S4+I )
UNITS
( 12)
NO.
EX FRECIKNCY OF ANALYSS (6243)
I646SI 0 ~lat SAMPLE TYPE (6ILre) 00000 1
0 0
EFFLUE T
GROSS VAL SOLIDSt TOTAL
USPENDED
'00530 1
0 0
'EFF UE T GROSS V
" 'EP.MIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT OvA AAWAA 6oO -"
'(
L r 9i0.
3090. g.-'00 ~ 0' 19)
A'ILYY Q I/B I NCE/
RAB L,
'4 "~
RAB'=
IL AND GREASE
": FREON'EXTR-GRAV HETH "00556 1
0 0
EFF EN GROSS FLOlf t IN CONDUIT OR THRU TREATttENT PLAN 50050 1
0 0
E UE R
S SAMPLE MEASUREMENT
. PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT
~fi
.Oi REPORT O,
REPORT
( 03) '.
1590 20o 0.'.
( 19)
NCE/-;"
AILZ-'AB STIttA
-. r PERMIT.
REQUIREMENT SAMPLE MEASUREMENT h
". ', PERMIT
'REQUIREMENT SAMPLE MEASUREMENT PERMIT
- RKQUIsrEMENT NAME/TITLEPRINCIPAL EXECUTIVE OFFICER TYPKD OR PRINTED I CERTIFY IPIDER PENALTY'OF LAW THAT I HAVE PERSONALLY EXAMttED AICI AM FAMISAR WITH THE lt4FORMATIC<<4~O HEREtL ANO BASED ON MY t40URY 4 OF THOSE t40IVOUALS SIMEIXATELY RESPONStsLE FOR OBTAtttIC THE INFCRMATIC<<L I BEUEVE THE SUBMITTEO u<<FORMATIC<<4 IS
- TRUE, ACCURATE ANC C~
I AM AWARE THAT THERE ARE SICI4FICANT PENALTIES FORr SUBMITTttC FALSE t<<FCRMATIC<<L t4CLUDt4C THE POSSIBLITY OF Ft4E ANO tnPISSONMENT, SEE Ie US.C.
6 l001 ANO 33 Usc.
13I9.
(Rutsttt<<s undhr rh<<se st<<rut<<s msy in<<tude frn<<s utt to S I(ISt)0 snd or museum imprisonm<<nt of h<<tw<<<<n 6 months snd 5 )Ysrs) 5 ATURE PRINCIPAL EXEC VE OFFICER OR AUTHORIZEDA NT TELEPHONE s
g-3'REA NUMBER YEAR DATE MO DAY coMMENT AND EXPLANATloNOF ANYVloLATIoNS (Refennce sll attachments here)
FLOWAND PH SHALL.BE'5EASURED'DAILY'tfHEN DISCHARGINGo
~<<sf &%+ ~ 'snr
<'u' v r<
~ ~ ~" ~
u EPA Form 3320-1 (Itev. 9-88) Previous ilions may be used.;
(REPLACES EPA FORM l'-40 WHICH MA BE USEDJ ri. I PAGE OF ITL
.>00567/930910-0922 1
PERMITTEE NAME/ADDRESS(Include Facility IVamer/Location ifdifferent)
NAME 2EKHSYl~LLIAM~L ~QUBJOUL ADDREssZRQ MQRIJi HIKTX. 4a.TREZZ 33J.Elf TOOM MA 1H1.01 0
PERMIT NUMBER DI5CHAROC 44IRrutR (S U B R 0 2)
Form APProved.
F FINAL OMB No. 2040-0004 NATIONALPOLLUTANTDISCHARGE ELIMINATIONSYSTEM (NPDES)
DISCHARGE MONITORING REPORT (DJIIR)
(2-I6)
HAJOR FACILITY LOCATION ATTN R ~
L ~
DOT UP OPE ECH 0 MONITORING PERIOD YEAR MO FROM (10-2I)
(ZZ-Z3)
(24-2$ )
(16-27)
(ZS-29)
(30-3l )
DAY YEAR MO DAY TO 41 TUHBINE %F80 -'%9ISWP 5N.P HO DISCHARGE l
l NOTE: Read instructions before compieting this form.
PARAMETER (32-31)
AVERAGE MAXIMUM (3 Card Only)
QUANTITYOR LOADFNG (46-$3)
($4-6I)
UNITS MINIMUM AVERAGE MAXIMUM (4 Card Only)
QUALITYOR CONCENTRATION (38-4$ )
(46-$3)
($4%I )
FREQUENCY
~vsts t624)I t64+S)
SAMPLE TYPE (69-70)
PH 00tt00 1
0 0
0 SAMPLE MEASUREMENT
- PEPMITr,
,RECILIIREMENT 6 ~ 0 4cc4-. 9.0
( 12)
I
'let te8 AILY RAB; SOLIDSa TOTAL SUSPEHDED 00530 1
0 0
E U
G OSS V
OIL AHD GREASE FREON EXTR-GRhV NET 00556 1
0 0
F U
G OSS
.V U
SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT 30+ 0 15i 01 l.p
( 19) 100m 0-20 ~ 0 HCE/.
ICE/'AB FLOrtfa IH COHDUIT OR THRU.TREATHEHT PLAN 50050 1
0 0
E PERMIT REQUIREMENT SAMPLE MEASUREMENT REPORT':
vraruREMENr I1 b131 O.@a<
REPORT-.
( 03),"
AILYT= STIGMA PERMIT-REQUIREMENT SAMPLE MEASUREMENT
-PERMIT <<
RECIUIREMENT SAMPLE MEASUREMENT
. PERMIT'-
REQUIREMENT NAME/TITLEPRINCIPAL EXECUTIVEOFFICER
.Cj, Irate r
v P IVu,dear QemkITIs TYPED OR PRINTED I CERTlFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMtIED AND AM FAMILIAR WITH THE 'INFORMATION SUBMITTED HEREtt AND BASED ON MY tIQVRY r OF THOSE t4CIV COALS MMEOIATELY RESPONSIBLE FOR QBTAttt43 THE t4FQRMATIQN. I BEUEVE THE SUBMITTED t4FQRMATIDN IS
- TRUE, ACCURATE AND COMPLETE.
I AM AWARE THAT THERE ARE SXiNFICANT PENALTIES FOR SUBMrrTtto FALSE tIFCRMATICtL ttCLUDtXI THE POSSIBLITY OF ANE AND IIPRISQNMENT. SEE 1B LISC. 0 1001 AND 33 Usc.
a 1319.
(penalties under these statutes may include fines up to SI0000 and or maximum imptuonment of betntrn 6 months and 5 yeats)
IG RE 0 INCIPALEXECUT E
OFFICER OR AUTHORIZEDAG T
TELEPHONE NLIMBER YEAR DATE MO DAY coMMENT AND ExpLANATloNoF ANYvloLATloNs (Reference all auachments herc)
PLOQ AHD PH SHALL BE 5EASORED DA'ILY MHEH DISCHARGIHG EPA Form 3320-1 (Rev. 9-88) Itievious edt'lions may be used.
IRKPLACES EPA FORM T-40 WHICH MAYNOT BE USEDS 00570/930910-0922 PAGE OF 1
PERMITTEE NAME/ADDRESS(Include Fac'ility Name/Location ifdi(ferent)
NAME
. 2PJIKS XLJLAtiLIAM~I~QUMUOi ADDREss~ ~tn~t MIRT~~TR~
JQJZBI TEGMEN MA Lf~
FACILITY LOCATION AT N
~
n 0
7 UPV NATIoNALPDLLUTANTDtscHARGK ELIMINATIoN8YBTBM((VPDES)
DISCHARGE MONITORING REPORT ( Dh(R)
(2-ld) tlAJOR (SOBR, 02)
Form Approved.
PERMITNUMBER plscHARcc Ntn uun F
FIR AL oMB No. 2040-0004 MONITORING PERIOD 02 TURBINE %FBI'%%'5%5 SNP YEAR MO DAY YEAR MO DAY FROM TO NO DISCHARGE j=
(20-2l)
(22-23)
(24-2$)
(26-27)
(25-29)
(303()
NOTE: Read instructions before compieting this form.
PH PARAMETER (32-37)
SAMPLE MEASUREMENT AVERAGE MAXIMUM (3 Card Only)
CIUANTITYOR LOADING (46-$3)
($44))
UNITS MINIMUM B.cc AVERAGE MAXIMUM (4 Card Only)
QUALITYOR CONCENTRATION (3B<$)
(46-$3)
($44()
UNITS
( 12)
NO.
EX (62UI)t FRECXKNCY CF ANALYSIS tddVB)
SAMPLE TYPE (69-70) 00400 1
0 0
SOLIDSt "TOTAL OSPENDED 00530 1
0 0
PEPMIT..."-
REaUIRKMKNT SAMPLE MEASUREMENT
".PERMIT;ER REQUIREMENT S
.40~040--
S
" "i%'. ~
6n0'..
'O:$
0444-.
30i 0 '-;-,-'-,
100n 0
( 19)
LILT-, RAB MCE/'. BAB U
OIL AND, GREASE FREOR 'XTR-GRAV-5ET 00556 1
0 0
SAMPLE'EASUREMENT
'PERMIT
..'EQUIREMENT
- Ofv~&OTY
<<04stl~~~~4:I"
- r'Fsr R,
'-'c 15o0=,
.'.4 20e0
('9)
ICE/.
RAB" T
r LOQt IH CONDUIT OR THRO.. TREATIEHT PLAM 50050 1-0 0
SAMPLE MEASUREMENT Oo Q P PERMITS!*
"-, REPORT
RKClUIREMENT
,: 'REPORT..
,sn sEt~tituUg AILY'= STISA SAMPLE MEASUREMENT PERMIT-REQ UIREMENT TS SAMPLE MEASUREMENT PERMIT'-;
RKQUIREMENT T'-
SAMPLE MEASUREMENT
.S PERMIT-REQUIREMENT M5 NAME/TITLEPRINCIPAL EXECUTIVEOFFICER TYPED OR PRINTED I CERTIFY ItaKR PENALTY OF LAW THAT I HAVE PERSONALLY EXAMtcED Art> AM FAMLIAR WITH THE INFORMATION SVBMITIKDHVKtt At4D BASED ON MY t4OVRY s OF THOSE tcotVOUALS IMMEDIATELY RESPONStBLE FOR OBTAttttG THE t4FCRMATION. I BEUEVE THE SUBtSuITED t4FORMATION IS TRUE ACCURATE Atty COMPLETE I
AM AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMfTTt4G FALSE t4FCRMATION t4CllÃXNC THE posstILJTY oF Ft4E AND tnpRtsot4MENT. sEE IB vsc.
5 4001 AND B3 USC.
d 4349.
(flea!ties under these statutes msy include lines ttp to 5tott00 und or mstdmum imprisonment of hettecen d months und 5 yeats)
GNATURE OF PRINCIPAL EXE TIVE OFFICER OR AUTHORIZEDA ENT TELEPHONE f
%2-o AREA NUMBER DATE g3 It dr2 YEAR MO DAY
'COMMENT AND EXPLANATIONOF ANY VIOLATIONS (Reference all attachments here)
.FLOM ARD'PHM SHALL. BE HEASORED DAILY MHEHT; DISCHARGIHG ~
EPA Form 3320-1 (Rev. 9-88) (sfevious ed(lions may be used.
IREPI,ACES EPA FORM,T-4D WHICH MAYNOT, BE USEDJ 00573/930 10-0922 PAGE l OF
/
1
PERMITTEE NAME/ADDRESS(Include Faci%ty ¹meiLocation IT dif(erent)
NAME RFJItNSXLJULKLKM~L-SKSQONOUt ADDRESS~ ~M~i LLEWTOSH Mk XMAG.
r (SU BR 02)
Form Approved.
FINAL OMB No. 2040-0004 SEQAGE TREATER'Nfd"RVFSRR PERMITNUMBER orsessARoe ssvssuen MONITORING PERIOD NATIONALPOLLUTANTDISCHARGE ELIMINATIONSYSTEM ()4PDES)
DISCHARGE MONITORING REPORT (DMR)
'(2-ld)
HAJOR FACIUTY LOCATION TTN Ro Lo DOT PV 0
YEAR MO FROM (20-2l)
(2Z-23)
(Z4-ZS)
(26-27)
(26-29)
(30-3l)
DAY YEAR MO DAY TO NO DISCHARGE I.
1-~~~
NOTE: Read instructions before completing this form.
PH PARAMETER (32-37)
SAMPLE MEASUREMENT AVERAGE MAXIMUM Q4 QA QA (3 Card Only)
QUANTITYOR LOADING (46-$3)
($4Ess ()sI)g 2.+
'REPOAT -"
s hh Qwrf A Itrg>>s 4
'sp
( '-26)
( o3) 6o0 Q4 Hg&nhg
- ~~4444 REPORT-.'-.
'4 l)eel'-'I 30m 00
~
03/
REPORT I 190 2000,-'-
9 ~ 0 A +AssIAA
.;" REPORT -.
OCcCACc~~
.'"0C 44 04,
( 19)
( 19),
K
( 13)'
isl k'ILY':
NCE/
AILY'.
AILY:
r 8CE/',
RAB" BODF CARBONACEOUS 05 DAYF 20C 80082 A
0 0
SAMPLE MEASUREMENT
.PERMIT 16 ~ 70
'EQUIREMENT SAMPLE MEASUREMENT I'
( 26)".
ooooo
, ~~0~0~;, 25m 0;
( 19)"
f~(
NCE/-".'BP-'8 PERMIT REQUIREMENT
'AME/TITLE PRINCIPAL EXECUTIVEOFFICER
. Ct.
Bura.rn 6r. V.f
)C<clcnr rokrn5 TYPED OR PRINTED I CERTIFY ItaISR PENALTY OF LAW THAT I HAVE PERSONALLY EXAIseAED AND AM FAMaJAR WITH THE ItsFORMATION SUBSuTTED HKREt4 AND BASED ON MY ttQIJRY s OF THOSE tIDIVOUALS taMSDIAYKLY RESPONQBLE FOR OBTAttt4G THE INFORMATION. I BSUSVE THE SUBMITTED t4FORMATION IS TRUE.
ACCURATE AND COMPLETE.
I AM AWARE THAT THERE ARE QGI4FICANT PENALTIFS FOR SInIMffTt4G FALSE trFORMATIOtL INCLUOttG THE POSStRJTY QF FtIK AND usPRISONMQ4T.
SEE IB USC.
$ IOOI AI4D 33 Us.c.
6 1319.
(Fcnsrrics under these srsrurcs msy include lines up to S tot)tro and or maximum imprisonment or hcruecn d months and S Jean)
S GNATURE F PRINCIPAL EXEC TIVE OFFICER OR AUTHORIZE GENT TELEPHONE DATE
(
5 g-384) g3 l(
NUMBER YEAR MO DAY coMMKNTAND ExPLANATloNoF ANYvloLATloNs (Re(erence all allachments here)
EPA Form 3320-1 (Aev. 9-88) (stevious ediliorrs tna) f)e used.
IREPLACES EPA FORM T-40 WHICH MAYNOT BE USED) 00576/930910-0922 PAGE OF
\\
~
~
w PERMITTEE NAME/ADDRESS(Include F~cility Name/Location ifdi(fermi)
NAME RElBLSXJJLKtLLLM~L SGSQQ}LR5LA ADDRESSTRG DORXt NIKTE.STREET.
JLLLEMTQlLN WA ~LE FACILITY LOCATION A
N NATIONALPOLLUTANTDISCHARGE ELIMINATIONSYSTEM (JVPDES)
DISCHARGE MONITORINGREPORT ( Dh(R)
~
(2-(6)
'h JOR 02'orm Approved.
PERMIT NUMBER I tsowAwoe N~o<<F
. Fz N AL OMB No. 2040-0004 MQNITQRINQi F ERIQD RADMASTE TR%'%84%0'M(5NT YEAR MO DAY YEAR MO DAY 0
1
~ ~. NO DISCHARGE (20.2()
(22-23)
(24-2$)
(26-22)
(26-29)
(30.3))
NOTE: Read instructions before completing this form.
PARAMETER (32-37)
AVERAGE MAXIMUM (J Lard Only)
QUANTITYOR LOADING (46-53)
($44()
UNITS MINIMUM AVERAGE
- MAXIMUM, (4 Card Only)
QUALITYOR CONCENTRATION (38<5)
(46-53)
($
4%I )
UNITS NO.
EX (624)1 FREQLENCY OF ANALYSIS (6AIa)
SAMPLE TYPE (60-20)
OLIDSa TOTAL USPENDED 00530 1
0 0
FF SAMPLE MEASUREMENT PERMIT REQUIREMENT
~'40 W' 4
30o 0.,
t 100'4.
Cj RAB.
LOMB INrCONDUIT OR THRU TREATHENT PLAN 0050 1
0 0
'I SAMPLE MEASUREMENT
'- REPORT'-
MEASUREMENT
~
d02lRI "I
.'REPORT
~44040 4 A 4 AAAg IIIA+Q~I AIL'TIGMA w"
PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT
~,
SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT RKQUIREMENT, SAMPLE MEASUREMENT PERMIT REQUIREMENT E
NAME/TITLEPRINCIPAL EXECUTIVEOFFICER Cq BI.(rotT.I 5r,. V t.
I iutjcN kkAls TYPED OR PRINTED I CERTIFY IÃ4DER PENALTY qF LAW THAT I HAVE PERSONALLY EXAInNED AICI AM FAMLIAR WITH THE toQRMATlON SUBMRTED HKREt4 AND BASED ON MY tIQVRY>OF THOSE ttCIVOUALS tSMECIATELY RESPONSIBLE FOR QBTAttttO THE t4FQRMATIQN. I BEUEVE THK SUBlnTTED t4FQRMAT1ON IS TRUE.
ACCURATE AND COMPLETE I
AM AWARE THAT THERE ARE.
SGI4FICANT PENALTIES FOR SUBMIITtIQ FALSE ttFCRMATIQIA t4CLUDtto THE PQSSIBLITY OF'RE AND usptuSQNMENT.
SEE IB VSC. f IQQI ANQ 33 Usc.
1319.
(penalties under these statutes msy include nnes up to
$10000 snd or msximum impn'sonment of between 6 monttts snd 5 >eats)
SI ATURE OF PRINCIPAL EXEC VE OFFICER OR AUTHORIZED ENT TELEPHONE AREA NUMBER YEAR DATE MO DAY COMMENT'ANDEXPLANATIONOF ANY VIOLATIONS(Refennee all attachments hen)
'PLOM SHALL BE MEASURED DAILY MHES DISCHARGING
, EPA Form 3320-1 (Rev. 9-88) Re ious editions maybe usecL IrtEPL+C ES EPA FORM T 40 WHICH MAYNOT BE USED),.
~
00579/030910-'0922 PAGE OF 1
PERMITTEE NAME/ADDRESS (Include Paci%ty Name/(.ocation ifdifferent) 2EtLNS EIJUl2kILM~I -'QlJEttNA ADDRKBSZRQMMtTIk NZtQ'WSTREET.
LI~iT~Oi NA 1Ik101 PERMIT NUMBER DlsCHARCC txUxxden MONITOR ING P E R I0 D (SUBR 02)
Form Approved.
F FI N AL,.- 0MB No. 2040-0004 MASTE FILTRPP'8'PAR'5 NATIONAL;POLLUTANTDISCHARGE ELIMINATIONSYSTEM (NPDES)
DISCHARGE MONITORING REPORT ( Dit(R)
. (2-(6)
MAJOR FACILITY LOCATION Oo r tJ V
OP.
(20-2l)
(ZZ-ZJ)
(Z4-2$)
(26-27)
(2$-29)
(30-J I )
YEAR MO DAY YEAR MO DAY FROM TO NO DISCHARGE j-¹¹¹ NOTE: Read instructions befo e co pleting this form.
PARAMETER (32-37)
AVERAGE MAXIMUM (3 Card Only)
QUANTITYOR LOADING (46-$3)
($44))
UNITS (4 Card Only)
(JS-4$ )
MINIMUM AVERAGE MAXIMUM QUALITYOR CONCENTRATION (46-$3)
($44()
UNITS NO.
EX (6243)
FREOIXNCY OF ANALYSIS (6A$S)
SAMPLE TYPE (69-70)
OLIDS ~
TOTAL USPENDED 00530 1
0 0
'EXTR-GRAV NETH 00556 1
0 0
0 FLOM IN CONDUIT OR THRU TREATMENT PLAN 50050 1
0 0
SAMPLE MEASUREMENT PEPMIT REQUIREMENT SAMPLE MEASUREMENT
'ERMIT.
REClUIREMENT SAMPLE MEASURKMKNT PERMIT REQUIREMENT REPORT
. REPORT
"- ~
A¹4
( 03)
¹¹¹¹¹¹
¹¹¹¹¹¹ x
30RO.
15RO 100d 0 20 ~ Ote
(. 19)
( 19)'CE/-.
RhB NCE/";
RAB.
hILY" LOIND SAMPLE MEASUREMENT PERMIT REClUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT
'ERMIT REClUIREMENT.
SAMPLE MEASUREMENT PERMIT REQUIREMENT x ~
'AME/TITLE PRINCIPAL EXECUTIVE OFFICER HG. Bg(Qw Sr V.P h/u.c, Iccu-henS TYPED OR PRINTED I CERTIFY UNDER PENALTY CP LAW THAT I HAVE PERSONALLY EXAMlNEO Atas AM FAMLIAR WITH THE INFCRMATxDN SUBMITIED HEREtt: AND BASED ON MY ttOtaRY
> OF THOSE ttDIVOUALS IMMEDIATELY RESPONSIBLE FOR OBTAtaNG THE ttFQRMATION I BEUEVE THE SUBxuTTED ttFORMATION IS TRUE.
ACCURATE AND COMPLETE '
AM AWARE THAT THERE ARE SIGNFiCANT PENALTIES FOR SUBMrfTttG FALSE dmCRMATlOtd INCLUDING THE POSstBLlTY OF FINE AND dtPRISCNMENT. SEE IB USC 6 IOOI AND 33 USC.
6 I319.
(Penalties under these statutes msy include fines utt to SI0000 and or maximum imnrisonmcnt of benin 6 months and $ )cats)
NATURE PRINCIPAL EXEC IVE OFFICER OR AUTHORIZEDA ENT TELEPHONE I
otPO NUMBER YEAR DATE MO DAY COMMENT AND EXPLANATIDNoF ANY VIOLATIONS (Reference all atlachments here)
FLOM.SHALL BE MEASURED DAILY-MHEN DISCHARGING EPA Form 3320-1 (Rev. 9-88) Previous editions may be used.
IREPLACES EPA FORM T 40 WHICH MAYNOT BE USEDJ 00582/930910-0922 PAGE OF
'ERMITTEENAME/ADDRESS(include Facility Name/Location ifdifferent)
"AME k&5LKSYIJULXDLM~I='~QUlOOQl ZRO.Muser 'XMTa. &THEET.
JQJJJf TOlUt 'h ~L01 I
PERMIT NUMBER
~t OISCSSAROC SIUSS4IR MONITORIlsttn PERIOD (SUER 02~
Form APProved.
- FIHAL OMB NOa 2040-0004 NEUTRALIsrh~'8" lAt5'XQ VLKHARGE NATIONALPOLLUTANTDISCHARGE ELIMINATIONSYSTEM (NPDES)
DISCHARGE MONITORING REPORT ( DhfR)
(2-l6)
HAJOR FACILITY LOC:ATION ATTN:
RE L ~
. DO SU tf ER C
(20-2( )
(ZZ-23)
(Z4-2$)
(26-Z7)
(ZS-ZS)
(30-3l)
YEAR MO DAY YEAR MO DAY FROM TO
¹¹¹ 80 DISCHARGE NOTE: Read instructions before completing this form.
PARAMETER (32-37)
AVERAGE MAXIMUM (3 Cant Only)
QUANTITYOR LOADING (46-$3)
($44))
UNITS MINIMUM AVERAGE MAXIMUM (4 Card Only)
QUALITYOR CONCENTRATION (38-4$ )
(46-$3)
($44( )
UNITS NO.
EX FREQUENCY ANALYSIS (6Z4J), (6446)
SAMPLE TYPE (69-70)
OLIDSF TOTAL SUSPEHDED 00530 1'
0 SAMPLE MEASUREMENT PEPMIT
,REQUIREMENT
¹¹¹A¹A Ra 30o0..
100o 0.;.E
( 19).
HCE/:
RAB:
'bt 6RAB IL AHD GREASE'REOH"EXTR-GRAY. HET 00556 1
0 0
U H
G V
U FLOlfa IH CONDUIT OR THRU TREATHEHT PLAN 50050 1
0 0
U S
SAMPLE MEASUREMENT PERMIT REQUIREMENT RESSORT; SAMPLE MEASUREMENT T PERMIT
,REQUIREMENT.
MEASUREMENT O 0 I 77 O.Oi90
< "I REPORT
¹stfc¹sts¹¹'.'5o0'0or0-(M19)
HCE/>>
hIL-Yt RAB '-"-
STIGMA PERMIT REQUIREMENT SAMPLE MEASUREMENT
" PERMIT REQUIREMENT
'A I
a SAMPLE MEASUREMENT
'ERMIT;.-
REQUIREMENT SAMPLE MEASUREMENT PERMIT" REQUIREMENT I
NAME/TITLEPRINCIPAL EXECUTIVEOFFICER g,. LI.
Stir a.m,$ r.
Y,I7.
- t. enr Runs TYPED OR PR D
,I CERTIFY UIDDI PENALTY OF LAW THAT I HAVE PERSONALLY EXAOED Atat AM FAMIIAR WITH THE INFORMATIQN SVBMITTED HEREte AND BASED ON MY ttQVRY I OF THOSE uttXVCVALS tIIMEDIATELY RESPQNSBLE FOR OBTAttttG THE ISFCSIMATION. I BEUEVE THE SIBMMITTED tIFORMATION IS TRIJE ACCVRATE AND COMPLETE. I AM AWARE THAT THERE ARE BCMFICANT PENALTIES FOR SUBMITTteo FALSE t&CsIMATICe>> INCLIIOING THE POSSIBLITY OF ARE AND SsptusCNMENT.
SEE 18 USC. f 1001 AND 33 USC. f 1319.
(Penstties under these ststutes msy inetude fines up to SION'nd or msximum imprisonment of bettreen 6 months snd S )eats)
IG ATURE PRINCIPAL EXE VE OFFICER OR AUTHORIZED ENT TELEPHONE DATE
/
g-A>LI AREA NUMBER YEAR. MO DAY COMMENT AND EXPLANATIONOF ANY VIOLATIONS (Reference all attachments herc)
FLOM SHALL BE MEASURED.DAILY QHEH DISCHhRGXHGo
¹EH.
FLOM SHALL BE HEASURED DAILY
¹HEH DISCHARGIHG ~ 'HERE SHhLL BE H¹ DISCHA'RGE OF POLYCHLORIHATED BIPH¹HYL CONPOUNDS ~
SEE PERMIT FOR OPIH Fo
-88) Previous editions may be used.
(REPLACES EPA FORM T-40 WHICH MAYNOT BE USED),
PAGE
+ OF 00585/930910-0922 1
PERMITTEE NAME/ADDRESS(include Facility (VameiLocation ifdifferent) 2EKlLIXIJLKBLIAM~I==~QUERlGL ADDREssZRQ MQR'Lff HILLTOP.STREET.
~~so~
MA 1KL01 0
PERMIT NUMBER OISCRARCC NUIIOER MONITORING PERIOD (SUBR 02)
Form Approved.
F FINAL OMB No. 2040-0004 MASTE FILTE%prgy+grggp-31-94 4I NATIQNAUPQLLUTANTDISCHARGE ELIMINATIONSYSTEM (IVPDES)
DISCHARGE MONITORING REPORT ( D)I(R)
- (2-(6)
~.-
()7-I>)
MAJOR FACILITY LOCATION ATTN
. R ~
L~
DOTY SUPV OPER TECHNOL DAY (20-2l)
(22-23)
(24.2$ )
(26 27)
(2tt. 19)
(30.3 I)
YEAR MO DAY YEAR MO FROM TO ED DZSCESEGE ~I NOTE: Read instructions before completing thh form.
PARAMETER (32-37)
(3 Card Only)
QUANTITYOR LOADING (46-$3)
($44()
MAXIMUM AVERAGE UNITS MINIMUM AVERAGE MAXIMUM (4 Card Only)
~.
QUALITYOR CONCENTRATION (3$<$)
(46-$3)
($44()
UNITS NO.
EX (6243)
FREQUENCY QF ANALYSIS (6446)
SAMPLE TYPE (6IL70)
SOLIDSa TOThL SUSPENDED 00530 1
0 0
LU N
G 0 S. VA U
SAMPLE MEASUREMENT PEPMIT <<
REQUIREMENT
~+r4~4>>
\\
1 "igQ~Qg h 30nhD '
100h ~ 0
( 19)
NCE/:
RAB--'
IL AND,GREASE FREON EYTB-GRAV METH 00556 1 0,0 EFFLUENT GROSS VALU LOM a IN CONDUIT'R HRU TREATMENT=PLAN 50050 1
0 0
EFFLUEN GROSS V
U SAMPLE MEASUREMENT PERMIT RECIUIREMENT SAMPLE MEASUREMENT QQAggA IS
~ t'-I'-
PERMIT.
- REPORT
,REQUIREMENT tie0 AVG SAMPLE MEASUREMENT REPORT th
( 03) 4 &hA ~ Ar>>
15 on'0 20RO t
c-I
( 19)
NCE/:
RAB AhI AILYr'OIND PERMIT REQUIREMENT h.
5 SAMPLE MEASUREMENT PERMIT'EQUIREMENT SAMPLE MEASUREMENT
.'PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT NAME/TITLEPRINCIPAL EXECUTIVEOFFICER TYPED OR PRINTED I CERTIFY LuaKR PENALTY QF LAW THAT I HAVE PERSONALLY EXASANEQ ANQ AM FAMEaAR WITH THE utFCRMATEON SUBMtrTEQ HEREut: ANQ BASEQ ON MY utotaRY
> OF THOSE utDIVCUALS MMEDIATELY RESPQNSBLE FOR QBTAuaNQ THK hlFQRMATEON I BEUEVE THK SUBMITTEQ utFQRMATION IS TRUE.
ACCURATE Atst COMPLETE.
I AM AWARE THAT THERK ARE SIGNFICAMT PENALTIES FCR SUBMtrTuto FALSE utFCRMATIQN THE PQSSIBLITY OF FutE ANQ nsPRISQNMENT, SEE 18 llSC. 'I IQQI
- 33. Usc.
6 13)9.
((vnshrcs unccr these hststutcs may incluch fines up to SI0060 and or matimum intpriSOnmcnt of between 6 months anC S >ears)
SIGNATU OF PRINCIPAL E TIVE OFFICER OR AUTHORIZE AGENT TELEPHONE
/
5 Qtk)
AREA NUMBER YEAR DATE
//
/8-MO DAY
'COMMENTAND EXPLANATIONOF ANY VIOLATIONS (Reference all attachments here)
FLOM SHALL BE MEASURED DAILY MHEN DISCHAR'GING~
EPA Form 3320-1 (RBv. 9-88) Previous editions may be used.
(REPLACES EPA FORM T 40 WHICH MAYNOT BE USED) 00588/930910-0922 PAGE OF 1
FACILITY LOCATION ATTH.
RE LE DOTY SUPV. 0 E
TECHH PERMITTEE NAME/ADDRESS(include Faci%'ty Name/Location ifdifferent)
NAME ZaSHS XZZ~LEAm~L =-~gamtmL ADDREssTRQ MlHLUi HEHTH STREET.
fQJ EHXO30l MA ~01 NATIONALPOLLUTANTDISCHARGE ELIMINATIONSY5TEM (NPDES)
DISCHARGE MONITORING REPORT ( DMR) fZ-I6)
MAJOR (SUBR 02)
F
'FIHAL Form Approved.
0MB No. 2040-0004 enseHARoc Nustuan PERMIT NUMBER 571 CIRC WAFR'R 9 '8t YEAR MO DAY YEAR MO DAY FROM
~
TO HO DISCHARGE I
I (ztt-zt)
(zz-z3)
(24-2$ )
lz6-z7)
(zs-zest)
(30-3))
NOTEIReadinstructionsbeforecompletingthisform.
PARAMETER (32-37)
AVERAGE MAXIMUM (3 Card Only)
QUANTITYOR LOADING (46-$3)
($44) )
UNITS MINIMUM AVERAGE MAXIMUM (4 Card Only)
QUALITYOR CONCENTRATION (3tr4$ )
(46-$3)
($44) )
UNITS NO.
EX (624))
FI4EOVENCY OF ANALYSIS (64446)
SAMPLE TYPE (69-70)
OLIDSa TOTAL SUSPENDED.
00530 1
0 0
OSS U
OIL AHD GREASE FREON
. EXTR-GRAV NET 00556 1
0 0
PLOsfa IN CONDUIT OR THRU TREATMENT PLAN 50050 1
0 0
EF E
R V
SAMPLE MEASUREMENT
-PERMIT!
REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT" REQUIREMENT SAMPLE MEASUREMENT 0440~0".:
D.i30gt "REPORT';
v O f REPORT
( 03)
'tt
. ~~~Cc -'
P 30'0"- -'-
I-15 ~ 0-.. "
I 100
0n0
'( 19)'
NCE/:
LOEHD Ill PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT PERMIT REQUIREMENT SAMPLE MEASUREMENT
- - -PERMIT RKQUIREMENT s
r NAME/TITLEPRINCIPAL EXECUTIVEOFFICER TYPED OR P INTED I CERtlFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED AND AM FAtnLIAR WITH Tt&~ORMATIDN~O HEREta ANO BASED ON MY t4QIasIY > OF THOSE t4OIVOUALS uaMEOIATELY RESPONStBIE FOR OOTAtaNG THE ttFC44MAYlON. I SEUEVE THE ~EO t4FORMATION IS TAVE ACCURATE Asap COMPLETE I
AM AWARE THAT THERE ARE SICtaFICANT PENALTIES FOR SIKMITTt4G FALSE t4FC44MATICtl t4CLUDt4C THE POSSteLIIY OF Ft4E ANO MFRISQNMENT. SEE 18 Us.c f IODI AND 33 USC. f l3I9. (Penatties under tttese smtutes may include I>net up to S IODOO and or maximum imprisonment of betueen 6 months and S penta )
IGNATUREOF PRINCIPAL EXE TIVE OFFICER OR AUTHORIZE GENT TELEPHONE AREA NUMBER YEAR DATE
~ MO DAY COMMENT AND EXPLANATIONOF ANY VIOLATIONS (Reference all attachments herc')
FtLOM SHALE BE "MEASURED '. DAILY'HEN DISCHARGING t
. EPA Form 3320-1 (Rev. 9-88) Rtvious fudijiqns.tnay.fpe tied.
,IREPLACES /PA FORM T 40 WHICH MA'7 N9T BK USEDP
.00591/930910-0922 PAGE
~ OF 1