ML20198K215
| ML20198K215 | |
| Person / Time | |
|---|---|
| Site: | Hope Creek  |
| Issue date: | 11/30/1998 |
| From: | Bezilla M, La Sala P Public Service Enterprise Group |
| To: | |
| Shared Package | |
| ML20198K207 | List: |
| References | |
| NUDOCS 9812300368 | |
| Download: ML20198K215 (10) | |
Text
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ADDENDA TO' MONITORING REPORT - TRANSMITTAL SHEET November 1999 12/17/98 i
DISCHARGE NUMBER i
PAGE PARAMETER CODE COMMENTS l
461A 1 of 3
- CPOX 1 0 Sample frequency was increased to greater than three/ week providing additional operating data.
J 2 of 3 00680 2 0 NET Values are calculated utilizing results from grab samples.
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9812300368 981217 PDR ADOCK 05000354 R
T-VWX 014 NEW JERSEY DEPARTMEhfr OF ENVIRONMENTAL PROTECTION DIVISION OF WATER QUALITY MONITORING REPORT - TRANSMITTAL SHEET NJPDES NO.
REPORTING PERIOD l0l0l2l5l4l1l1l Mo. Yr.
Mo. Yr.
l1l1l9l8l l1l1l9l8l PERMITTEE: Name:
Public Service Electric & Gas 4
Address:
P.O. Box 236 Stancocks Bridge, N.J. 08038 FACILITY:
Name:
Hope Creek Generating Station Address.
P.O. Box 236 Hancocks Bridge, N.J.
08038 Telephone:
(609) 339-3463 FORMS ATTACHED (Indicate Ouantity of Each)
Operatine Ex.ceptions SLUDGE REPORT-SANITARY YES NO
_T-VWX-007 _T-VWX-008 _T-VWX-009 DYE TESTING x
_ EPA Form 3320-1 TEMPORARY BYPASSING x
SLUDGE REPORT-INDUSTRIAL
)
T-VWX-010A T-VWX-010B DISINFECTION INTERUPTION x
WASTEWATER REPORTS MONITORING MALFUNCTIONS x
_T-VWX Oll T-VWX-012 T-VWX-013 UNITS OUT OF OPERATION x
GR.OUNDWATER REPORTS
_VWX-015(A,B) _VWX-016_VWX-017 OTHER x
_ ELECTRONIC SUBMISSION (Detail any "Yes" on reverse side in appropriate space)
NJPDES DISCllARGE MONITORING 5 EPA FORM 3320-1 NOTE:The " Hours Attended at Plant" on the rmerse of this sheet must also be completed.
AUTHENTICATION I certify under penalty of law that this document and all attachments were prepan:d under the direction or supenision in accordance with a system designed to assure my inquuy of tie person or persons wie manage the system or those persons dirtetly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility offine and imprisonment for knowing siolations.
LICENSED OPERATOR PRINCIPAL EXECUTIVE OFFICER OR DULY AUTHORIZED RLTRESENTATIVE Name(Printed)
Peter R.
La Sala Name(Printed) Mark B. Bezilla l
Grade & Registry No.
N-2,(0.005928 )
Title (Printed) Gen. Wqr. Hope Creek ops.
Signature 7U[M Signature
- b Date r 11, 1998 Date De 17, 1998
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OPERATING EXCEPTIONS DETAILED i
- Please refer to the attached Transmittal sheet Addenda.
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HOURS ATTENDED ATPLAH Month l1]1]
Year l9]ej
[
i Day of Month 1
2 3
4 5
6 7
8 9
10 11 12 13 14 15 16 10 i
Licensed Operator 10 10 10 10 10 to 10 10 Others 3-10 3
10 10 10 3
3 10 10 10 to 3
3 3
10 i
Day of Month 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 i
Licensed Operator 10 to 10 e
x 10 to 10 i:
Others 10 10 10 10 3
3 10 lo 10 3
10 3
3 10 x
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OPERATING EXCENIONS DETAILED
- Please refer to the attached Transmittal Sheet Addenda.
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l HOURS ATTENDED ATPLANT Month l1l1l Year (9)8]
Day of Month 1
2 3
4 5
6 7
8 9
10 11 12 13 14 15 16 Licensed Operator 10 10 10 10 10 10 10 10 10 Others 3
10 3
10 10 10 3
3 10 10 to 10 3
3 3
10 Day of Month 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Licensed Operator 10 10 10 e
x 10 10 10 Others 10 to 10 10 3
3 10 10 10 3
10 3
3 10 x
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i T-VWX-014 NEW JERSEY DEPARTMENT OF ENVIRONMENTAL PROTECTION DIVISION OF WATER QUAllTY MONITORING REPORT-TRANSMITTAL SHEET NJPDES NO.
REPORTING PERIOD l0l012l5l4l1ll]
Mo. Yr.
Mo. Yr.
1/14/131 1/1/ifWI ffRMFITEE: Name:
Public Service Electric t. Gas Address:
P.O.
Box 236 Hancocks Bridge, N.J. 08038 FACILITY:
Name:
Hope Creek Generating Station Address:
P.O.
Box 236 Hancocks Bridge, N.J. 08038 Telephone:
(609) 339-3463 FORMS ATTACHED (Indicate Ouantity of Each)
Operatine Exceptions SLUDGE REPORT - SANITARY YES NO T-VWX-007 T-VWX-008 T-VWX-009 DYE TESTING
(
)
~
TEMPORARY BYPASSING
_ N_
SLUDGE REPORT - INDUSTRI AL
_T-VWX-010A __ T-VWX-010B DISINFECTION INTERUPTION Y
WASTEWATER REPORTS MONITORING MALFUNCTIONS _
T-VWX-Oll T-VWX412 T-VWX-013 UNITS OF OPERATION Y_
GROUNDWATER REPORTS
_VWX-015(A,B) _VWX416_VWX-017 OTHER
[_
_ ELECTRONIC SUBMISSION (Detail any "Yes" on reverse side in appropriate space)
NJPDES DISCHARGE MONITORING 5 EPA FORM 3320-1 NOTE:'Ihe " Hours Attended at Plant" on the reverse of this sheet must also be completed.
AUTHEN71 CATION 1 certify under penalty of law that this document and all attachments were prepared under the direction or supervision in accordance with a system designed to assure my inquiry of the person or persons who manage the system or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, tme, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations.
LICENSED OPERATOR PRINCIPAL EXECUTIVE OFFICER OR DULY AUTHORIZED REPRESENTATIVE Name (Printed)
Andres Nurk Name (Printed) Mark B.
Bezilla Grade & Registry No.
S-4 (0006979)
Title (Printed)
Gen. Mgr._ Hope Creek ops.
Signature bf M
Signature t.o 12/[/98
/d[/
Date Date
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- OPERA 71NG EXCEI'TIONS DETAILED t
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HOURS ATTENDED ATPLANT Month d Year l7l8l Day of Month 1
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8 8
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8 '/-
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Licensed Operator f-2 8
/
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Others f-P Day of Month 17 18 19 20 21 2.2 23 24 25 26 27 28 29 30 31 Licensed Operator
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OPERATING EXCEPT10NS DETAILED YO ]$Ya &
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HOURS A*TTENDED AT PLANT Mooth W Year M Day of Month 1_
2 3
4 5
6
,7 8
9 10 11 12 13 14 15 16 Licensed Operator f-P 8 4
M d'
f-6 8
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Day of Month 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Licensed Operator 7 8 6 8 9
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-4 PERMITTEE NAMEJADDRESS g,iewe racery mmetaconas erDgmer)
NATONAl. Mlt.LUTANT OfSCHARGE EUMMATION SYSTEM (NP E Form' Approved.
rNS CREATED: 10/02/98
- E" NAME PSECG 3.g,
ADDRESS P.O. BDX 236/N21 MJ0025411 461A HANC0CKS BRIDGE,NJ 08038 PERMIT NUMBER OtSCHARGE NLMBER MONITORING PERIOD FAClu W PSECG HOPE CREEK GENERATING ST YEAR MO DAY YEAR MO DAY LOCAm N LOWER ALLOWAYS CREE,NJ 0803S FROM 11 41 TO W
11 50 SOUTHERN REGION / SALEM DMR NUMBER: NJ0025411 461A 111995 (2a 9
<22 23; (2+25; (2 s 2 73 pS2ei g3ast; NOE Read inse W complews form.
(3Camonly) OUANTITY OR LOADING (4 Cad C.sy)
OUANTITY OR CONCENTRATION NO.
rREOUENCY SAMPLE PARAMETER (4&53)
(54 67)
(3845)
(4S 53)
(54-s t)
EX OF TYPE WI AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS M70)
PH SAMPLE
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7.8 8.7 0
NEEKLM GRAB MEASUREMENT
- 5 0EEEK
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PERMIT-01RPMN'
- 01RPMX' *J S
N EFFLUENT GROSS VALUE REQUIREMENT
+
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LC50 STATRE 96HR ACU SAMPLE MYSID. BAHIA MEASUREMENT CODE =N 0
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EFFLUENT GROSS VALUE REQUIREMENT 4i 31MDAWMND 49' M W9M MT 1C25 ST ATRE 7 DAY CHR SAMPLE MYSID. BAHIA MEASUREMENT CODE =N O
CODE =N CODE =f TCP3E 1 0
- PERMIT -
REPORTO j******A s******M PERCE 1. QTRLY CK1 REQ EFFLUENT GROSS VALUE REQUIREMENT 01MOAWMN; T
NT IC25 STATRE 7 DAY CHR SAMPLE CYPRINDDON MEASUREMENT CODE =N 0
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')1MDAWMN1 CHLORINE PRDDUCED SAMPLE
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- CP0X 1 0
PERMIT-
- e.2MlW9x
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. MG/L
_ THREEfGRAB; EFFLUENT GRDSS VALUE REQUIREMENT 01MOAV D1DAMX i ~
' WEEK 4
TEMPERATURE, WATER SAMPLE CONLN 20.7 26.7 0
UOUS CK FE4 9EG. CENTIGRADE MEASUREMENT 00010 1 0
PERMIT
$ 31 DARK ' '
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NAME/ TITLE PRINCIPAL EXECUTIVE OFFICER iCERT UNDE HA WED AN TELEPHONE DATE mp g
Mark Bezilla m""e "78sdwpgs n,oigg7pwu"s^u?uirrfo"n*r*5E"Ero"n "s'*EE
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A me Gencra1 Manager N E T's % nC"uYnrrmd""AEE*"* $[a*ro'n"' ^u"'tu'o$i E'E
^
s mr SIGNATUR OF PRINCIPAL EXECUTIVE 609 339-346 3 98 12 17 Hepe Cree > One rat i e n <=
( W '" "y n IJ *m* ^,", J."",' 3 7 m d E
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OFFIC OR AUTHORIZED AGENT ARE^
NUMBER YEAR MO DAY TYPro OR PRINTED maxmim e.r~.-
- of eenseen e morrhe amf 5 years J OE COMMENTS AND EXPLANATION OF ANY VIOLATIONS (f aference allattachments here)
/
Please refer to the attachad Transmittal Sheet Addenda.
FPA Form 3ro-1 (OR-95) Provinm primor[ rmv nnt bn meri (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.)
PAGE OF
LA55:
51 77434 06413 PERMITTEE NAME/ ADDRESS (inet dr raestiry Na-etocar*= (Dfemer)
NATIONAL PORUTANT DSCWMGE C;A.a SYSTEM Form W.
0*
CREATED: 10/02/98 NAME PSECG pgg ADDRESS P.O. ROK 236/M21 NJOO2=n11 an61 a HANC0CKS BRIDGE,NJ 08038 PERMIT NUMBER DSCHARGE NUMBER MONITORING PERIOD FACIUTY PSEEG HOPE CREEK GENERATING ST YEAR MO DAY YEAR MO DAY LOWER ALLOWAYS CREE,NJ 08038 FROM 98 11 01 TO 98 11 30 SOUTHERN REGION / SALEM DMR CUMBER: NJ0025411 461A 111998 razn r2:23 (2+25, oorn (252s>
cmo NOTE: Read instruchons before cornpleting tris form.
(3 Card OnM QUANTITY OR LOADING (4 Card OnM QUANTITY OR CONCENTRATION NO.
rREQUENCy SAMPLE PARAMETER
( 4 53)
(54-61)
(3845)
(4 53)
(5441)
EX OF TYPE I3#
AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
%38 (69%
TEMPERATURE, WATER SAMPLE
- 3 JOWZd DEG. CENTIGRADE MEASUREMENT 13.6 16.9 0
JOUS CK REQ D3010 7 0
PERMIT -
REPDRTy,
REPORT ; ' DEG.C
'E CONTIHCK5MEQ INTAKE FROM STREAM REQUIREMENT 31MDAV 31 DARK ^
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TEMPERATURE, WATER SAMPLE cesses cesec*
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JOUS CK REQ DEG. FAHRENHEIT MEASUREMENT DD011 1 0
PERMIT REPORT 97.19333-DEG=F CONTINCKJRE4 EFFLUENT GROSS VALUE REQUIREMENT 31MOAV E D1DAMXi JOUS' TEMPERATURE, WATER SAMPLE
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CONTlb 3EG. FAHRENHEIT MEASUREMENT 56.4 62.4 0'JOUS CK REQ 03011 T O
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MEASUREMENT 16.2 16.2 0 MONTH GRAB 3C680 1 0
PERMIT
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MEASUREMENT 7.2 7.2 0 MONTH GRAB 30690 7 0
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31DAMX HAME/ TITLE PRINCIPAL EXECUTNE OFFICER 3 QF A
lA.
TH H IN ORMATIO T D BAS N
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Mark Bezi11a gg,T, HOSE WpB
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T D FO M T N IS COMPI AM RE T"^T E E ARE GN
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General Manager g g ANg9 UB INFORP Hope Creek Operations geiu4T0LrmE,awo,iu,rR giEgsEEguygigigogg SIGNATijdE OF PRINCIPAL EXECUTWE 609 339-3463 98 12 17 l
TYPED OR PRINTED maximum ;...
.; er twween e months a xr 5 pers )
OFFfER OR AUTHORIZED AGENT pgA NUMBER YEAR MO DAY COMMENTS AND EXPLANATION OF A*JY VIOLATIONS (Reference allamichments here)
- Please refer to the attached Transmittal Sheet Addenda.
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NATIONAL pot.t.UTANT DISCHARGE EtJMINAT10N SYSTEM Form Approved.
PSEEG
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CCEATED: 10/32/93OMB % g NAME DISCHARGE MONITORING REPORT (D$*
AppimmeW1-98 ADDRESS P=D. CDK 236/021 Einn m 11 kr.i a PERMIT NUMBER OtSCHARGE NUMBER HANCDCKS BRIDGE,NJ 08038 MONITORING PERIOD FACIUTY PSEEG HOPE CREEK GENERATING ST YEAR MO DAY YEAR MO DAY LOWER ALLOWAYS CREE,NJ 08038 FROM 98 11 01 TO 98 11
.50 SOUTHERN REGIDN / SALEM EMR NUMBER: NJ0025411 461A 111998 p2n p2si (2+2s c2s 20 is-2W rm NOTE: Read instructorts befom -M v this form.
(3 Cartf OnM OUANTITY OR LOADING (4 Caif Onry)
OUANTITY OR CONCENTRATION NO.
rREOUENCY SAMPLE PARAMETER
( 4 53)
(544f)
(3845)
(48-53)
(54471 EX OF TYPE y
99 (32 g AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 3*aisa 4 EAT ORINTER)
SAMPLE
[PER HOUR)
MEASUREMENT 189 331 0
DAILY CALCTI 51387 1 0
PERMIT -
REPORT -
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r BAILY. CALCT3 EFFLUEMT GRDSS VALUE REQUIREMENT 31gggy' 11 DARK -
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4-PERMIT t - i NAME/ TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED AND TELEPHONE DATE AM FAM1UAR WTTH THE INFORMATION SUBMITTED HEREIN: AND BASED ON MY Mark Eezilla INQUIRY OF THOSE INOMDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING sHE INFORMATION, i BEUEVE THE SUBMITTED INFORMATION IS TRUE, ACCURATE AND COMPLETE. 1 AM AWARE THAT THERE ARE StGNtFICANT
~f-g General Mana9er PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE Hope Creek Operations POSSIBlUTY OF FINE AND IMPRISONMENT. SEE 18 U.S.C. I 1001 AND 33 U S C.
SIGNATURE h PRINCIPAL EXECUTIVE Ano t1o 1ac7 oR 1>
1r 51319 (%nomes saider these statures may ticiude fires up 10 Sf0,000 aruf or OFFICE AUTHORIZED AGENT NUMBER YEAR MO DAY TYPED OR PRINTED me*xan l
-..;of Demeen e months amt 5 reers)
/
COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference allanschments here)
EPA Form 33201 (08-95) Previous editions may not be uSed.
(REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.)
PAGE OF
LCCS::
1
= = - -451 77434 06413
=
PERMITTEE NAME/ ADDRESS (Nchnie racarp Nainefararke dfafant)
NATIONAL PORUTAP(T DISCHARGE ElmmNADON SYSTEM Form'AppM p$ggg GE MONITORING REPORT (DyRg NAME DISC ADDRESS P.O. CDX'236/C21 NJOEP%11 M1C HANC0CES. BRIDGE,NJ 08038 FERMIT NUMBER OtSCHMtGE NUMBER FACIUTY MONITORING PERIOD PSEEG HOPE CREEK GENERATING ST YEAR MO DAY YEAR MO DAY NON LOWER ALLDWAYS CREE,NJ~08038 FROM vs 11 Ul TO 95 11 30 SOUTHERN REGION / SALEM CM2 NUMBER: NJOG25411 461C 111995 carr; r22mi (2+2s>
ra27) <reas raar; NOTE: Read instructions before completing tNs form.
(3 Card OnM QUANTITY OR LOADING (4 Cad OnM QUANTITY OR CONCENTRATION NO. FitEQWNCY SAMPLE PARAMETER (48-53)
(5447)
(3845)
(46-53)
(544f)
EX OF TYPE (32g AVERAGE MAXIMUM UNITS MINIM U M AVERAGE MAXIMUM UNITS
%e (69-70) es243 UN'##
5DLIDS, TOTAL SAMPLE SUSPENDED MEASUREMENT 2
2 O
MONTH COMPOS 00533 1 0
. PERMITr c888888-
,P~r EFFLUENT GROSS VALUE REQUIREMENT
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' 30 20999 a 100.MMMSj RG/L B. DNCE/ CORRE5:
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TOTAL RECOVERABLE MEASUREMENT 2
2 O
MONTH GRAB 45501 1 0
- PERMIT
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PERMITA REPORTJJ
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(TOC)
MEASUREMENT 16 16 0
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NAME/ TITLE PRINCIPAL EXECUTIVE OFFICER I RTIFY UNDE PC HA P EXA TELEPHONE DATE O
D Mark Bezilla INOUIRY OF NOSE INDMDUALS IMMEDIATELY RESPONSIBLE FOR OBTAIN!NG g
mE INFORMATION, i BEUEVE NE SUBMIT'ED INFORMATION IS TRUE, General Manager ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT a
PENALTIES FOR SUOMITilNG FALSE INFORMATION, INCLUDING THE Hope Creek Operations POSSIBIUTY OF FINE AND IMPRtSONMENT. SEE 19 0.S C. 51001 ANO 33 U S C.
SIGNATURE PRINC: PAL EXECU7VE 609 339-3463 98 12 17 91319. (Pennmes under these sinfuros mer erhie Anos @ so 3ro.000 and or i
OFFICE R AUTHORIZED AGENT E
NUMBER YEAR MO DAY TYPED OR PRINTED rneenum :..v;
. et ben. css 6 months and S rests.)
COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference allattachments here)
/
l l
EPA Fnrm 3370-1 (OR-95) Provinm editions may not bn ilmpri (REPLACES EPA FORM T-40 WH'CH MAY NOT BE USED.)
PAGE OF
n.m u PERMITTEE NAME/ ADDRESS (7 cWe riacituy %melecorkm (Dfemr)
NADONAL PCLLUTANT DISCHARGE EUMINADON SYSTEM (NPDE))7451 77434 06413 FonnApproved NAME
NE " " ""
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CREATE 3: 10/C2/93 1
PSEEG m es ADDRESS
'P.D. BOX 236/N21 tr_ ann m it u2 n PERMIT NUMBER DISCHARGE NUMBER HANCDCKS BRIDGE,NJ 08038 MONITORING PERIOD FACIUTY PSECG HOPE CREEK GENERATING ST YEAR MO DAY YEAR MO DAY ION LOWER ALLOWAYS CREE,NJ 08038 FROM 98 11 01 TO 98 11 30 SOUTHERN REGION / SALEM i
DMR CUMBER: NJOO25411 %2B 111998 v321;
<22-22; r24 53 pra (2s-rei vant; NOTE: Read instmetions befe compleeg Ws fonn.
(3 CartiOnM QUANTITY OR LOADING (4 Carcf OnM QUANTITY OR CONCENTRATION NO.
FAEOUENCY SAMPLE PARAMETER (48-53)
(544f)
(38-45)
(46-53)
(5447)
EX OF TYPE "d3'8 (69-70)
(32g AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS BLGo 5-DAY SAMPLE ONCE/
O.3 0.3 0
MONTH COMPOf:
(20 DEG. C)
MEASUREMENT 33310 1 0
PERMITg S.gaget-REPORT KG/ DAY
- C A******..
au BNCEL CORPOS' O
N' W RONTN WW EFFLUENT GROSS VALUE REQUIREMENT DEMOAW' 31DAPX-SDLIDS, TOTAL SAMPLE ONCE/
SUSPENDED MEASUREMENT 23 23 O
MONTH COMPOS 05530 1 0
. PERMIT
- f i******-
- ^ 30.DDome g -REPORTA ' 4G/L E
3NCE/. COR305 ginggy-
- 31gggg:
P.
EFFLUEitT GROSS VALUE REQUIREMENT qqggyg
- a
+
11L aND GREASE SAMPLE ONCE/
FREON EXTR-GRAW METH MEASUREMENT 4
4 O
MONTH GRAB 30555 1 0
PERMIT 9
- LO.MMMBS:6 15 5 00155 ' RG/L R' 3NCE/
GRAST
'ff*
.o
} 1 g g g y p 'X O 313AggpW Ui 40NTM PES EFFLUENT GROSS VALUE REQUIREMENT
+
i s' G.
4 FLGWa IN CONDUIT OR SAMPLE THRU TREATMENT PLANT MEASUREMENT O.011 0.024 O
DAILY METER l
5C050 1 0
PERMIT REPORTL REPORT - -
4GD
- p
- w
- M ****
BAILY METEM 5;e G'
EFFLUENT GROSS VALUE REQUIREMENT 31MDAWf 31DAMX
- W MF
- DLIFDRM, FECAL SAMPLE UNCE/
GENERAL MEASUREMENT
<1
<1 O
MCNTH GRAB T4055 1 0
. PERMIT p******
- r 200.G9300r' 400.;SSaott
=/100 g; 3NCE/. GRAB :
I EFFLUEMT GRDSS VALUE REQUIREMENT
~
31MOGE :
31DAGEF>
'It 4DNTH M
403, 5-DAY PERCENT SAMPLE
$$$333 ONCE/
98.0 0
MONTH CALCTI l
REMOVAL MEASUREMENT 51010 K 0
- PERMIT 57 55550*
'****** *- M******* PERCE t
3NCE/ CALCTD' PERCENTREMOVML REQUIREMENT 31MDAVMN -
': MT
- '90 NTH
"^
SDLIDS, SUSPENDED SAMPLE ONCE/
PERCENT REMOVAL MEASUREMENT 93 0
MONTH CALCTI 51011 K O
' PERMIT 55.XkeR207 a******-
- ] PERCE
- 3NCE/ CALC,TD PERCENTREMOVAL REQUIREMENT 31MOAVMN-WT RONTH NAME/ TITLE PRINCIPAL EXECUTIVE OFFICER I
A FAMtuAR IN O MA S
D BAS Mark Bezilla THE INFORMATION, I BEUEVE THE SUBMITTED INFORMATION IS TRUE.
[
INQUIRY OF THOSE INDIVIOUALS IMMEDIATELY RESPONSIBLE FOR 083TAINING ACCURATE AND COMPT.ETE. I AM AWARE THAT THERE ARE SIGN!FICANT General Manager PENALTIES rOR SuBuiTnNG FALSE INFORMADON, INCLUDING THE y
tinno c'rnnk ono ra H nn a POSS10tuTY OF RNE AND IMPRISONMENT. SEE 18 U 9 C. 91001 ANO 33 U.S C-SIGNATURE O PRINCIPAL EXECUTIVE 609 339-3463 98 12 17 I
OFFICER AUTHOR! ZED AGENT E
NUMBER YEAR MO DAY TYPED'OR PRINTED or 5
y COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference a!1 attachments here)
EPA Form 3320-1 (08-95) Previous editions may not be used.
(REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.)
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