ML18086B452

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NPDES Repts for Mar 1982
ML18086B452
Person / Time
Site: Salem  PSEG icon.png
Issue date: 04/19/1982
From: Miller L
Public Service Enterprise Group
To:
Shared Package
ML18086B451 List:
References
NUDOCS 8204300443
Download: ML18086B452 (17)


Text

r, * £l:.b**oost*o3s MITTEE Niit'ME/UD ESS ,,,,,.,.. NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOf:sJ D!SCHARGE MONITORING REPORT fVMRJ Form Ap/m'v~d * ...

OMB No. 158-R001J (11-lfJ I GP AT r.':

PERMIT NUMBER DISCHARGE NUMlll:R 17 2 ..

MONITORING PERIOD DAY YEAR MO DELAWARE RIVER FROM 01 TO 82 03 COOLING WATER (11*11} (11-1.IJ (1f-17J (11-1'1 NOTE: Read lnltructlon* before completlng thlaform.

JOO lU PARAMETER EMPERATURE,WATER (J1-J7J Z

x SAMPLE MEASUREMENT (J (.'*dtlrt'1J

(#-.UJ AVERAGE QUANTITY OR LOADING t--------.--------.-----+-------.--------.---~--'----.----~ EX MAXIMUM UNITS

,, C"*d """'

(.U*'*'I MINIMUM QUALITY OR CONCENTRATION

(#-.UJ AVERAGE (JUI}

MAXIMUM UNrT8 NO.

(11-4JJ l'llE~Y ANALYlllS (U-#J CONT SAM..U:

TYl"E (l'-711 NA JEG.CENTIGRADE NF LUE NT JUU1U 1 SAMPLE EMPERATURE,WATER DEG.CENTIGRADE MEASUREMENT

        • **** CONT NA.

EFFLUENT GROSS UUUlb 6t SAMPLE

~EMPERATURE MEASUREMENT * * * * * * *

  • OIFFERENCE EFFLUENT NET UU"tUU 1 H

SAMPLE MEASUREMENT $ *** * ... * * \ 2/7 GR EFFLUENT.GROSS UU'"tUU PH SAMPLE MEASUREMENT *$ $ *

        • 2/7 GR NFLUENT

>UU5U 1 FLOW SAMPLE MEASUREMENT .. * $ * ***

  • CALC NA EFFLUENT GROSS

~UUf>U

  • l SAMPLI!
  • CALC GR CHLORINE, TOTAL RESIDUAL MEASUREMENT $ $
  • EFFLUENT GROSS

~


1 NAMEmTl..E PRINCIPAL EXECUTIVE OFFICER THIS DOCUMENT 19 SIGNED WITH RECOGNITION THAT KNOW-INGLY MAKING A FALSE CERTIFICATION ON THIS REPORT OR ~ J/./

./( U..,

~ "*/')

fJt".

DATE L. K. Miller SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING w1Tt1 ANY MoN1ToR1No DEv1cE oR METHOD ARE cR1M1NAL 1----:11L:u.=:-=~~~-----~ I 609 365-700( 82 04 19


1 """"'o"""' o/

TYPED OR PRINTED OFFENSES. SEE Ill U.9.C. I 1001 AND 33 U.9.C. 11318.

llr1 *rtdrr lltr11 *l*I*"* ,..,, 61 /lrtra *P 10 Jll,111 *rt'/or .,.. ,,,, * .,

& . f -

  • _,,., .,, ~ JINn.J (Plftlll- SIONATUREO,.P'..INCIP'ALEXECUTIVI:

OFFICER OR AUTHORIZED AOENT t-T-r-t-------jr---;---r---t CO~E I HUMBER YEA" MO DAY MMENT AND EXPLANATION OF ANY VIOLATIONS (Rt/nlftrt .n .,,<<11,,,,..1, Anti OIS 401 IS CONDENSER COOLING WATER.WHEN lNTK PH LESS THA~ 6.0~DIS PH NOT TO BE LESS. HHEN INTK PH GREATE R THAN 9.0,0IS PH NOT TO EXCO INTK NOT MORE THAN 3 CONDENS MAY DIS FREE Cl AT ANY TIME,OR ~ORE THAN 3CMIN Unit Shut Down -*No Discharge Occurred During this Report Period.

1 17

RMITTtll NAMll/ADDIH9e (111dllll1 NATIONAL ~LLUTANT DlllCHARGE !ELIMINATION. llYllTl!M (/YrDF.S) Form Approv~d rlll11 Narrw /Loc*tfort II "11~""') DISCHARGE MONITORING REPORT (DMR) OMB No. 158 - R007 JC!

1!!1~~~ ~._-_mw_m ___ ~------- l-16) 11-19)

!R!!.~_PSE&~-------"---*------- NJ0005622 481 GP. AT MI

  • -~_J?_&. 00,t 57.Q__.J.OC. __________ _ PERMIT NUMBER DlllCHllAOE NUMBEll 17 2 1

___ .JmiABK__ _ _ _ .JU__filJJll.. ______ _

MONITORING PERIOD

~cm.o:r_SALEM_GENERA~ ~

CRFEK _________-------- _ ,...OM 8L UJ IU.l ITO 82 103 131 mDMARE mvm 9.~~ICMER_ALW'lAYS YEAR MO I DAY I YIEAR I MO I DAY CJ:x)I.JN3 WA'IER (10-11) (22-ZJ) (24-ll) <Z6 ll) (211-l!I) (JO-JI) NOTE: Reed lnetruetlone btfor9 eompleftng Ihle forlll.

(J Card Only) (4 Cnrd Onlr)

X QUANTITY OR LOADING QUALlfY OR CONCENTRATION PARAMll:TllR ...__~(~"-~-J~)---r--_;..(J_4_~_1~)---r-----+--(~J-3~_J~)--...,---(~4-6"'_J~)~--r---(~J-4~~1~)~-..,....._--~

NO, EiC

~lllEOg:NCY ANAL .,

eAMl9Lll TYPlt (JJ:.,,7) 919 AVERAGE MAXIMUM UNITe MINIMUM AVERAGll MAXIMUM UNITe t**-70) 00530 SOLIIlS, 'lUlm.

SUSPENDED F.FFT JTl<'tJTI 1

I BAMPLE MEASUREMENT Plt.. MIT REQUIAl!lt481"iT

  • fr** *.'It.*
  • . J;.  :.. 't

~~~~---t-~. *.*.~.* *.**~~*-.~---.~--~.~~.--1~.,,....._,,..~..,._-1

.., ~ .. : . ***.:*:. .. ... : .*****

.. "<\ ...:: *.

?<<;/I, 1/30 GR 00530 B eAMP'Lll SOLIDS, 'lUl2\t, Ml:A*UREMENT

        • ,__........~----..--....-~~-t-o....-~~~~M:;/I, 1/30 GR USPENDED

---.** n1*1--n.M:

. ...,:*.. ~ *, ..

' ..... ::* * ... .:.::\.:..*:

00530 4 SOLIIlS, ~ ** ** **** 1/30 GR

". ,. "" .. < " *: ,, . " ....... * """'""" < M:;/I, SUSPENDED EFFli.JEm' NF:!' *.. ******* .::::30.~q * :..;..: *:, ioo~.~**>* .

. "*** .* .. >* .(:. .* ,,.,.. ~.J.;fr "GR

..<: ;..*;.* .. \> .~*;.. . . *. ~ ..

00550 1 9AMPLll: fr fr fr fr

  • *
  • fr ***
  • OIL AND GRFME MllA8U RllMllNT 1/30 GR .

l-

Git 00550 B fr *
  • fr *
  • OIL.AND~
  • AMl9Lll MllAeUREMll:NT fr fr fr * * * **** 1/30 GR STREAM INmKE

\: ......~.

UU:>:>U 4 eAMPLll .,, * .,, fr .,, * * * **

  • fr ****

OIL AND~ MEA*URl:Ml:NT

~ "!""1.~~.3-0-i-G-IRe*

EFFLUENl' NET

~* " "

... . ~ .

10. (j() ......

. ... *.. ~.

... ;-+-

1/30 'GR*

eAMPLll MllA*UAllMllNT

~ ., ...

t1'~k DAT I!


1 AMll/TITLll PRINCIPAL lllCIECUTIVll OP'irlCER THI* DOCUMENT 19 SIGNED WITH RECOGNITION THAT KNOW-INOLY MAKING A f'ALllE CERTIFICATION ON THIB REPORT OR I_ Ji/. ttLll:PMONll 1 ---lt.!..',u._:._:_;V.~*~-*~::::l/Sl,....._ _ _-1 609 I365-700( 82 9UP'l"'OATING DOCUMENT& OR INTENTIONALLY TAMPERING L

  • K ), - M]. er *11 WITH ANY MONITORING DEVICE OR METHOD ARK CRIMINAL.. 04 19

---------1 O~~EN9Ell.

TYPED OR PRINTllD llEI! 19 U,11.C. § 1001 AND 33 U.11.C. 11318.

lltt 11ncfrr rltru 1ra1u1r1 "" l*r fi"rJ 11r 10 $10,000 nnd/ar 11101/mum

/mprl1onmrn1 nf twrwrrn 6 rnulllh.* anti J rror1.)

(Prnnl* elGNATUllll! OP' PRINCIPAL IEJCl!CUTIYE OFFICER OR AUTHORIJ:l!D AGllNT 1-r-r+----"-'-~'t---l.__

~I NUMlll
R YEAR MO

_,..._ _-t DAY MMl:NT AND l:JCPLANATION OF ANY VIOl.ATIONll (Rrf,,rnrr all nll11rl1n1rnl.1 l1rrr)

Unit Shut Down - No Discharge Occurred During this ~eport Period.

2 17


~- - -*- -- . __ ..., .. *-*"" u.uu*u MAV NnT Rf: Ulll:O.) PAGE OF

P'ERM~E NAME/ADDRE99 ,,...... NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDESI Form Approvrd Fecl/11, N-r/ 1.-lolt U'UT1nrdl DISCHARGE MONITORING REPORT (IJlllRJ OMB No. 156-ROOJ'J (J.16/ (11-1'}

NJ0005622 I 82 GP AT Ml PERMIT NUMllE" Dl9CHA"°K NUM*K" 17 2 I MONITORING PERIOD YEA" MO DAY YEAR MO DAY DELAWARE RIVER P'ROM 82 03 01 TO 82 03 1 COOL ING WATER (21-211 (22-1.11 121-2.*1 (21*17} (21*2'1 (Jf-Jll NOTE: Reu lnltruct~n1 before completing thl1 form.

C>< * *

(J <"*dO,,r,I QUANTITY OR LOADINCJ f' C*' Onr,1 QUALITY OR CONCENTRATION PA"AMIETI:" f4'*.UJ (~*'11 fJ8*'-'I f"*!IJI (J4-41J NO. P'MQUIHCY t--~~~~~-..~~~~~~-.-~~~-r-~~~~~~...-~~~~~--.-~~~--~~....-~~--4 EX ANA~* *

(J1-J11 AVERAGE MAXIMUM UNITS MINIMUM AVE .. AOE MAXIMUM UNIT8 (IJ-4JJ (U41J 00010 z TEMPERATURE, WATER SAMPLE MEASUREMENT $ * * * *

  • CONT NA DEG.CENTIGRADE INFLUENT 00010 1 TEMPERATURE, WATER SAMP'LE MEASU.. EMENT * **
  • DEG.CENTIGRADE EFFLUENT GROSS 00016 ct TEMPERATURE SAMPLE MEASU .. EMENT * ** * * **
  • CONT NA DIFFERENCE EFFLUENT NET 00400 l PH SAMPLE MEASUREMENT **** *** * *.:;"f.":0 .

2/7

'~: ~.(* .... _ ,;,..;.:~--

GR

.,:.r*,.~**.,*.,
  • ' _'.. ~RMIT i '

EFFLUENT GROSS '- Al!QUIAEMENT

_,  ::;':: 2Jl\;::;T 00400 2 SAMPLE PH 2/7 GR MEASUREMltNT INFLUENT

".>UU'.:>U l FLOW IAMP'LE MEASU.. EMENT .. * * * ****

EFFLUENT GROSS

~OUbO l llAMP'LE CALC GR CHLORINE, TOTAL RESIUUAL MEASURIMl:NT

,...~.**~;):. . . ' ; ~

..,:, ('., P'llllMIT : .

EFFLUENT GROSS .* ,; lllltQUIREMICNT t------------------1 NAME/TITLE PRINCIPAL EXECUTIVE Ol"P'ICE" THiii DOCUMENT IS SIGNED WITH IUCOGNITION THAT KNOW*

INGLY MAKINO A P'ALSE CERTl,.ICATION ON THl9 REPORT OR

~K.. (k, *c*o.1 TELIP'HONE DATE L. K. Miller SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINAL 1--~......:::~~:.=liL.C:::l.llmoi!..----~ I 609 365-7000 82 04 19 1-----------------111,.

TYPED O" PRINTED OFFENSES. SEE UI U.S.C. I 1001 AND 33 U.S.C. 11310.

undrr lliur ll*l*lrr ,,.., h /lflll

,,,.,,rhortm"'I oJ """""I ""'"'"'Md 5 ,,.n.J up lo SIO,OOI .,,d/or ,,. ..

fPr,,.1-

,,,.u,,. SIGNATUREOP'PRINCIPALEXl:CUTIVI:

O,.P'ICE" O" AUTH0,.1%ED AOENT nrir+;;....;;...:=..._.;..~:....:..i:----t---+---1

"'"""" I NUMllE" YEA" MO DAY COOE COMMENT AND EXPLANATION OP' ANY VIOLATIONS fRrJrrrrttr *ff *ll*<lt"'" lirrrl OISC 482 IS COND COOLING WATER.INTK PH LESS 6.0 DIS PH NOT LESS.INTK PH GRTR 9.0,DIS PH NOT GRTR.NOT ~ORf.

THAN 3 COND MAY DIS TOTAL OR FREE Cl AT ANV Tl~E,AND NOT MORE THAN 30 MINUTES EACH TIME unit Shut Down - No Discharge Occurred During this Report Period.

3 17

Fac1111, folam* /LoHllan II "llnrnl) DISCHARGE MONITORING REPORT cDMR)

~~~~~?a~-:_m/_AFF' __________ _ ll-16) 17-19 ID0005622

~~u*_P~&~----------------- OO>l- 51..Q__.J.OC. __________ _

GP. AT MI

--~J>..&P~ PERMIT NUMBER OlllCHARGt: NUMBER 17 2 1

--~~----_m__filJ..QL _______ MONITORING PERIOD u~m_SALEM_GENERATINGSTA~-------- 82 lU3 l ill 1 82 l 03 I 31 DElAWARE RIVER J.2C~TJ2'L~-.ALI.£MAYS CREEK __________ FROM YEAR MO l DAY J TO YEAR I MO I DAY COOI.ING WA'IER NOTE: Read ln*tructlone befo,. completing thl* form.

x (10-ll) (22-2J) (U-25) (1617) (1H-l<J) (.10-JI)

(J Card Onl,.) QUANTITY OR LOADING (4 Card Onlr) QUALlfY OR CONCENTRATION PARAMETl:ll (46-,J) (J4-M) (Jll-.f') (41WJ) <'4411) NO. P"llEQU[NC'I' *AMPLE OP" EX ANAL'l'lll* TYPll:

(JJ.J7) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNIT9 6141J) (64418) (69-70) 00530 1 &AMPLE MEASUREMENT **** **** **** 1/30 GR SOLIDS, rorAI.. f.'G/L SUSPENDED PERMIT

~ITRl\TI1 l".!"DnC!C ltEQUIREM*HT **** **** **** **** 1/30 GR GR.

00530 E;

~l')I;IDS, rorAI..

SAMPLE MEAllUREMENT **** **** **** 1/30 SUSPENDED. ...* * **

~ *:

        • **** * *** * * * ** K;/L 1/30 I S'l'RF...>>1 INTAKE PENMIT ltl:QUIREMllHT

~30 4 SAMPLE MEASUREMENT

  • * *,. * *** * **** 1/30 GR SOL100, rorAI..

8:.JSPENDED *:':,A. ::,.

I EFFLUENl' NET Pl!ltMIT IUIQUIREMl:NT *_;} ** ~ .. ***

  • * ** * **** 30 .. 00 100.00 Ki/L 1/30 GR 00550 1 SAMPLE MEASUREMENT **** **** * ** * * * *
  • 1/30 GR OIL AND GRE:ASE

.,, .,, Ki/L ..

EFFIIlF.J\TI' GBCSS P'EAMIT 118QUIREM£NT

. (fr.
: 'It*:

.,, **. * * ***" 1/30 GR 00550 B SAMPLE MEASUREMENT **** **** ** ** **** 1/30 GR OIL AND GREASE .,,

. ** * * * . Ki/L STREAM INTAKE PBRMIT A£QUUlllMll:NT

        • **** **** *** \

1/30 GR 00550 4 SAMPLE OIL AND GREASE MEASUREMENT **** **** 1/30

, ~/L 10.00 1/30 EFFWENr Nfil' ft*RMIT , .

ltlQUIRIEMllHT

~ * * ** * * * ** **** ****

SAMPLE MEASUREMENT PERMIT RltQUIAEMENT THIS DOCUMENT IS SIGNED WITH RECOGNITION THAT KNOW- TELEP'HONE DATE

~r_ (.1. ..lid NAME/TITLE PRINCIPAL EXECUTIVE OF.-ICER INGLY l\llAKING A FALSE CERTIFICATION ON THIS REPORT OR SUPPORTING DOCUl\llENT6 OR INTENTIONALLY TAMPERING L. K. Miller 04 19 WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINAL OFFENSES. SEE 18 u.s.c. § 1001 AND 33 u.e.c. §131S. 1Prnal- SIGNATURE OF PRINCIPAL EJIECUTIVE 609 1365-7000 82 rl'J 11111fr, thrJI' JIHIUll"J nulJ' I*** /inrf 11r 10 S/0,fl00 t1nd far ma.drtlllWI TYPED OR PRINTED imprbunmrnt r*I l*rrwrrn 6 muntlu and j J*rOr$.) OFFICER OR AUTHORIZED AGENT ~!!~!I NUMBER YEAR MO DAY COMMENT AND EXPLANATION OF ANY VIOLATIONS (Rr/rrrnrr all allarl1n1rn1J /1rrr)

Unit Shut Down - No Discharge Occurred During this Report Period.

4 17 PAGE OF

Form Approvtd *

  • OMB No. 138-RJMJlJ GP AT MI 17 2
  • I DELAWARE RIVER COOLING WATER NOTE: RHd ln1tructlon1 before completing thl1 form.

(JC'*dOrtlyJ QUANTITY OR LOADING (4 c:.,4 Ort/yJ QUALITY OR CONCENTRATION UUUlU PARAMETER (Jl-J1J t!

C>< (N-.UJ AVERAGE

(.'U*llJ t--~~~~~--..~~~~~~-.-~~~-+-~~~~~~.--~~~~~-..~~~~~~-.-~~---t MAXIMUM UNITS

(.15*4.'J MINIMUM AVERAGE (41*.UJ (:U..IJ MAXIMUM UNIT9 NO.

EX (IJ.f.JJ FR£~Y ANALY~S (IUIJ 9AM~E TYPE fl'-1'J TEMPERATURE, WATER SAMPLE MEASUREMENT * * * .* **** CONT NA DEG.CENTIGRADE INFLUENT UUUlU 1 TEMPERATURE 1 WATER DEG.CENTIGRADE EFFLUENT GROSS' SAMPLE MEASUREMENT ****

. : .*.:** *<..,.. ,.; ***~.-.

~ -~: ~- *i.

~*

,*. .. '". .' ';; ! .. y

' . ' ?~***~**':'

Y"\\:>~'

46. o<>

DEG.C DEG.C CONT*

CONT CONT

    • .*.*". -~
  • NA .

. .. *. ' ~

UUUlO ..

TEMPERATURE 9AM~LE MEASUREMENT **** * * *

  • CONT NA DIFFERENCE * ~:: * * -.: < ***

.: : .*. *:~. :~.,t:~* . ~/:**. ':>.- *';';*;*>* ,*:."  ?*?.:":'*~ *\~<* .'*,,

EFFLUENT NET I* *; ** * ., **, *.  ; !. . * *:.: :/ 31" *~. * '.

uu~uu 1 PH SAMPLE MEASUREMENT $ *** **** 2/7 GR

  • , .
    , . ~ \ *~:*', ~=* * .{ t;-~,°7~*'. * *~ *lj*~**"*;l'. ~;, ~t;V 'I~\~*'.~!~**.~

EFFLUENT GROSS 6~00 2/7'.::r': :; GR UU'tUU ~

SAMPLE PH MEASUREMENT PERMIT' REQUIREMltNT

. ,_ . .'i,

" * :~'-~-~>* MGD  ::-r~ ;*; ~~  : - *=*i-;:, .

'.

  • l"EltMIT)'

EFFLUENT GROSS '. "l:QUlltf!MllHT *: * * * '. CONT;~

>UUbU 1 SAMPLE CALC GR CMLOiH NE, TOTAL RESIDUAL MEASUREMENT
  • *
  • J*'.::** KG/0,\1 ::;,** .,,_,,_.  ;.* <: *.. ... : -:-: . ,\ . :. r* *:.:- .*.
-
  • ~*'*<* ~'

EFFLUENT GROSS

. l"E"MIT '. * '

ltl!QUIREMENT

  • * * *** * * * * ** * * * (*:*a.z'o '" 'CONT:~ .

~'~~ TELE~HONE DATE


1 NAMEITITLEPRINCIPALEXECUTIVEOFFICER THIS DOCUMENT 15 SIGNED WITH RECOGNITION THAT KNOW-INGLY MAKING A FALSE CERTIFICATION ON THIS REPORT OR -

L. K. Miller SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING WITt1 ANY MONITORING DEVICE OR METHOD ARE CRIMINAL ,___ _

OFFENSES. SEE 1e u.s.c.11001AND33 u.s.c.1131e. ,,.,,,.,_

_,,.___"=..--::"""'_..,____

siGNATUREOl"PRINCIPALEXECUTIVE

'IL

-I I 609 365-7000 82 04 19

---*~-------11/n ur1drr lltru *l*luln ,..., 6r TYPED OR PRINTED lmp1bor1rnml of 6"wttr1

  • lflDrtlltJ ud J ynnJ I'" up lo Ill.HI .,.d/or ,,. .. 1,,. .. ,,.

OFFICER OR AUTHORIZED AGENT

,..,....,REAr-+-l-----+---i~--+----t 1-....

CODE NUMBER YEAR MO DAY C:OMMENT AND EXPLANATION OF ANY VIOLATIONS (Rr/nrrtcr .U *ll*rltmml1 ltnrJ DISCH 483 IS COND COOLING WATER.INTAKE PH LESS 6.0 DIS PH ~OT LESS.INTPH 6RTR 9.0 DIS PH NOT 6RTR.NOT MOR E THAN 3 CONO MAY DIS TOTAL OR FREECL AT ANY TI~E & NOT ~ORE THAN 30 MIN EACH TIME Unit Shut Down - No Discharge Occurred During this Report Period. 5 17

Fat:llll~ Nam* /Loc*llon II 1Altl*rrn1)

DISCHARGE MONITORING REPORT <DUR) OMB No. 1'3

  • R007.J

. .* ~ r-r:;R - EN\1 AFF (1-16) 17-19)

&~-~~-~---------------- NJ0005622 483

~~u*_P~&~-----------------

  • --~J'.....O~BC>>t'57.Q__.J.OC. __________ _ PERMIT NUMBER DISCHARGE NUMBER GP. AT MI 17 2 1

--~~----JU._fillfiL ______ _ MONITORING PERIOD u~m_SMm_GaIBRATINGs~noo _______ _ DEIAWARE RIVER FROM t-8_2_ _,__0_3-t-_0.._l-t J.2C.AT~~IC.WER_ALLCMAYS CREEK - - - - _ _ - - - - YEAR MO DAY COOLING WA'JER x

(10-}/) (21-lJ) (14*1') NOTE: Reed ln*lruclloM belo,. complellng thl* fonn.

(J Card OnlJ*) QUANTITY OR LOADING (4 Cnrd Onl~) QUALITY OR CONCENTRATION "AR AM ETIER (46-H) (H~I) (Jll..fj) (46.JJ) (J4~1) NO. ,-llf:OUENCY o,- 8AMPLE EX ANALY919 TYPE (J.1..J7) AVERAGE MAXIMUM UNITll MINIMUM AVERAGE MAXIMUM UNITll

~61~J) (64-61) (69-70) 00530 1 SAMPLE MEASUREMENT **** * * * * ** **

SOLIDS, 'lUl'AL l /10 r-~

SUSPENDED Pl!RMIT REQUIAEM*HT **** **** **** **** * * *

  • M3/L 1/30 GR "C'k't;'T J """"'..... 1"'1"VV"r-00530 **** * * * * ****

B mtL SAMPLE MEABUAEMENT SOL.IDS, 'lUl'AL 1/30 SUSPENDED M;/L 1/30 GR

_:o-..*1*-M [J..IVI. w "IERMIT REQUIREMltNT **** *** * **** **** * ***

00530 4 SOL.IDS, 'IDI'AL SAMPLE MEASUREMENT * * * * * * ** * **

  • 1/30 GR SUSPENDED Pl!RMIT REQUIREM*NT
    • ,. ..,, * * ** ** **** 30 *. 00 100.0Ci M:;/L 1/30 GR EFFLUENT NET .*.

00550 1 * * * * ****

OIL AND GREASE SAMPLE MEASUREMENT * * ** * * *

  • 1/30 GR EFFLUENT GIDSS PEA MIT IUtQUIREMlltNT
        • * * ** * * * * * * * ** Ki/I: 1/30 GR 00550 B OIL AND GREASE SAMPLE MEASUREMENT
  • * * * ., **** **** **** 1/30 GR STREAM INI'AKE P'l!IRMIT **** **** ** * * * . *. * * **** M:;/L 1/30 GR 00550 OIL AND GREA.SE 4

REQUllUMltNT SAMPLE MEASUREMENT Jr " 'If 'If K~/L 1/30 "1/30 G._

EFFllJENT rl'

,.l:RMIT

  • RaQUIRIEM*NT **** **** **** 10.00 GR llAMPLE MEASUREMENT l"ERMl"t RltQUIREMENT

~U .. ~-

NAME/TITLE PRINCIPAL EXECUTIVE OFFICER THIS DOCUMENT IS SIGNED WITH RECOGNITION THAT KNOW- TELEPHONE DATE INGLY MAKING A FALSE CERTIFICATION ON THIB REPORT OR SUPPORTING DOCUMENT& OR INTENTIONALLY TAMPERING 609 '365-7000 82 04 19 WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINAL L. K. Miller OFFENSES. SEE tB U.S.C. § 1001 AND 33 U.8.C. §1319. 1rrnt1I- lllGNATURE OF PRINCIPAL EXECUTIVE 111* finr.t ur to TYPED OR PRINTED llr.1 1m1frr thr.*r .1t111utC".f "

imprl.1unmrnl nf l1r1wrrn 6 munllu at1d j rrar.t.)

$10,000 n"d/or rnaxlnrnm OFFICER OR AUTHORIZED AGENT ""EA r~~_.

I NUMllER YEAR MO DAY COMMENT AND EXPLANATION OF ANY VIOLATIONS (Rr/.,rncr all n11m*/1n.,n/J /1.,rl Unit Shut Down - No Discharge Occurred During this Report Period.

6 17 PAGE OF

.. ATIONAL POLLUTANT DISCHARGE ELIMINATION BY!ITEM (NPDESJ Fann Ap/iNJvn DISCHARGE MONITORING REPORT (IJMRJ OMB No. 151*RoDl I NJ0005622 (l-ftl I I I,__ 484_____(17-lfl IDISCHA..01[ NUM*I:"

..... GP AT MI I P'ERMIT NUMl!IEA I 17 2 I MONITORING PERIOD YEAR MO I DAY I YEAR I MO I DAY DELAWARE RIVER l"AOM 82 03 I 01 I TO 8~ I U3 I 31 COOLING WATER (lO-lll (ll-l.11 (ll-l1J (ll*l*I NOTE: R**d lnltructlon* before completing thl* form.

00010 P'A.. AMnEA j (Jl-J'TJ TEMPERATURE,WATER 2

I r><

  • eAMP'LIE MIEASUAEMIENT tJ c ..do11"1

'"""I AVIEAAGIE QUANTITY OA LOADING 1-----------~----.;._------.....,._--

(.W*tll MAXIMUM UNITS

' ' ('*d 011'11 (Jl*'~I MINIMUM 2.90 QUALITY OA CONCIENT"ATION

(<lf*JJI

.....--'---------~------'----~----'-.....;..~.....-.-~----~

AVIEAAGIE 6.30

(!JUIJ MAXIMUM 9.70 UNM HO.

IEX

('1.f.JJ PM~ENCY AHALY819 CONT (fUIJ eAMl"LI:

TYP'IE

,,..1'}

NA DEG.CENTIGRADE:

  • INFLUENT 00010 1 TEMPERATURE,WATER SAMP'LE MIEASUAIEMIENT $ $ ** ** *
  • 10.00 19.40 28.10 DEG.CENTIGRADE EFFLUENT GROSS 00016 4 TEMPERATURE SAMP'LE MIEASUAIEMIENT * * * * * *** 1.30 13.10 23.20 1 CONT NA DIFFERENCE EFFLUENT NET OU40U
  • l eAMP'LIE 6.88 7.72 8.77 O 2/7 GR PH MIEA9UREMENT \t; * $ $

EFFLUENT GROSS 00400 2 6.69 7.12 2/7 GR PH ** *

  • 7.56 INFLUENT 50050 1 eAMP'LE' FLOW MIEAeUAEMIENT
      • * **** 266.40 1\83.70 532.RO EFFLUENT GROSS 50060 l CALC GR SAMP'LIE 0.04 CHLORINE, TOTAL RESIDUAL MIEABUREMIENT
  • * *
  • 0.06 0.08 0 EFFLUENT GROSS NAME/TITLE P'RINCIPAL EXECUTIVE o ..FICER 1--------------------------l INGLY THIS DOCUMENT 111 e1GNED w1TH RECOGNITION THAT KNow-MAKING A l"ALSE CERTIFICATION ON THIS REPORT OA

/A~ (J ~

@. DATIE SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING *

. WITH ANY MONITORING Dll:VICE OR METHOD ARE CRIMINAL l----~~..._........_~*-*..,,c....=....*-.---.....~609 1365-7000 8'2 04 19 L. K. Miller rr....

1----------------------i ,,.,,_,.Off_

TYPED OR P'AINTl:D oFFENsEs. sEE 111u.s.c.1 1001 AND 33 u.s.c. 1 u1e.

1111 101d1r '""' II*'"'" ,,.., 61 /11111 "fl lo Ill.HI ud/or "'ul111u111 of IHI*- * -111111 .,.d 5 yNn.J 1- siGNATuAEOl"PAINCIP'AL11:xEcUT1v1:

OFFICER Oft AUTHORIJ.IED AGl:NT ~O~E j NUM*IEA YEA" MO DAY OMMENT AND EXPLANATION oir ANY VIOLATIONS (R(/nmct .n .tt*c~m ...11 lift-1J DIS 484 IS CONDENSER COOLING WATER.INTK PH LESS 6.0,0IS PH NOT LESS.INTK PH GRT 9.0,0IS PH NOT GRT.NOT MO RE THAN 3 CONO~NSORS ~AY DISCH TOT.R FREE CHLORINE AT ANY TIME,ANO NOT MOR~ THAN 30 MINUTES EACH TIME 21A Conden~er Out of Service 5 hours5.787037e-5 days <br />0.00139 hours <br />8.267196e-6 weeks <br />1.9025e-6 months <br /> 3-10-82.

7 17

RMITTElt NAMl!/ADDREllll (lnd111l1 NATIONAL POLLUTANT DISCHARGE ELIMINATION llVBTEM (Nrof:s) torm Approvra

1111, ,.,.,_ 1Loc*rlor1 II dlf!-rtl) DISCHARGE MONITORING REPORT (DMR) OMB No. U8 - R007 J

.g~~~ M:;R._-_mw_m__________ _ (l-111) 11-19)

!~a*_P~&<L----------------- NJ0005622 GP. AT Mt

__ ..:_J_aP-!.. oot 57..Q.._.J.OC. __________ _ . PERMIT NUMBER Dl9CHAAGC NUMBER 17 2 1

  • --~----_NI._..Q7.l.QL ______ _

MONITORING PERIOD*

fill.a.r_SALEM_GENERATING S'm'I'ION - - - - - - - - DEU\WARE RIVm FROM ,__8_2-!_0_3-+_0_1--i COOLING WATER

.~TJ2f!_u::MER_ALLCMAYS CREEK - - - - __ - - - - YEAR MO DAY (1n.JI) (11-11) (U-1~) (1H-l9) (Jn. II) NOTE: RHd lnatruc:tloM hfof9 completlng lhla form.

(J Card Onlr) QUANTITY OR LOADING (# Cnrd Only) QUALlfY OR CONCENTRATION JS30 PARAMETER 1

(J1-J7)

IX SAMPLE

(#IJ.jJ)

AVERAGE (j#-61)

MAXIMUM UNITll (J/1-#j)

MINIMUM

(#11.JJ)

AVERAGE 16.76 (j#-61)

MAXIMUM 16.76 UNITll NO. P"llEOUIENCY EX

~111-6.J)

OP" ANALY919 (11#-611) llAMPLE TYPE (119-70)

JLIDS, 'lOTAL MEASUREMENT

        • **** **** 1/30 ~R JSPENDED 4'li'r I Tli'llJ'TI :-----

D530 B PER ..UT REQUIREMENT

  • **' * * **** **** ** *** **** M:;/L ..

1/30 GR SAMPLE OLIDS, 'lOTAL MEASUREMENT **** **** **** 58.32 58.32 1/30 G USPENDED TREAM INTAKE Pl:RMIT llltOUIREM*HT * * * **

        • **** *fr
      • ** ** K;/L 1/30 1_~:~ __.l 0530 4 9AMPLE II I OLIDS, 'lUI'AL MEASUREMENT **** **** **** 0.00 0.00 0 *!

1/30 9R .

USPENDED ~

Pl!AMIT llltQUIREM*NT

      • * * *.. * * * * ** 30.00 100.00 M3/I. 1/30 . c.:* i FllJENT NET 0550 1 l!IAMPLE
        • **** **** **** 1/30

... *2.60 MEASUREMENT IL AND GRFASE GR FFLUENT GR)SS flEAN1T lt8QUIREMENT ** * * * **** * * ** * .*.****

'.*' * *. M:;/L 1/30*' GR 0550 B llAMPLll ...

IL AND GRF.ASE MEAllUREMENT **** **** * ** **** 1.40 1/30 GR TREAM INI'AKE

  • * * ** 1/30 Pl!AMIT .

fU!CIUIRllM*NT **** M3/L GR 0550 4 II AMPLE 0 1/30*

        • **** **** **** 1. 20

~-

MEAl!IUREMENT IL AND GRFASE PltRMIT ;

F'FLUE.Nr NET lllOUllUM llNT **** **** 10.oa M:;/I, 1/30 GR llAMPLE MEASUREMENT P!:IUU"f RltQUIREMEN1'

~

ME/TITLE PRINCIPAL EXECUTIVE OP'FICER THIS DOCUMENT 19 SIGNED WITH RECOGNITION THAT !(NOW. TELEPHONE DATE INGLY MAKING A FALSE CERTIFICATION ON THIB REPORT OR SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING  ::f./((L -JO.

L. K. Miller WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINAL OFFENSES. 9EE 18 U.9.C. 'i 1001 AND 33 U.8.C. §13111. (l'r"nl-v - -

l!llGNATURE OF' PRINCIPAL EXECUTIVE 6091365-700( 82 04. 19

"*' ,,,,,,,., ,,.,,.* ,. JfrlfUfr.* "'" ,,,. finr.t ur '" Sl(J,OO(J ""d '"' motln111n1 TYPED OR PRINTED lmprfJrmmrnr of l*rrwrr" II '""""" 11,,d ' rror.*.) OFFICER OR AUTHORIZED AGENT ~~~~I NUMBER YEAR MO DAY MMENT ANQ EJCPLAN.ATION OF rNY VIOLATIONS (11.rfrrrnrr nll nrrr1rl1"ornr.1 lorrr) 03.ily Max. (rrg/ ) M:mthly Aver. (rrg/l)

C-22 0.145 0~119 0-5 Out of Service 8 17


======~=-=-:-- --* .,.,..nu T-An WHICH MAY NOT BE USED.I PAGE OF

tRMITR:lt NAME/ADDRESS fl<<... NATIONAL ~LLUTANT DISCHARGE ELIMINATION SYSTEM fNPIJf.'!J}

Fann Approvtd OMB No. 156-RlllllJ' .

(17*1'1 I I LtW> GP AT f.41 PERMIT NUMBER IDISCHARGE NUMllE" 17 2 I MONITORING PERIOD DELAWARE RIVER COOLING WATER NOTE: Reed Instruction* before completing this form.

C><

(Jl'*dOrt/yl QUANTITY OR LOADING (4l:*d011lyl QUALITY OR CONCENTRATION Pi"RAMETER : (4'*-'JI (5'**11 f.11*4.fl f#-.UI ($4-41} NO. FR£~Y SAMf"UE 1-------..-----.---t------.----....-----~---1 EX ANALY819 TYPIC fJl*J71 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNIT8 t*2-4JI fU-"I OUUlU l, TEMPERATURE, WATER SAMPLE MEASUREMENT * * $ $

        • 2.50 6.10 14.00 CONT NA DEG.CENTIGRADE '.*. '.'** . . ~~~.;-~.<:* .'.'::  ;;; -:*

INFLUENT UUUlU 1 ******* ~;:~:;;

SAMl"l.E.

  • 16.00' 23.30 45.30 TEMPERATURE, WATER DEG.CENTIGRADE MEASUREMENT $ * *
        • i;> ,,,:*fr~' .. ';\ :;;.* _,  :; .,.... '~::,,..-:_ -~ -:*~,*~~~r.. T:~*- ~.* ;<t~*:

EFFLUENT GROSS uuu lb If.

SAMPLE TEMPERATURE DIFFERENCE MEASUREMENT **** 7.30 17.20 41. 70 1 CONT NA EFFLUENT NET UU"tUU 1 SAMPLE .

8.98 0 PH MEASUREMENT

  • * ** * * ** 7.14 8.05 2/7 *GR EFFLUENT GROSS UU"tOO PH SAMPLE MEASUREMENT $ *** **** 6.69 7.12 7. 56. 2/7 GR

'f. .*" ..... '(,~1.._;, i!. "j\..':** : :;:'~---~:--~; ;-.-*, ~ '

INFLUENT , *. *~11f;_t -.~> c;~:

~uu~u l FLOW SAMPLE MEASUREMENT *** * **** 266.40 477.30 532.80

~;: *:"";H' MGO EFFLUENT GROSS * **.:** :**'.~

~UUC:>O l CHLORINE, TOTAL Mu5:J':EL.:ENT '* * * * $ $ *

  • Q
  • 04 0.06 0.08 O CALC GR RESIDUAL *:'.\ PERMrt '> *. ..;:.**:'"'.' '* ;*_,.-,: * ; '/' . ,...,. KG/DAY .. ~.. . ... -~~- ';. \.:
  • :*.~.*-'*** MG/l EFFLUENT GROSS * *. * *,: ** * ** *  :.* /: o.2'o:,,
  • o~5*a*: *

-NAMEITITLEPRINCIPALEXECUTIVEOFFICER

- - - - - - - - - - - - - - - ! THIS

' HQUIREMENT $

DOCUMENT 19 SIGNED WITH RECOGNITION THAT KNOW-INGLY MAKING A FALSE CERTIFICATION ON THIS REPORT OR tl V#'" /

\A,.

    • ov._ TELEP'HONE DATE L. K. Miller SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING WITH ANY MONITORING DEVICE OR OFFENSES. SEE 1e u.s.c. 1 1001 AND 33 u.s.c. 113ut.

METHOD ARE CRIMINAL tPno*I-1

/(_ _.

1---~-l*o.e:..."'--=-.3..-"~.c::::;..__ _ _~

SIGNATUREO,.PRINCIPALExEcUTivE I

609 365-7000 82 04 19

. . - - - - - - - - - - - - - - - - - - 1 1 l r 1 undrr U1rrr *l*lufrr rtt*y br /lr111 up lo Jll,lfl *rtd/or **d"'u"' 1--r-....,.-+-_.._.__.-.__.._""-+---t----+----t TYPED OR PRINTED ilnptb01111,.nl of bttwrm * "'01fllr1 Md 5 yn11.1 OFFICER OR AUTHORIZllD AGENT ~~~~ I NUMBER YEAR MO DAY OMMENT AND EXPLANATION OF ANY VIOLATIONS fRr/rrr11tr .ii .it*rlimm11 lrnrl I

DIS 485 IS CONDENSER COOLING WATER.INTK PH LESS 6.0,UIS PH NOT LESS.INTK PH GRT 9.0,DlS PH NOT GRT.NOT MO RE THAN 3 CONOENSORS MAY OIS TOT. OR FREE CHLORINE AT ANY TIME,AND NOT MORE THAN 30 MINUTES EACH TIME

~~~~~~qpr Out of Service 2 hours2.314815e-5 days <br />5.555556e-4 hours <br />3.306878e-6 weeks <br />7.61e-7 months <br /> with this high value recorded on 9-8 2 9

~---=-__.::...-..=..:::=------------~~-------=-~-

Facllllr Ham1/l.oc111iait *I dl/ltrflll) DISCHARGE MONITORING REPORT (Droflt) OMB N°d. U3

  • R007 J

. &!!!.&*~~....:.. r-t;R._-_EW_AFF____________ . (1-16) (17-19)

-~~u*_P~&~----------------- I tu0005622 I I 485 GP. AT MI

. __ ...:._J_.9_,_ BO.'t' 57J!.._J.OC. ___________ I PER,..IT NUMBER I lo111cHARGC NUMllCA 17 2 1

_ _ _ _WiABit _ _ _ _ JU__fillQL _ _ _ _ _ _ _

u~m_SALEM_GENERATINGS~fioo ________

MONITORING PERIOD .

82 DID.AWARE RIVER CREEK - - - - _ _ _ _ _ _ FROM 03 I 01 I TO 82 I 03 I 31 COOLINi WATER

.b....oc:A.T..!!!.'LUMER_AI...t.a-lAYS YEAR "'o ID,~ YEAR I "'O I DAY NOTE: Read lnstrucllona before complellng lh'9 form.

x (10-l/) (21-ZJ) (1f*1J) (26 11) (111-H) (.10-.11)

(J Card O"IJ') (4 Card Onlf)

PARAMETER (46-,J)

QUANTITY OR LOADING (H-61) (J8...fJ)

QUALi fY OR CONCENTRATION (46-JJ) <"-) NO. f""ltOUltNCY EX OP" ANALYl!ll9.

  • AM~LE TYPlt (J2-J7)

AVERAGE "'AXl,..UM UNITll "'INl"'U"' AVERAGE MAXIMUM UNIT*

KU.6J) (6'--68) (69-70) 00530 1 &A,..PLE I MEASURE,.. ENT **** **** **** 13.44 13.44 1/30 GR SOLIOO, TOl'AL SUSPENDED l-13/L PltRMIT REQUIAIEMllHT * * ** **** ****  :

      • * * *** 1/30 GR EFFLUENT GOOSS **:*

00530 B SAMPLE 58.32 58.32

        • **** **** 1/30

~

MEASUREMENT SOLIDS, 'rorAL SUSPENDID PERMIT .,..

STRF.AM INTAKE REQUIREMllHT

        • * * * * *** * * * * **** M31'L 1/30 00530 4 llAMPLE SOLIDS, 'lOTAL MEASUREMENT
        • ***
  • 0.00 0.00 0 1/30 GR SUSPENDFD PERMIT  : ~i11. * **' . 30.00 100 *. 00 r-t;/L 1/30 GR EFFil1ENI' NET RllQUIREMllNT  :*{;- ..:. **** *** * ..  :

UU550 1 II AMPLE

        • **** *** * **
  • 1/30 GR OIL AND GREME EFFLUENT GR:>SS MEABUREMltNT PERMIT RllQUIREM£NT
1. 40
  • * **
  • M3/I,  : 1/30 GR 00550 B II AMPLE
1. 40 1/30 GR OIL AND GREASE MEASUREMENT **** **** **** ****

STRF.AM INI'AKE P'llRMJT ,,,. M3/L 1/30 RIEQUUUl:MllNT * * * ** * * ** ..***:*' '*

  • ** * * * * * *. * \

GR 00550 4 o.oo 0 1/30 GR SAMPLE OIL AID GREASE EFFllJENT NET MEASUREMENT PllltMIT ,

.. IQUl"EMllHT

        • 10.00 ID/I. l/30 *e-llAMPLE MEASURE,.. ENT PERMl"f RltQUIREMEN"f Y.'~~

NAME/TITLE PRINCIPAL EXECUTIVE OFFICER THl9 DOCUMENT 19 SIGNED WITH RECOGNITION THAT KNOW- TELEPHONE DATE INGLY MAKING A FALSE CERTIFICATION ON THIS REPORT OR SUPPORTING DOCUMENT(; OR INTENTIONALLY TAMPERING L. K. Miller WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINAL 82 04 19 OFFENSES. SEE 18 U.9.C. § 1001 AND 33 u.e.c. §1319.

tlf'J 1rn1ft-r thf'Jt 11111111r1 nwy ,,,. /inr., ur to SI0,000 nnd /or mo*,mum (l'rnnl- SIGNATURE OF PRINCIPAL EJIECUTIVE 609 '365-7000 TYPED OR PRINTED impr*1cmmtnf ol PJf'fM'rrn 6 muntlu arid j )'tarJ.) OFFICER OR AUTHORIZED AGENT ~!!~!I NUMBER YEAR MO DAV CO ... MENT AND EJIPL.ANATION OF ANY VIOLATIONS (Rrfrrrnrr nil nllndmir"IJ lirrr)

Daill Max. (rcg/l) M:mthl:t Aver. (nq/l)

SC-22 ID-5 0.145 Out of -Service 0.119 I 10 1

- -- - - - - ......... ..- ,.."" u1u1ru uav NnT AF" UAEO., PAGE OF

NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NrVESJ Famr APfll'Ovrd DISCHARGE MONITORING REPORT tnMRJ (1-U) ,,,_,,, OMB Na. 1'6*R001J.

I NJ0005622 I I li---_4_8_6_ _~ GP AT r:

I PERMIT NUMBER I *1Dl!ICHAlllOll: NUMllll:" 17 2 MONITORING PERIOD YEAR MO I DAY I YEAR I MO I DAY DELAWARE RIVER FROM 82 03 101 I TO 82 103 I 31 COOLING WATER (11-Jll (ll-:'-'J (U-1.fl (1'-171 (11*1'1 (:.J11 NOT!: Reed lnltructlon* before completing thl* form.

(J c*.40,,,,1 c:., o ..l?I X

QUANTITY OR LOADINCI ,, QUALITY o .. CONCll:NT.. ATION

..A .. AMETE" (#1-.UI (_.,_.,I (.tl-4.*I f"*.UJ (5'-411 NO. fla:~Y 1--~~~~~-...~~~~~~.....-~~~--1-~~~~~~....-~~~~~-....~~--~~~...-~~---4 ll:X ANALY*8 (Jl-J71 AYE .. AGE MAXIMUM UNIT* MINIMUM AYll: .. AClll: MAXIMUM UNIT8 (0-4JJ (IUIJ 00010 2 SAMPLll:

0.90 13.60 22.90 TEMPERATURE, WATER DEG.CENTIGRADE MEASUREMENT

  • * ** * * * :et

:';.*::.:** :,:'/' --.*~.--.'..~ *,_~.'., ;.- l :.~.-I>;~~:.- ;; : ~~i-; ~.,

ONT

~: -*~ *... ~:~***::.~17 NA

."~'-~***' ':" :...~* ;; ......

INFLUENT * ;*.. * '*>, ***. '* *-.. ~ *~ i-ci CONf_. ._,,$_.,,:*

00010 1 SAMPLE 12.60 18.90 .37.70 TEMPERATURE, WATER MEASUREMENT

        • * *' * *' ., O CONT DEG.CENTIGRADE EFFLUENT GROSS 00016 4
  • -r*!;._:*::

.~ . ~*>

.-11:au1"EMl:NT  ;"":' , ..~~*~;-:; ;:****

  • .*... --~

,,., i llAMP'LE 0.00 5.40 28.90 TEMPERATURE DIFFERENCE Mll:ASU .. ll:Mll:NT

  • ** * **** l  ::ONT NA EFFLUENT NET 00400: 1 PH SAMP'Lll:

Ml:A9UREMICNT

  • * .. * **** 6.78 7.34 8.02 0 ~/7 GR

.:*>** '.~:<*}*!':~

    • ., F***J' ... *". ,., , , .;.

EFFLUENT GROSS I U0400 2 llAMl"Lll:

PH F>;

Mll:ASUREMENT Pll:AMrT! ' *

.'.. . .*.' '>:.;), -:~*.;~

6.69 7.12 7.56 2/7 GR INFLUENT >f\iQUIRltMICH't

  • ~L*, **::.*\.:;i'

~IJO.:>>O l FLOW SAMl"LIE Mll:AlllUREMENT * * * * **** 244.20 377.80 532.80 EFFLUENT GROSS 50060 I SAMl"L.11:

0.04 0.06 O :ALC GR CHLORINE, TOTAL RESIDUAL Mll:AeU .. ll:Mll:NT

  • * ** * *** 0.08 EFFLUENT GROSS t------------------1 NAME/TITLIE l"IUNCIP'AL IEXECUTIVll: Ol'P'ICI:" THIS DOCUMENT IS *IONED WITH "!:COGNITION THAT KNOW*

INCILY MAKINO A P'ALllE CE..TIP'ICATION ON THI* "EP'ORT OR i~

, ..a~

JU Tl:Lll:l"HONll: DATii:

L. K. Miller SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPE .. INO WITH ANY MONITO .. ING Dl:YICll: OR METHOD ARE C"IMINAL 1--..1.~:...~~C:l..l....._ _ _ _-l.

609 I 365-~0C 82 04 19 t------------------1 TYl"ED OR PRINTED OFFENSES, lllEI[ Ill u.s.c. I 1001 AND 33 u.111.c. I 131D.

Un .,.4., IAru *l*l*lrl ,,.., 6*

hprlsa"m"'I o/ l>rfw-

  • 11t011tA1 Md~ yMn.J I'"" *P to JU,flf *rt'/or lflHl"'u"'

,,.,,..,. *IONATURll:OP'P'RINCll"ALll:XIECUTIVll:

Ol'l'ICI:" 0" AUTH0"1%11:D AClll:NT 1-r...,r+-----t---+---t---I CODE I NUM*IE" Yll:A" MO DAY COMMENT AND IEXl"LANATION 01' ANY VIOLATIONS (Rr/rr"'cr *ll .it*rllm"'ll Arrr}

DIS 4R6 IS CONDENSER COOLING WATER.INTK PH LESS 6.0,0IS PH NOT LESS.INTK PH GRT 9.0,DIS PH NOT GRT.NOT ~I RE THAN 3 CONDENSORS MAY DIS TOT. OR FREE CHLORINE hT ANY TIME,~ND NOT MQR[ THAN 30 MINUTES f:f\CH TIME 23B Condenser out of Service 14 consecutive hours on 3-8-82 17 11

RMITTEE NAME/ADDRIE811 (111~lrult NATIONAL POLLUTANT DISCHARGE ELIMINATION BYllTEM t11/r1Jf:S) r orm ,,, p11run:u

1111, Nnmr 1Loco1lon II dl(Jrrr111) DISCHARGE MONITORING REPORT tDMR) OMB No. UB. R007J Ml.~~~ K;R._.-_ENV_AFF'___ ...... ________ _ (l-161 11-19)

'e!i~_PSE&q_ _____ ~-----*------- N.10005622 486 GP. AT Mi:

  • -~_J?_.J)-L BC>>t- 57..Q.._.lOC.. __________ _ PERMIT NUMBER Dl&CH .. AGE NUMDCR 17 2 1

___ JmiAmt ____ .JU.._..Q1lQL _ _ _ _ _ _ _ '*

PERIOD cc..u,.o:r_SALEM_GENERATING STATION - - - - - - - - DEU\WARE RIVER

~~*o~UMER_ALL<MAYS CREEK _________ _ To ....0_2_-t--__ o...;;;.3-....;;:3;...::1=-i COJLING WATER YEAR MO DAY x

(lfol) (1R.JY) (.10-11) NOTE: Resd lnslructlon1 befoN completing lhlt form.

(J Cord OrtlJ") QUANTITY OR LOADING <' Crml Onlv) QUALlfY OR CONCENTRATION

,,,-61) NO. F""COUENCY llAM,.LE "ARAMETER ('6-H) "'-"I) (18-4.Y) 1'6--'J>

EX OF" TYPE ANALY919 (JJ.J7) AVERAGE MAXIMUM MINIMUM UNITB AVERAGE MAXIMUM UNITll

~61-6n (6'-41!) td9-70) I 0530 1 SAMPLE .* * *

  • 0LIDS, 'lUl'AL MEASUREMENT **** **** 8.84 8.84 1/30 GR USPENDED 1/30* GR mwENT GROOS PERMIT REQUIREMllNT * * ** * * *** **** **** **** M:;/L 0530 B OLIDS, 'lUl'AL SAMPLE MEASUREMENT **** * *** **** 58.32 58.32 1/30 GR USPENDED M:;/L 1/30 GR STREAM INrAKE f'ERMIT REQUIREMENT **** * *** ** * * * **

00530 4 OLIDS, 'lUl'AL SAMPLE MEASUREMENT

  • * * * * *** 0.00 0.00 0 1/30 GR USPENDED EFFWENT 00550 1 NET fll!RMIT REQUIAEMllNT
    • * * * *** * * * ** 30.00* i00.00 r.13/L

' 1/30 GR llAM ..LE

        • **** ***
  • 1. 20 1/30 GR OIL AND~ MEASUREMENT ***
  • FFLUENr c;iu;s PERMIT RIOUIREMIENT . .*. * ** * * *** * * *.. * *** * ***
  • Mi/L 1/30. GR 0550 B
  • **** **** ***
  • 1. 40 1/30 GR BAM ..LIC MEAllUREMENT OIL AND GREASE TREAM INTAKE .............

REOUUllMINT * * ** * ****

      • * ...* * * ** *
  • K;/L

\

1/30 GR 00550 4 llAMPLE MEASUREMENT

        • **** **** **** 0.00 0 1/30 GR OIL .AND GREASE flllAMIT , .,, 10.00 1/30 GR F.FFT IJF.N'l' NP.I' IHQUIAEMKNT
        • ** * -It
      • **** t-ti/L 9AMP'LE MEASUREMENT l"EAMl1' RIEOUIREMEN1' JJCu.1' '~~

AME/TITLIE PRINCIPAL EXECUTIVE OF"P"ICER THIS DOCUMENT 19 SIGNED WITH RECOGNITION THAT KNOW- TIELE .. HONE D A T E INGLY MAKING A FALSE CERTIFICATION ON THIS REPORT OR SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING L. K. Miller WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINAL 82 04 OF"FENSES. SEE IB U.9.C. 'i 1001 AND 3] u.s.c. §1310. 1rr""'- SIGNATURE OF. PRINCIPAL EXECUTIVE 609 b65-7000 ld TYPED OR PRINTED

,,,, ,,,,,,,., '""*" Jlntlllr.f """' ,,,. finr.* ur '" s10.non and for madn"""

OFFICER .OR AUTHORIZED* AGENT AREA I

,..,,,,,.,. NUMBER YEAR MC ...,, . :

'"'prf111nmrnr nl ltrtwrrn f, munrlu anti j rrar.r.)

MME'NT AND ElCPLANATION OF ANY VIOLATIONS (Rr/rrrnrr all n11nrl1nornt.1 /irrrl

  • Il:lily Max. (mg/l) M:Jnthly Aver. (m:J/l)

C-22 0.145 0.119 D-5 12 17

-~*-*-.. . . * - ........ **er'"' rRF:PLACE9 IEPA FORM T*AO WHICH MAY NOT BE UBED.) PAGE OF

..ERMITTEE NAME/ADDRESS ,,......., NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (Nl'DESJ Form Approv~d F<<lllty N-*/ I. /alt U tJ DISCHARGE MONITORING REPORT flJMRI OMB"!Vo. 1'8-RWJ I GP AT r-;

PERMIT NUMBER DISCHAlllGE NUMBE" 17 2 MONITORING PERIOD MO DAY YEAR MO DAY DELAWARE RIVER FROM 92 03 01 TO 82 03 1 (10.11} m-1*1 (1'*1.*J (1*-171 (11*1'1 (Jf.Jll NOTE: Reed Instruction* before completlng thl1 form.

. (JC."*dOrrt,,J QUANTITY OR LOADING ,, <"*d ,,,,,,I QUALITY OR CONCENTRATION Flft:QUENCY

..ARAMETER (#1-!0J

'*"-"' (.U-4.*J ('4-.'UJ (!U-111 OF (31-371 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNIT8 ,,,.,,,

ANALYSIS HEAT MILLIONS OF o. oo*. 14747.00 BTU 1 S PER HR NET **

  • EFFLUENT NET I
  • SAMPLE MEASUREMENT i
i:
t,i  ; '.\ .HAMl'f ~-*:* **

. fltOUIREMl:Nf SAMPLE MEASUREMENT 82 04 19

  • TYPED OR PRINTED OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY COMMENT AND EXPLANATION OF ANY VIOLATIONS (Rt/nmu *If llfl*tlt111m11 llntl TOTAL OF OiSCH *481,482,483 1 48414851486 13 li

ICIHIP ftl*- /1..oc*llOll I/ flllrNlll J . blSCHARGE MONITORING REPORT tDURJ UM B No. U8

  • RUtJI J a.M* e f!C'tJ* ftl;R. -

a=a-~!------~------.._...,...._ 0.W AFf4 ____

. ** ._. l-161 ,,_,,

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PSE&G 57..Q.._J.OC. __________ _

___ JmilWK. ____ _w__ml.O.L ______ _

. 1'1J0005622 "l'."MIT NUMBIE" 48C 01.CHAAQI[ NUM*l:lll GP. AT MI 17 2 l

&~m.JiALEM_GENERATmi~--------

MONITORING .

c t--8_2_t-0~3__,f--~-t 0.TJ2'f.J;Q-JER_~ CREEK---------- PlllOM YIEAR (Jfl.)I)

TO t----t---t--3_1-t MO DAY (211-19) (JO.JI) NOTE: Rnd IMbllCllcM* . , . _ .......... 1111 foml.

(Jc.,.,, 011lr) QUANTITY OR LOADING (4 Carel 0 ..1,, QUALlrY OR CONCl:NTRATION PAlllAMllTKR (JJJ7)

X *AMP'LI'.

...___(_4fl_.J_J~)---.----'-~-'->---.-----+--(~J_8~--'J)----...---~(4_6_J_J_)_ _..---'-(J_'4_1):;...___,.______-INO. ~lllC~:NCY r*

AYl:RAGI: MAXIMUM UNITe MINIMUM AYl:RAGI: MAXIMUM UNlft U ANAL.,.,. *AMPI.&

TY,.K Ml:A*URIEMl:NT 62.83

  • AMP'LI:

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    • * * **** **** **** 5.00 0 1/30
    • .. ** .... -10

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  • l/30 00551 1 eAMP'LI:

PE.9mOLEllM MUeU"llM llNT **** * *** **** <0.40 1/30 GR HYO~

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EFFWENr GIU3S

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.: Oi.37 KG/OAY ***v'

,.i JO 24 Ul045 1 eAMP'LI:

I:R:N' 'lorAI.t MRA8URl'.MllNT 2.14 7.84 **** 1. 49 1.49 4 1/30 24 (AS FE)

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        • 0.38 1.39

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CONT

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        • **** **** 47.00 47.00 1 1/30 GR

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(AS~) ltllRMIT

        • * ** * * *** 35.00 * * "'. *. . ~/L
  • l/30 RS.OU IR llM llN1' a

EFFliJENT GK:GS

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1 AM&/TITLll: P'RINC:IP'AL K*llCUTIYI: OP'l"IC:l'.R THI* DOC:UMIENT 19 lllGNIED WITH RIEC:OONITION THAT KNOW-INOLY Mill.KING A F"ALllE CIERTIF"IC:ill.TION ON THiii RIEPORT OR BUP'P'ORTING DOCUMENT& OR INTIENTIONill.LLY Till.MPERINO

  • YJ J. _J/ _

Tl:Lll:,.MONll D A T It L

  • K 0 Ml* 11 er WITH ill.NY MONITORING DIEVICI[ OR MIETHOD ill.RI: CRIMINALl--~-.W::~--6..,oQj-~----f609 Of"~IEN91Ell. lllEIE 19 u.e.c.' 1001 AND 33 U.9.C. 113111. tl'rftal* e10NATUR1!: 01" P'RINC:IP'AL ll:XECUTIVll l365-700C 82 04 19 llr* 11ncfrr lhrJw 11a111rrJ "" 1,,. finr1 up 10 SI0,000 and/or MOdnt1un TYP'IED OR P'RINTll:D '"'P*lro"'"'"' of brtwrrn 6-muftth.* a"tl j 1..a,..) OP'P'ICIE" OR AUTHO,.IZll:D AGl[NT  ::!~ j NUM*P YllAlll MO DAY MMllNT AND ll:XPLANATION OP' ANY YIOLATIONll (Rr/rrtftU all at1acl11111nl1 h"t)

TSS, Copper, Iron & Ammonia Effluent - Investigation and characterization of influent sources is in progress. Design effic1ency for two unit operation is under evaluation. 17 14

-* * --- *** ..,..nu T-*n WHICH MAY NOT *E U811:D.) PAGE OF

r<<1111r tH11Nf&.oc*110111I **Dwnn11 DISCHARGE MONITORING REPORT (DAIR)

~g~~~?a~-:_nN_AFr __________ _ (1-16) 17-19)

~~~~PSE~------------------

--~J_J)~ oot 57.Q._J.OC. __________ _

NJ0005622 PERMIT NUMBER OlllCHARGIE NUMlll:A GP. AT MI 17 2 1.

--~_NfHABK. _ _ _ _ JU._fil11lL ______ _

MONITORING PERIOD U.GU.ID'_SALEM_GENERATING

~~~~W'JER_ALUH\YS STA~

CRmK _ _- _- _- _- _- _- _- _-_ FROM 82 03 01 YEAR MO DAY (10-11) (2l-1J) (U-1') NOTE: R..d lnatructlons before complellng Ulla fom1.

(J Cord 01111*) QUANTITY OR LOADING (4 Cord 0Rlr) QUALITY OR CONCENTRATION NO. "Al:OUIENCY 8AMP'Lll:

PAllAMETIPI (46-JJ) (JU*I) (J8-4J) (46.JJ) '"~'> l!X OP" TYP'IE (JJ.J7) ANALYSIS AVERAGE MAXIMUM UNIT8 MINIMUM AVERAGE MAXIMUM UNIT8 61~J) (6'-&9) (69-70)

I .

00056 1 llAMP'LE Flil-l RATE MEABUREMENT **** **** **** l53QO.QO 20800.QO CALC 24 (GAIU:NS PER DAY)

EFFLUENT GH:GS Pl!AMIT fllEQUIRl>MaNT *. ** * * * * ** * * ****. "' * * * * * . .*.__

  • -l-_GPO
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00310 1

......_-t*---------+-----4-~-------+--~-------+.._.,_._ _ _-+__.....___~---i.-----l

&AMPLE 3.69 7.48 63.70 95.00 3 5/31 BOD, 5-DAY, MEA8UREMENT

    • ** G 20 DEX;. C. PEllMIT . *,

EFFlllENr GR:6S llll:QUUIEMaHT.

0.97 KG/mY. **** 30.00 45.00 K;/I: 1/30 24 00530 1 SAMPLE MEABUREMIENT 0.42 0.82 **** 7.30 10.40 0 5/31 24 SOLIDS, 'lUrAI.

SUSPENDED P'l!R~UT EFFLUENl' GRES llll:QUIAEMaNT ~****** * **** KG/mY **** 30*.00 *. 100.00. M;/L 1/30 24 74055 1 COLIFOBM-FEX:AL

  • AMPLE Ml!ABUREMENT **** **** **** 12.00 40.00 0 5/31 GR

)>Ir.*.* 1t * * .*.* *. 200.00 400 *. 00* N/100 1/30' P'EAMIT * '* *.

  • lllQUIREMIENT
  • .~ ..
  • *** GR 00010 1 &AMPLE MEASUREMENT ** * * ** ** **** **** 10.90 0 CALC GR TEMPERA'IURE, WATER DEX;.CENTRIGRADE P'llRMIT .

RIEQUIRaMltNT

    • ** ** * * * *. **** 43.30* DEG.C .1/30 GR 00400 1 SAMPLE PH MEASUREMENT * *** 7.60 7.81 8.80 0 23/31 G EFFllJENT c;Ra;S P'ltAMIT *
  • lllQUIREMIHT *** ** ** ** 6.00 **** 9.00 SU 1/30 GR BAMP'LE MEASUREMENT

.. ERMIT Rll:QUIREMENT TELEP'HONE DATE 82 04 19 OMMENT AND EXPLANATION OF ANY VIOLATIONS (Rr/rrrnrr all allarl1nrrRIJ lrrrr)

DIS 87A IS DISCHAR3E 487A. AVERAGE VALUE IS 30 DAY DAILY AVE, MAX VAL IS 7 DAY DAILY AVE (TSS,OOD5). DISCW.RGE f.UiI'IDR PRIOR 'ID ro1B WI'IH DIS487. FUM MEAS CONT FOR mNT DIS, 1/30 FOR INTERMI'ITENT DISCH. '!HIS DISCHARGE.IS FOR 'lHE OID X NEW SEWAGE TRFA'IMEm'PLANT. BOD - System flow exceeds design capacity due to excess personnel for refueling outage. 15 17

  • - - - * * .--- --* - - n u ""'~A" \AIUlrM uav NnT AE URED.) PAGE OF

i111, ,,,_ ,,__.,,,,,. ,, "'"'""') DISCHARGE MONITORING REPORT (DMR) OMB No. ua. R007J g~~~M;R._-_mv~---~------- l-ltl) 11-19 PSE&G . l'U0005622 487 GP.AT MI

~~-----------~---------

-~J~~~ 57.Q._J.OC. _ _ _ _ _ _ _ _ _ _ _ PERMIT NUMllEA 1-------~

Dl*CHAllO HUM*R 17 2 1

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MONITORING

~m_SALFN_GENERATm;~-----~-- CREEK _________ _

a~~~-ALW'lAYS P'"OM 82 0 YEAR (10-11) NOTE: Re8d IMtNclloM ...._. eo111pledftg W. fonll.

(J CflTfl 011lr) QUANTITY OR LOADING (4 Car' 011lr) QUALITY OR CONC~NTRATION 0530 PA.. AMrr.ll 1

(J1J7)

X *AMPLE AVllRAGll

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MAXIMUM UNIT*

(J3-4J)

MINIMUM (464J)

AVllRAClll (JUI)

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MAXIMUM UNIT8 NO. ~*s.og:HCY U4JI ltJl 0

ANALY*le (6'-")

OLIDS, '.lUl2Ui MKA*UREMKNT 0.10 Q.10 ** ** 2.64 2.64 USPmDED FFWENr~

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1 THI*

MK/TITLR PIUNCl,.AL UllCUTIVK OP'PICK" DOCUMENT 19 BIGNIED WITH RECOGNITION THAT KNOW.

INGLY MAKINO A P'AL9£ CEATIP'ICATION ON THI* REPORT OR

  • U .. l"OATINO DOCUMENT& OR INTl:NTIONALLY TAM .. ERINO
  • I.
  • ~ .

TllLllPHONK D A T K I

L. K. Miller w1TH ANY MoN1ToR1No DEv1cE oR METHOD AA* cR1M1NALl----"~.::.ll...:::::~-.....:::i....4-1._,............~ 1365 _ 7000 82 04 1 9 O~P'IEN9£*. 91[1: " ' U.9.C. t 1001 AND 33 u.11.c. l1311P. ,,.,,,n/- *1GNATUR* OP PRINCIPAL lllll!:CUTIYll 609 1 1 - - - - - - - - - - - - - - - - - - - - - f Uu """ '"'" hr 11r SI0,000 *11d lll**lmum l-T--N'-------+---t---::-1'1'-=-".":':'4 TYPED OR PllllNTllD 1tn1u1r1 "" (inr.

1...pr110,,..,,.,, 1 nl brlwrrn 11 munllu and J rrar*.)

10 /Or Ol'l'ICEA OR AUTHOAIZl:D AGKNT ~!:~ I NUM*D TKAll MO DAY MMl:NT AND 1:11 ..LANATION OP' ANY VIOLATION* (Rt/rrt11rr all a11arl1"1HIJ hrrt) 16 17

..... --* ... "'"" ... _ ....... ***11'.0.l PAGE OF

Kl/If, H-/1.AC*lfoR II ..10fFHI) DISCHARGE MONITORING REPORT (Dllflt) OMB N~.. i 38 ~ R007J

&M~~~M:;R._-_JW_J\FF __________ _ 1-16) 17-19 tu0005622 489 v~m_P~_!_G--------~---------

--~J>--.D~~2~_.J.OC. __________ _

GP. AT MI

___ ..:..N&lABK.____ JU__filJJlL ______ _

l"l:AMIT NUMlllEA 018CHAROI: NUM*l:R 17 2 1 MONITORING PERIOD la~_SALFM_<illmRA~~--------

IZQ.TRL~-AU.<W\YS CRm{ _ _ _ _ _ _ _ _ _ _ 82 03 I 01 I TO 82 I 03 I 31 l'"OM YEAR MO I DAY I I Yl:AR I MO I DAY (10-11) (21-lJ) ('4-n) I 16 U) (11'-/!I) (JO-JI) NOTE: And lnltlllClicM* ..... co.,l1dng W. lam.

(J C*d 0Rlr) (4 C**d o ..,,,

X QUANTITY OR LOADING QUALlfY o" CONCl:NT.. ATION l----"'(~46_-_JJ~)____....,..._ _..;.(J_4_~_1~)----.------+--~(J_8~-'~'~---..---~(4_6"'_J~)----..---,_.;..('44 ___1)'---_,.---~NO. ~**o::NCY llJl ANA\. Y8t8 eAMA.11 TYl"ll AYll"AOll MAXIMUM UNITI MINIMUM AYll"AOll MAXIMUM UNIT9

,.,_70) I 00530 1 ilAMl"Lll MllAilU"IEMf.:NT 0.87 0.87 **** 11. 48 11. 48 0 SOLIOO, 'lUrAL 1/30 GR SUSPENDED

  • KG/DAY  ; * ., * *  ;...': *.;' ,.:ao *.oo. .*

.... lOQ~OO;** l-C/L 1/30:. ;;GR 1"FF'l"I~ ,* ... '

00550 1 OIL AND GRFA4iE.

IAMl"Lll MllAilU"l:MllNT *** * **** **** **** 2.90 0 1/30

        • *..** * ' **** 10. 00.....':.' :M:;/L 1/30

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Mf.:AilU .. l:Mf.:NT **** **** **** **** 0.80 1/30 GR

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  • 00010 1 ilAMl"Lll

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        • **** **** **** 20.00 0 1/30 GR DF.X;. CENI'RIGRADE
    • =: ... ** . .. *.. . .. . . '.:-*. -~

EFFLUENr GiaiS  :  : :* .. ** ** .. * ******

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  • 43.30 .' * !l:a;.C.

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MllAilUAl:MllNT IUIQUIR*.. l:NT IAMll/TITLI: l"RINCll"AL l:Xf.:CUTIYI'. OP'l'ICI'." THI* DOCUMl:NT Ill SIGNED WITH RECOGNITION THAT KNOW-INGLY MAKING A f'ALllE CERTlf'ICATION ON THl9 REPORT OR llUP'PORTING DOCUMENT& OR INTENTIONALLY TAMl"ERINO 1---~-*~--=~e::..*c=:ii.,.l.-;:..__ _ _-I WITH ANY MONITORING DEVICI[ OR METHOD ARI'. CRIMINAL

~;;eu._

1 a T&LU'MONll I

DATii:

L. K. Miller Of'~EN9Ell. 111[1[ Ill U.11.C. ~ 1001 AND 33 u.11.c. lt318. 609 365-7000


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crrnnl- illONATUlltf.: 01' l"lltlNCll"AL l:Xf.:CUTIYI:

JlarurrJ '""' l*r fi"" 11r ro SI0,000 nr1d for 111a.1mu"'

OP'FICll:" OR AUTHO"l'ZED AOl:NT  ;;,:;: I NUM81:R

>MMl:NT AND ll:Xl"LANATION OP' ANY YIOLATIONil (Rr/rrrr1u all allarhrnrnlr hrrr) 17 1

--* * --- --* rnaM T 0 AO WHICH MAY NOT 8E Ulll:D.I PAGE OF