ML18086B543
ML18086B543 | |
Person / Time | |
---|---|
Site: | Salem ![]() |
Issue date: | 06/25/1982 |
From: | Public Service Enterprise Group |
To: | |
Shared Package | |
ML18086B542 | List: |
References | |
NUDOCS 8207070430 | |
Download: ML18086B543 (17) | |
Text
ForAf,provftl QMWfi. 158-ROOlJ GP AT .r.':
17 2 OELAWAl\E RIVER COOLING WATER NOTE: Read ln1tructlon1 before completing thl1 form.
(Jc:.do11~J QUANTITY OR LOADING ,, C*dOn~J QUALITY OR CONCENTRATION UUUlU
~ARAMETER
(.J1-J1J Z
l>< SAMPLE (4'*.UJ AVERAGE f."*'1}
1--~~-'-~~-..~~~~~~.....-~~~-t-~~~~~~.--~-'--~~~-..~~-'--'-~~-.-~~---t MAXIMUM UNITS
(.111-4.'J MINIMUM (4'*.UJ AVERAGE
~IJ MAXIMUM UNIT9 NO.
EX (11"'1}
FR!:~Y ANALY~S (U*UJ 9AM~ll:
TYPE TEMPERATUREtWATER lJEG.CENTIGRADE MEASUREMENT r* ~ r ':;~"'_, i :*... ~
- 14.20
... '-~-~ i. : i<. 1 '.'
lR.RO
._;: .. ,~>~=~*::;.,'.,**.-~.'; ~: . *-<** 4 14_qn
.-'.- \-+. *~*::*..-:* .*~:" .;'~"~<"{I 0 EG. c CONT
........... '?
NA
- * . .f<.*
.*.*;;~~:*'.*;
. ':>'PERMIT INFLUENT .. l!:OUIREMl!:N"f" '*.. *.* *:
~ ~ ' :. ~: . * .*. f.
- * * $,;
- ...... ' '. ;,.'.
- '.**.
CONT.
- IUUUlU l TE~PERATURE,WATER SAMPLE MEASUREMENT :0: *** ***
- 22.70 29.80 36.90 0 CONT NA DEG.CENTIGRADE i~ ---*.~** DEG.C "PERMIT* . .\ . ;\* : , . *.f *:_,
EFFLUENT GROSS UlJUlb It AltQUIREMIENT *. . 46*00. CONT '.
- SAMPLE TEMPERATURE M*ASUREMl!NT 5.40 11.00 17.50 I 1 CONT NA DIFFERENCE ;. : ... , '* **:. =: ~:*. , . . . . ~DEG :C EFFLUENT NET ,._:.;: '.:: '* '.
- ~;15. 30 I
I
- r.
- UU6tUU 1 SAMPLE
- \
PH Ml:ASUREMl!NT
- * * ** *
- 6.90 7.06 7.20 0
,'.o'l}.-,:.
2/7 GR 6.90 7.04 7.20 2/7 GR 299.70 499.90 532.80 CALC NA
, ..... '"!f'"**'~(ty\:"('"'"":.-,.*.:.v<~ -~~"-~;-:- .*~\\1.t'!-"'-.~-*. *:,.,.,~1.~'*.1!°~";'..~i-'.'.~~-"""~-~-;~,.: MGO
- s;*~u*
- ~*,~~'.~; .-*' '*
- "*:*:<, .> *,~~~",'~~,::*:'.*,*~i 1
- 0.05 0.15 0.40 0 CALC GR
- '*.**...
- .
.:.~f;:;'. *~:*:~.g:;t: "G/D Ay ,'."i:*; :;f;"}
NAME/TITLE PRINCIPAL EXECUTIVE OFFICER THIS DOCUMENT 19 SIGNED WITH RECOGNITION THAT KNOW- ~t"r-~ Tl!:LEPHONI! DATE 1----------------~ INGLY MAKING A FALSE CERTIFICATION ON THIS REPORT OR
- L K
M . 11 1 er SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINAL OFFENSES. SEE Ill u.s.c.11001 AND 33 U.9.C. 11319. ,,.,,..,_
l----'¥--=----==-----------1 91GNATUAEOl"~"INCl~ALEXECUTIVI:
I 609 365-700( 82 06 25 t------------------1 TYPED OR PRINTED tlrr *11drr
"""r&ort"'"" o/
tArrr lf*l*lr* **!!
&.fw..., I -rttlu .,,d' yrsn,J 6r //11r* *P I* Jll,111 *rtd/or ,,. * ..,,,..,,.
Ol"FICE" O" AUTHORIZED AGENT
....,_...,.-+-----i---+---f----l
~~~; t NUMBER YEA" MO DAY OMMENT AND EXPLANATION OF ANY VIOLATIONS (Rrfrurtcr .n .,,..."'"" ,,,.,,
OIS 481 IS CONDENSER COOLING WATER.WHEN lNTK PH LESS THA~ 6.0,0IS PH NOT TO OE LESS. WHEN INTK PH GREATF R THAN 9.0,0IS PH NOT TO EXCD INTK NOT MOR[ THAN 3 CONVENS MAY DIS FREE Cl AT ANY TIME,OR ~ORE THAN 3CMI~
Effluent Ternnerature Differential-Less than the design number of CirculatorR in RervirP. ------- 1 17
0
!RM ITTl!IE NAMl!./AD...a. (111d11de NATIONAL P'OLLUTANT Dl9C~E ELIMINATION *Y*TEM (IYl'DF.S) For~o1*td
- f'Clllt1 Narn*/l.oc*tlon 1fSnt) DISCHARGE MON~ING REPORT (DMR) OM* . U3 - R001J *
~!!!'-~~...!... ~._-_w_m
~Dita*_PSE&CL_
___ ~-------
_______ ._ __._______ NJ0005622 2-111, 11-1*>>
481 GP. AT MI
--~J-a9~001t'51_Q__.J.OC. __________ _ PERMIT NUMBER DlllCH,.RGE NUMlll!:R 17 2 1
---~----_m__m.10L ______ _ MONITORING PERIOD llcm.m_SALEM_GENERAT:m:; ~ - - - - - - - - 82 O'i I 01 I To l.Q? I nc; I 11
~T~J!_l:QiER_ALUMAYS CREEK - - - - - - - - - - P'ltOM YEAR MO I DAY I YEAR I MO I DAY (10-ll) (Z2-2J) (U-2J) 12617) (211-19) (JO-JI) NOTE: And lnttructlone before compl9'1ng ttilt form.
X (J Cord Onl1*) QUANTITY OR LOADING (f Card Onl1') QUALITY OR CONCENTRATION (48-JJ) (Jf-61) (J8-4J) (46-3J) ('4-61) NO. P'Jll!:OiJ,.'-NCY *AM ..LE r---------------,--------'------,..------r-----'--------..,..--------'------r----..;._--'--~-.,--------4 EX ANALYlllll .TY.. I!
AVERAGE MAXIMUM UNIT* MINIMUM AVEltACllE MAXIMUM UNIT9 81-61) (84~) <***70) 00530 1 BAM .. LE **** * *** ****
SOLIDS, '10rAI.
Ml!A9UREMENT
t-~3~36_.~o~o--~__-1_3_6_.~o~o-4M3/L 1/30 GR SUSPmDED P'IAMIT ltEQUIRKM*NT * <,*...*,. * *** * } * .,, * .* * ... oft
- 1/3tL' ,:~.
F.FF'Tlw.N'T' ~c: ... *. '..,: ' .:**: .**:: .*:.-J .. * . . :* ~*
00530 B *AMP'L.IS SOL:Ia;, 'lOm.L MEA8UIH:MltNT
- **** 252.00 252.00 1/30 GR SUSPEmED
- -t" 1*-w*.uM Irv --"'~ .*.:*.:....:
- .. : ~.
- .. . *.:~
. .*...;.. ,::
. -,_1 ;.*: . 1/30 .
GR 00530 4 llAMPLIC **** .,, * * * ****
SOLIOS, '1UrAI.
Ml!ABURl:MIENT 84.00 84.00 1 1/30 GR SUSPENDED "~:~:::~U-~' ,:._::~1\1:~:-r~ ,i. . ,
EFFLUml' NET : ~. . . . : :* .*.: ::-.. ..... :f ..:.. -:~*;:_*::*._::- ,...
r 00550 1 *** ..
BAMP'LIE It **** **** ****
OIL AND GREASE M*ABURl:MllNT 5.00 M3/L 1/30 GR .
l
,_GR 00550 B *** ****
OIL AND~
llAM ..L*
MICA8URl:M*NT It
- ** * **** 5.00 1/30 GR Ki/I.
STREAM INl'AKE
- *,*: *. *>*'. . ' ........ *>::: l/30
- ..., '. *.'.\. : .
UU!>!>U 4 OIL AND GRFASE
- AMl"Lll M*AllUltllMIENT
- **** ** * * **** 0.00 0 1/30
.*. .._;~. : . ~
.. ~- . ~-. . . **.* . **:.
1/30.*
- AM ..LIE MIEA8UltllMIENT ltl:OU II.SM ENT
'd ,..~
01 TIELIE.. MONll D A T I:
1 AMIE/TITLll ""INCl .. AL ICXIECUTIYIE OP"P"ICE" THiii DOCUMl!:NT 19 fllONl!:D WITH RECOGNITION THAT KNOW-INOLY MAKING A F"ALBE Cl!:RTIF"ICATION ON THIB REPORT OA f/ / _
- ( - \J.., J.
L. K), - M]. er
. 11 9UP'P'OATINO DOCUMENTS OR INTENTIONALLY TAM .. EAINO WITH ANY MONITORING DEVICE OR METHOD ARit CRIMINAL l-----~WL---~~~~~....----1 0P"P"EN9E9, 111!:1! 18 U.9.C. § 1001 AND :'3 U.8.C, 11318, CPr"al- *IGNATURE OP" PRINCl .. AL EXECUTIVE 609 365-700(
I 8 2 06 25 tin 11ndrr tltr.r 1ta1u1r1 "1"' l*r fi"rJ 11r to $111,000 and /or maximum Ty .. l[D O" .."INTllD lmprl*anmrnt "' brtwrrn ..A munt/1.* an d ' rra,,,) OF"F"ICEA OR "*UTHORIZ: .. .. D "*Ql!NT .....
~ !:~
...... ~ I NUMll ..
.." y**A.. .. MO DAY MMll:NT AND EXPLANATION OF ANY YIOLATIONll (Rrfr.,nrr all allar/1,,,rnl.1 /rrrr)
TSS - See cover sheet.
2 17
'!_~l'provtd ' *
<JWVo. 1$6-RDOJJ GP AT 'Ml 17 2. *I DELAWARE RIVER COOLING WATER NOTE: Read lnltruct~n* btfore completlng thle form.
flA .. AMIEtt" (JJ.J7J 00010 z TEMPERATURE, WATER 9AMflL.lt Mll:A9UREMENT **** **** 14.10 1 Q 1() CONT NA DEG. CENT I GRADE*
INFLUENT 00010 1 TEMPERATURE, WATER 9AMflLll Mll:A9Uftll:MKNT
- if: * *
- *** 26.60 32.10 17.80 DEG.CENTIGRADE EFFLUENT GROSS 00016 4 TEMPERATURE 11.t.MP"LI:
Mll:A9UftEMKNT * * * $
- 7.50 12.70 17.60 1 CONT NA OIFFERl:NCE
'-~~~,~'.j~:~;{~'.:1- I~.:,:\. l'.~~r~t:: .1~:,~*£;'1'~?.~T~ir 0
EFFLUENT NET EG c 004UU l PH 9AMP"LE MEASUREMENT * * *
- 7.00 7.10 7.20 0 2/7 GR EFFLUENT GROSS 00400 2 PH II AMPLE MEASUREMENT **** * **
- 6.90 7.04 7.20 2/7 GR INFLUENT
':>UU':>U 1 eAMP"Llt FLOW 88.80 Mll:AllUftll:MllNT $ * * *
- 255.30 266.40 EFFLUENT GROSS 5UUb0 l CHLORINE, TOTAL llAMflLll Mll:A9Uftll:MllNT **** ** *
- 0.05 0.13 0.40 0 CALC GR RESIUUAL EFFLUENT GROSS NAMEITITLE P"RINCIP"AL EXECUTIVE Ol"l"ICEft 1------------------i THiii DOCUMENT 19 lllONED WITH Rll:COONITION THAT KNOW-INGLY MAKINO A l"ALSE CERTIP'ICATION ON TH19 REPORT OR
~ ~
c ~ IJ(l Tl:LllP"HONll DATE
- ~*;r~r:.~1N:o~1~g~t:,~N1'::v~~El~TRENMT~~~~J-L:R~A~::1~~'!~ 1--~~*~::::_~'~-~-~....-----f609 1365-7000 8'"'
L. K. Miller OF'F'ENSIES. SIEE Ill U.S.C. I 1001 AND 33 U.9.C. I 1319. (Pnt*I* SIONATURl:Ol"PRINCIP"ALl:XECUTIVll ,/
1------------------1 TYPED OR poRINTll:D 1111 *11d,, lft*u *l*l*lrr ,,.., 6* //1111 *p lo 1/1,IH e11d/or
""""0""'" o/ M l - . "'°"'"'Md 5 '""*'
111n/"'u"'
OP'l"ICE" Oft AUTHOftl'Zl:D AOl:NT c~~i I NUMllltft YEAft MO DAY OMMENT AND EXPLANATION 01" ANY VIOLATIONS DISC 482 IS COND COOLING WATER.INTK PH LESS 6.0 DIS PH NOT LESS.INTK PH GRTR 9.0,DIS PH NOT GRTR.NOT MORf.
THAN 3 CONO MAY DIS TOTAL OR FREE Cl AT ANY Tl~E,ANO NOT MORE THAN 30 MINUTES E~CH TIME Effluent temuer~ture differential see coversheet 3 17 i
DISCHARGE MATORING REPORT (DMR) * .* °N't;:. i $3: ROO~.J (1-111) - 11-19 NJ0005622 GP. AT MI PERMIT NUMBER DllJCHARGIE NUMBIER 17 2 1
--~_NEJiABK_ _ _ _ _ .JU__fil.lQL _ _ _ _ _ _ _
MONITORING PERIOD u~m_SALEM_GENERATINGSTA'119.H ________ DEU\WARE RIVER 82 05 I 01 I TO 8?. I n'1 I ':\l
~ATJ2f!.J;QiER_ALUl'lAYS CREEK - - - - - - - - - - . Coor.ING WATER FROM YEAR MO I DAY I YEAR I MO I DAY x
(10-JI) (21-1J) (U-2J) 11611) (1H-1'1) (.10-JI) NOTE: Read lnatrucllona before complellng thl1 form.
(J Cord OnlJ*) QUANTITY OR LOADING (4 Cord Onlr) QUALlfY OR CONCENTRATION PARAMETllR (411-JJ) (J4-4SI) (Jll-4J) (411.,,J) ($4-411) NO. P'lll:OUENCY, *AM,.LE EX OP' ANALY919 TYPll (JJ..J7) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNIT9 llJ-6J) (114-418) (119-70) 00530 1 SAMPLE MEASUREMENT **** **** ****
SOLIDS, 'lu.rAL .?r..4 nn ?F.6. nn 1/30 GR f>C/L SUSPENDED Pl!AMIT F.FFT ITRtJTl ~C:
f(EQUIAEliHHT * * *.. *.. **** **** **** 1/30 GR 00530 E*
~IJliIDS, 'lu.rAL SAMPLE MEAllUREMENT **** **** **** 252.00 252.00 1/30 Ir ~UST:?ENDED .
... *.. * ,ft. *
~*=
?-C/L I S'l'RF'....AM INTAKE PERMIT f(EQUIREMCHT
- ~
- **** **** * * * ** 1/30 GR I SOLIOO, 00530 4 SAMPLE MEASUREMENT
- **** **** 1/30 GR
'IOrAL 12.00 12.00 0 I o:JSPENDED EF.F.LUENl' NET PERMIT llEQUIAEMllNT '}
... * **** " **** 30.00 100.00 K;/L 1/30 GR 00550 1 SAMPLE MEASUREMENT **** **** **** **** 5.00 1/30 GR on. AND GRFJ\SE , K;/L EFFIITRtJTl GR:ES "ERMIT IUlQUIAEM£NT.
~* ** *
- ff ** * * * * **' * * **** 1/30 GR 00550 B SAMPLE MEASUREMENT **** **** **** **** 5.00 1/30 GR OIL AND GRFJ\SE STREAM INrA.KE Pl!AMIT R£0UIRllMIENT
- .... * * * **** **** **** **** ' f>C/L 1/30 GR
\
00550 4 on. AND GREASE SAMPLE MEASUREMENT **** **** **** **** 0.00 0 1/30 G.
f'ltAMIT
- 10.00 r-li/L 1/30 GR EFFI1JENT Nm.' AllQUHUtMllNT SAMPLE MEASUREMENT
'I*'
PERMIT RltQUIAEMENT NAME/TITLE "RINCIPAL EXECUTIVE OF'l"ICER THl9 DOCUMENT IS SIGNED WITH RECOGNITION THAT KNOW- TELE,.HONE DATE L. K. Miiller INGLY MAKING A FALSE 'CERTIFICATION ON THIS REPORT OR SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINAL
';f fc-U. :. (;I, 82 06 25 OFFENSES. SEE ID U.9.C. § 1001 AND 33 U.8.C, §1319 .. 1Prnnl- SIGNATURE OF PRINCIPAL EXECUTIVE 609 '365-7000 flrJ wulrr 1llr1t' 1rruu1r1 "'" l*t* fin,,, up to SI0,000 nnd/or ma.rlnrum TYPED OR PRINTED imprlJunmrnl o/ l1r1wrrn 6 muntli" 011d .J J'*OrJ.) OFFICER OR AUTHORIZED AGENT ~~~:I NUMBER YEAR MO DAY COMMENT AND EXPLANATION OF' ANY VIOLATIONS (Rr/rrrnrr all n11acl1nirn/J lrrrr) 4 17 PAGE OF
- ~;~Mil GP AT* ~l 17 2 I I
DELAWARE RIVER COOLING WATER NOTE: Read lnltructlon* before completing this form.
(J c*-~0.11,,1 QUANTITY OR LOADING ,, c:.d Ortl}'J QUALITY OR CONCENTRATION l'AlllAMETl:l'I f"*"I (!U*'11 (.fa*'-*I f"*-01 ('4-111 NO. f'M:~Y SAMl'LE fJN11 1----~---.-------....-----+--~~---~------.---~-'---~--~ EX ANALYmS TYPE AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNIT9 (12-IJI ("41 ,,,_1'1 auu10 ~
TEMPERATURE,WATER SAMPLE MEASUREMENT ** $ .*
- 1Li._ld) 19.60 21.80 CONT NA DEG.CENTIGRADE :* :*~;'=.:.'~<* ~-<:~*~,<~~~-- ~~
INFLUENT -** *..*.*.
UUUlU l TEMPERATURE, WATER SAMPLE MEASUREMENT * * * *
- 26.20 31.10 39.20 DEG.CENTIGRADE EFFLUENT GROSS' uuu1.<> ..
TEMPERATURE DIFFERENCE
- *"* 6.50 11.50 19.10 DEG C 1 CONT NA EFFLUENT NET UU~Ull 1 PH ***
- 6.90 7.06 7.20 0 2/7 GR EFFLUENT GROSS 00400 ~
PH
&LE MEASUREMENT **** **** 6.90 7.04 7.20 2/7 GR INFLUENT
'.':>lill°'U 1 FLOW
&LE MEASUREMENT **** **** 233.10 430.40 532.80 EFFLUENT GROSS
':>UU<>U .l SAMPLE
- * * * ,0 :ALC GR CHLORINE, TOTAL MEASUREMENT
- *
- 0.10 0.17 0.30 MG/L RESIDUAL 0 ***-~*'"*"*
.. f t:*:_*a~~-2*0*.
"'**; , . , . , *... , _ , , , . , .......,_, ,.
EFFLUENT GROSS **:*!*: :rc,:*so~:
NAME/TITLE PRINCIPAL EXECUTIVE OFFICER THIS DOCUMENT 19 SIGNED WITH RECOGNITION THAT KNOW- ~ ~""' TELEl"HONE DATE
1 INGLY MAKING A FALSE CERTIFICATION ON THIS REPORT OR "t,_
L. K. Miller SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINAL OFFENSES. SEE 1e u.s.c.11001AND33 u.s.c. 1131e. ,,.,,..,_
1---~-
~
.. - = - - - - " - - - " " ' " ' - - - - - - t siGNATUREOP'PRINCll'ALEXEcUTivE I
609 365-7000 82 06 25
t TYPED OR PRINTED 1/u urtdrr '""' ll*l*lu "'"' 6* //HJ *P lo 111.IH *rtd/or Mulrr11""
lrttprltort"'" o/ Mwttff
- Mortlli1 Md J J'NTl.I OFFICER OR AUTHORIZED AGENT 1--r.....r+------11----+---t----t
~~~: I NUMBER YEA" MO DAY
- OMMENT AND EXPLANATION OF ANY VIOLATIONS (Rt/nntu .a *ll0<ll,,,m11 lin*I DISCH 483 IS CONO COOLING WATER.INTAKE PH LESS 6.0 DIS PH NOT LESS.INTPH 6fiTR 9.0 DIS PH NOT 6RTR.NOT HOR E THAN 3 COND MAY DIS TOTAL OR FREECL AT ANY Tl~E & NOT ~ORE THAN 30 MIN EAC*t TIME Effluent Temperature Differential - see cover:S.heet. 17
DISCHARGE M.RING REPORT-(DMR)
(l-16) 11-19)
.o.'d. "jj8: R007J NJ0005622 483 GP. AT MI PERMIT NUMBER DlllCHAAGE NUMBER 17 2 1 MONITORING PERIOD DEU\WARE RIVER FROM 82 05 I 01 I To l--"R"""2'-f.l_..._n1~')1,_~. . 1~
. COOLING WA'JER YEAR MO I D_~ YEAR I MO I DAY (10-JI) (22-2J) (24-1') (26ll) (1R-J9) (.10-JI) NOTE: Read ln11ruclloM before complellng lhl1 lonn.
(J Card Onl1') QUANTITY OR LOADING (4 Cnrd Only) QUALlrY OR CONCENTRATION 00530 P'ARAMETl:lll 1
(JJ.J7)
X SAMPLE MEASUREMENT (46-JJ) (J4-61) 1--~~~~~~.....-~~~~~~~~~~~1--~,--~~~~....-~--'~.....,;.~~-...~~"'"-~--~--.~~~--1 AVERAGE MAXIMUM UNIT9 (J8-0)
MINIMUM (46.JJ)
AVERAGE
('4~1)
MAXIMUM UNIT*
NO. nir.~:NCY.
EX ANALY!lla
- AMPLE TYPE (69-70) I SOLIDS, rorAI. 324.00 324.00 l 11n t"!t>
SUSPENDED 1"l4'1n' JTin.Y'J1 ~~
Pl!RMIT lllEOUIAEMaNT * .*:.. * * * * *** **** *** * **** .r.G/L 1/30 GR 00530 B SAMPLE MEA8UREMENT **** * *** * * *
- SOLillS, 'lOrAL 252.00 252.00 1/30 SUSPENDED P'l!AMIT . *'* ** .* * **** * * ** *** * **** M3/L 1/30 GR
,. *&..11.K1ot*
lllli:QUIAEMaNT 00530 4 ***
- SOLillS, rrorAI.
SAMPLE MEASUREMENT *** * **** 72.00 72.00 1 1/30 GR SUSPENDED ** M3/L 1/30 EFFLUENT NET Pl!RMIT REQUIREMaNT
- ..** * * * ** **** 30 *. 00 100.0(i GR 00550 OIL AND GRFA.sE:
EFFLUENT GIVSS 1 9AMPLE MEASUREMENT PERMIT lllllQUIREMENT.
fr .. 1t. *.
5.00
- * ***-. M3/I:
1/30
.l/30 GR 00550 B SAMPLE ** ** **** * *** ** **
OIL AND GREASE MEASUREMENT 5.00 1/30 GR STREAM INI'AKE P'llRMIT AEQUUlllMIENT **** **** * *** **** M3/L 1/30 GR 00550 OIL AND GREASE
- 4 SAMPLE MEASUREMENT
- ** ** * * * * * **
- 0 .. 00 1/30 GF.e ftllRMIT
- lllllQUIRltMllNT
"* " * " **** **** * * *
- 10.00 M.~/L 1/30 GR 9AMPLE MEASUREMENT 0 l"ERMl'f RIEQUIR&MENT NAME/TITLE PRINCIPAL EXECUTIVE OFFICER THIS DOCUMENT IS SIGNED WITH RECOGNITION THAT KNOW*
INGLY MAKING A FALSE CERTIFICATION ON THIS REPORT OR
-;t,
- J,.. 1J ~
~-
'A TELEPHONE DATE SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING 1---J;r..:..r.(llo..{_~.--t..~..f~y.l.*.,c:::_¥'~1!!tw.-----L I....
L. K. Miller WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINAL OFFEN9E9. BEE IB u.s.c: § 1001 AND 33 u.e.c. §1319. 1rr"n/- 609 p65-7000 82 06 . 25 1------------------f 1kr TYPED OR l"RINTED
'""'" 1hru lmrrbonmrnl nl hrrwrrn ti"'"""' and )'rars.)
J1111u1ri "'" l*r* fi"'*' 11r 10 SI0,000 j
nnd/or '"a*lmum lllONATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT 1-r...-r-1------;---;---r~--1
- ~::.~ 1 NUMllEA YEAR MO DAY COMMENT AND EXPLANATION OF ANY VIOLATIONS (Rrfrrr"rr al/ n1111rlin1r"IJ l1rrr)
TSS - see coversheet.
6 17
/:,".'JJ,~f!":':'"'
O,. .o. IJl-ROiJJ '
X 1 (JC.'*dOrtlyJ QUANTITY OR LOADINCJ (H.'*d 011lyJ QUALITY OR CONCllNTRATION P'ARANIETl:R i (#t*.UJ (.W-tlJ (Jl-<IJJ (4'-!JJ (54-tlJ HO. FM~DCY . eAMP'LIE (JJ.J7J 1------------.;__----r-----+----'-----~--'--~-~---'----'-~--.-~~~~ llX ANALY~8 TYP'll AVllRACJIE MAXIMUM UNITe MINIMUM AVllRAGIE MAXIMUM UNIT9 (0-tJJ (u.#J (lf.11J 00010 2 IAMP'LIE TEMPERATURE,WATER MIEABUREMIENT * * * $
- * *
- CONT NA DEG.CENTIGRADE:
INFLUENT 00010 1 IAM~ll TEMPERATURE,WATER DEG.CENTIGRADE MllASURllMIENT $ $ $ *
- 26.10 31.30 38.30 EFFLUENT GROSS OOOlb 4 TEMPERATURE I IAMP'Lll MKA9URllMllNT * * $ *
- 9.60 11.40 .20.00 1 CONT NA DIFFERENCE EFFLUENT NET 00400 l PH IAMP'Lll MllADUREMIENT $ * $ $ $ $ *
- 6.90 7.07 7.20 O 2/7 GR EFFLUENT GROSS ;~.~~~=~d~~;; f{~1~'~f,~~*1 ~I ~w~~~i~~;~11~~il;:
00400 2 PH IAMP'Lll MllABUREMllNT $ $ * * * *** 6.90 7.07 7.20 2/7 GR INFLUENT 50050 ' l IAMP'Lll'
- * *
- 277 .50 489.10 FLOW MllAIUREMllNT
- 532.80 EFFLUENT GROSS 50060 l CHLORINE, TOTAL 8AMP'Lll MllABUREMIENT ** $ ****
- 0.05 0.14 0.30 O CALC GR RESIDUAL {~I£~
- _~
EFFLUENT GROSS NAMEmTLE P'RINCIPAL EXECUT1Vll OFFICER THIS DOCUMENT 18 SIGNED WITH RECOGNITION THAT KNOW-
1 INGLY MAKING A FALSE CERTIFICATION ON THIS REPORT OR
~
~J,. ./
t:ld. DATll
- w:t~~~iN:o::i~g~~~N 1~v~~E ~~E~T~~~tJ-L:R~A~;,'i,.~~'!~ l-_.l&*'-b:*-'::J-~~*~~ .. ~~:=-----'609 1365-7000 82 1 1 L. K** M1" ller &EE UI U.9.C. I I 00 I AND 33 U.S.C. I I 3 I 9. f Pnial- 06 25
*--------------i OFFENSES. llH .,.4., lll*n 11*111,.1 ,.,., ** /l11H 11p la Sll,H* *1111/or ,.,.,.,.,.,,,..
"""'boRmnil o/ Mlw...,
- r11a11llu Md 5 1Nn.J SIGNATURE OP' PRINCIP'AL EICECUTIVll OFFICER OR AUTHORl21lD AGllNT CODE I NUMBER YllAR MO DAY TYPED OR P'RINTllD OMMENT AND EXPLANATION OF ANY VIOLATIONS (Refnniu .n .,,**,,...,,,,. ,....,
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 CO~D~NSORS ~AY DISCH TOT.R FREE CHLORINE AT A~Y TIME,ANO NOT MOR~ THAN 30 MINUTES EACH TIME Effluent Ternperatu~e Differential - See Cover Sheet 7 17
,..*.~IEE NAM 1E;~DDRE-llr;.,,,.
lry Nn~/Loc*r/011 II dlt1trr11r)
NATIONAL POLLUTANT DISCH,.. ELIMINATION DISCHARGE MONl"J9NG REPORT (DUR) 9Y9TE~- tNriJF.s1 t orm A ppfol'rif OMB - 5 8 ~ R001J Ll~~~ ~._-_ENV_AFr____________ 11-1111 11-191
- !!ue_PSE&<L__________________
-~J>_J)~OO*S~_.J.OC. __________ _
NJ0005622 GP. AT Mt
__ .JE'lABK. ____ JU._filJ.Ol_ ______ _
PERMIT NUMBER DISCH"RGIE NUMlllEA 17 2 1 MONITORING PERIOD*
~m_SALEM_GOO:RATINGSTAnoo _______ _ DEIAWARE ;RtVm T~P.L.:ra-JER_ ALI.a-IAYS CREEK - - - - - - - - - - FROM 1-'.......-+-.J..L-L.J---l~ COOLING WATER x
NOTE: Reed lnstniclloM before complellng UIS. form.
(J Cord OnlJ") QUANTITY OR LOADING (4 Cord Only) QUALlfY OR CONCENTRATION PARAMETER (411-,J) ($4-61) (Jll-4J) (411.JJ) (,4-61) NO, F"AIEOUltNCY 9AMl'LE OF" Ell llNALY919 TYPE (JJ..J7)
AVERAGE MAXIMUM UNIT9 MINIMUM AVERAGE MAXIMUM UNIT*
~61.6J) (6'-611) (119-70) I 30 1 SAMPLE IOO, 'lU1'AL MEASUREMENT
- * *** * *' *
- 31h.nn 11 i; - ()() 1/30 f':'D PENDED T I 1F."1'T'
- Pl!:RMIT REQUIREMl!HT
- *** * * * * *.. * **::* *** fr M;/L .. 1/30 GR 530 B SAMPLE LIDS, 'IDmL MEASUREMENT **** * * * * * **
- 252.00 252.00 1/30 GR PENDED '
EAM INl'AKE 30 4 PISRMIT lll*OUIREM*HT Ki/L 1/30 1_~:~ __.l 9AMPLE II I IDS, 'IDrAL MEASUREMENT **** * * * * * * *
- 64.00 64.00 1 1/30 !3R -
PENDED
.uENT NF:!'
50 1 Pl!:RMIT llll!OUIREMl!NT * :".Ii
- .. * * *.. * ** ** 30 .. 00 100.00 M;/I.
1/30 . C.~*
I 9AMl'LE AND GRmSE LUEN!' GmSS MEASUREMENT itl!RMtT llllQUIRIEMt:NT 5.00 M;/L 1/30 1/30*.' GR GR 50 B 9AMl'L* f; AND GRFA'>E MU19UREMENT
- ** * **** * * * * **
- 5.00 1/30 GR E'J.\M INTAKE Pl!RMIT REQUIRl!MIENT ft
- **** * ** * * * * * ** **
- fr r.t;/L 1/30 Gil 50 4 SAMPLE AND GRFASE MEASUREMENT ** * * * * * * **** * * ** 0.00 0 1/30 GR PltRMIT ;
- ** * * ** * * *** * **
- 10.0(J M;/J, 1/30 GR
.tJENT NF:!' IUIQUIAIEM llNT 9AMPLI!
Ml!ASU REM ENT l'l!RMl'f RIQUIREMEN'f THl9 DOCUMENT 19 SIGNED WITH RECOGNITION THAT KNOW- TELEl'HONE DAT I!
~t IE/TITLE PRINCll'AL l!Jll!CUTIVI! OFFICER INGLY MAKING A FALSE CERTIFICATION ON THIS REPORT OR SUPPORTING DOCUMENT& OR INTENTIONALLY TAMPERING ~:. f~
L. K. Miller WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINAL OFFEN9E9. 9EE 18 U.9.C. lj 1001 ANO 33 U.S.C. §1319. Cl'rnnl- 910NATURE OF' PRINCIPAL EJIECUTIYE 6091365-700( 82 06 25 lf'f umfr,. tllr.tf' JfttfUft'.t nutt' l1r /;""*' ur In SffJ,000 nntf /or ftlatfrtllrn1 TYl'ED OR PRINTED lmprlJ1Jnmrnr nf l1r1wrrn Ii muntln and J J'f'dr,,) OF'F'ICER OR AUTHORIZED AGENT :~~:I NUMBER YEAR MO DAY MENT ANQ EJIPLANATION OF iNY VIOLATIONS (Rr/rrrnu nll n1111rl1n1rnl.1 lorrrl I~nly M:lx. (m:;J/ ) M.Jnthly Aver. (IDJ/l) TSS - See Cover Sheet
-22 0.136 0.120
-5 ---------
8 17
"M!Tn:IE NAMIE/:DDRE * ..,,..,, NATIONAL POLLUTANT DISCHeiELIMINATION SYSTEM (NPIJ!"!>)
F~~o~td
- O~. 1'6-RO/JlJ 117-lfJ I I 6t!i'> GP AT tA*l PERMIT NUMBER IDISCHARGE NUMIJI[.. 17. 2 . J MONITORING PERIOD DELAWARE RIVER COOLING WATER NOTE: Read lnltructlon* before completing thl* form.
X IJC'*d01tlyJ QUANTITY OR LOADING (4l'*d011lyJ QUALITY OR CONCENTRATION l"/t'"AMIETER : 14'-.UJ (.'U*"I (.11*4.'J 14'-llJ (.U-411 NO. fR£~Y 'SAMl"LK (J1-J7J .
t--------.--------,.-----+------..--_;_----r----'--'----..-----1 EX ANALYBl9 TYN AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MA.XI MUM UNIT9 111-4JJ (IHIJ (lf-1tJ UUUlU l. 9AIAPLE TEHP~RATURE,WATER $ * $
DEG.CENTIGRADE MEASUREMENT *
- 14.40 2n ?n ?h 1n CONT NA INFLUENT UUUlU l SAMPLIE' TEMPERATURE,WATER DEG.CENTIGRADE MEASUREMENT $ * $ $
- n
~~--->
CONT
- = .< ~--~-~ r:*~-~:*' .--~t*::*_,_ ...,j-.:::i'_:
EFFLUENT GROSS :' *. CONt,*.:.i .:~ *~.:_ '.:,*.,
UUUlb If.
TEMPERATURE SAMPLE MEASUREMENT * $ * * ***
- 5 .10 1J . 40 ? 1 QO 1 CONT NA DIFFERENCE EFFLUENT NET UU"tUU 1 SAMPLE PH MEASUREMENT $ $ * $ $ * *
- 7.00 7.08 7.20 o 2/7 GR EFFLUENT GROSS 6.00 0 lJ"t 00 l SAMPLE PH
~
MEASUREMENT
.. :;
- *** **** 6.90 7.04 7.20 2/7 GR
"" ~*"" ~, .,.,. "'-::"""' ,,,_' .
- , , 2 ;1~rr--. ;':GI( .
- , ,* '. nNMIT L-' '.
INFLUENT .* "EQUIREMENT ..*
- >UU~U 1 SAMPLE FLOW MEASUREMENT
- * * * **** 233.10 395.30 532.80
>*,
- PE..MIT ~ {"
EFFLUENT GROSS ;/ftKQUIREMIEMT.
- ~... . *. .'
50060 1 SAMPLE CHLORINE, TOTAL Ml!ASUREMENT
'* * * * * * *
- 0.05 0.13 0.40 o CALC GR RESIDUAL *.;::-.. :* *... ~
- _ t \,' :... ._; ":'. --?. " ~,;: *, -, . *: ::~: *:-;:. :.-~. MG'/.L EFFLUENT GROSS
- ' l"E.. MIT . . ".
- fil:QUIRIEMENT : ; - . o.2.cf;: :.," :* o~ sci:~.
- - - - - - - - - - - - - - - < THIS NAME/TITLE PRINCIPAL EXECUTIVE OFFICER DOCUMENT IS SIGNED WITH RECOGNITION THAT KNOW*
INGLY MAKING A l"ALSE CERTIFICATION ON THIS REPORT OR ~~ /' "
IJ "://
TIELEPHONI: DATE 6UPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING WITH ANY MONITORING DEVICE OR METHOD ARIE
.._/<' ( '--l ~...
CRIMINAL 1--.¥!:..J._:=~~~~~~---'
Ya I L. K. Miller OFFENSES. SEE 111 u.s.c. I toot AND 33 u.s.c. I t319. (Pmol- 61GNATUREOP'PRINCll"ALEXECUTIVIE 609 365-700() 82 06 25
- - - - - - - - - - - - - - - ,,.. * ,,4., ,,.,,. ............, ,,, /IHI *P la ' " * ' " 011d/or ,,. .. ,,,..... .....,....,.-t--"-~-'-'~~--t---t----1 TYPED OR PRINTED IMprU0111f1- of 6nwttr11 I "'0111lu Md J ynn.I OFFICER OR AIJTlfORIZl:D AGENT ~~~~ I NUMBER YEAR MO DAY OMMENT AND EXPLANATION OF ANY VIOLATIONS (Rt/trtn<o oll o11ocll111m11 llrr*J DIS 485' IS CONDENSER COOLING WATER.INTK PH LESS b.O,OIS PH NOT LESS.INTK PH G~T 9.0,DIS PH NOT GRT.NOT MU RE THAN 3 CONOENSORS MAY DIS TOT. OR FREE CHLORINE AT ANY TIME,AND NOT MORE THAN 30 MINUTES EACH TIME H'-~fl 111=>nt: 'T'empera'ture Differential - See cover Sheet 9 1
F.ellllr Nam* /l.ac*lio-ill6nt'11I) r *~g~~..:... t-t;R._-_ENV_.AFF__________ _
'.. A~!!!!.ru_PSEliiq_ ________________ _
DISCHARGE -ITORING REPORT (DMlt) .
(1-16) r7-IP) w N°d. 1.53 - 1\00,7J NJ0005622 485 GP. AT MI
- .. - -...:....J>....P...1. :eat 57.Q.._..lOC. __________ _ P'ERMIT NUMBER OltlCHARG£ NUMllCA 17 2 1
_ _ _ .JEiABK__ _ _ _ JU._filJ.01_ ______ _
MONITORING PERIOD m~m_SALEM_GENERATINGSTATIOO _______ _ DEIAWARE RIVER J:2C.AT~'!_UJtlER_ALUJiAYS CREEK - - - - - - - - - - COOLING WATER x
NOTE: Read lnatrucllona befo,. complellng this lonn.
(J Card OnlJ') QUANTITY OR LOADING (4 Card Onlv) QUALlfY OR CONCENTRATION P'ARAMETl:R (46-H) (H-6l) (Jll...fJ) (46.JJ) (H-6l) NO, ""IEQUCNCY EJI Of' ANALY91*
- AMP'LI!
TYPE I (Jl.J7)
AYERAOE MAXIMUM UNITll MINIMUM AVERAGE MAXIMUM UNIT*
61-6J) (114-611) (119-70) 00530 1 SAMPLE I SOLIDS, 'IUI'AL MEASUREMENT **** **** **** 124 00 1?4.00 1/30 GR M;/L SUSPENDED Pl!AMIT EFFWEm' GRCSS ftEQUIREMlllNT
- **** ** * * * * **
- 1/30 GR 00530 B SAMPLI!
SOLIDS, 'lurAL MltAllUREMENT **** **** **** 252.00 252.00 1/30 SUSPENDED PllRMIT .,..
STRF.AM INTAKE REOUIREMllNT
- **** *** * * ** **** M:i/L 1/30 GR 00530 4 SAMPLE SOLIDS, 'lurAL MEASUREMENT ** * * * * * * * * *
- 72.00 72.00 1 1/30 GR
,'J\' ** .
SUSPENDED l'l!:RMIT EFFllJENI' Nm' RIQUIAEMllNT ** **** * **
- 30.00 100.00 r-t;/L 1/30 GR 00550 1 SAMPLE I OIL AND GREASE MEA9UREMENT **** **** *** * **** 5.00 1/30 GR EFFLUml' GIDSS P'ERMIT llll!QUIREMl£NT: * **'*
"* * ** * *** * **** ** * *
- M:;/I, 1/30 GR I
00550 B SAMPLE 1/30 GR OIL AND GREASE MEASUREMENT
- * ** * ** * * * * * ** ** 5.00 STRF.AM INTAKE P'IRMIT REQUIAltMl:NT * * ** **** *' ** * -A*
- * -A* ***
- f.l;/L
\
1/30 GR 00550 4 1/30 OIL AID GREASE SAMPLE MEASUREMENT * * ** **** * * * * * * *
- o nn n I l"ltRMIT ,
_.,,, .,,. 10.00 M;/I. 1/30 GR EFFWmI' NET RllQUIR£M*NT * * ** **** * *' ****
llAMPLE MEASUREMENT PERMl'f RIEQUIREMENT NAME/TITLE PRINCIPAL EXECUTIVE OFFICER THIS DOCUMENT 19 SIGNED WITH RECOGNITION THAT KNOW- TELEPHONE DATE INGLY MAKING A FALSE CERTIFICATION ON THIS REPORT OR SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING :Zt'r~~ .~ ~~
L. K. Miller WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINAL OFFEN9E8, SEE 18 u.s.c. § 1001 AND 33 u.e.c. §1319. (l'rnnl*
SIGNATURE OF PRINCIPAL EJllECUTIYE 609 '365-7000 82 06 25 rltJ 1mcfrr lhtJt Jlntllft'J ""'>' ,,,. finr.* ur 10 sro,ooo nnd /or madmurn TYPED OR PRINTED impr*Jonm~nr uf l*rtM*~rn 6 muntl*.* and $ J'l'Or.r.) OFFICER OR AUTHORIZED AOENT ~~~;I NUMBER YEAR MO DAV COMMENT AND EJllPLANATION OF ANY VIOLATIONS (Rr/ntnct all nrrnd1n1rnlJ l"rrl Daill Max. (rrg/1) r.t>nthly Aver. (rrg/l) .
SC-22 0.136 - 0.120 .
BD-5 TSS - See Cover Sheet 10 l'i
- -- ..... --' PAGE OF
. ~~w.ov~d o..156-R001J,
- GP AT *r1 17 2-DELAW*RE RIVER COOLING WATER NOTE: Read lnltructlona before completing thlaform.
00010 2 TEMPERATURE,WATER 9AMPLlll:
MEASUREMENT **** * * * .* 11 /.('I 10 Q{) 'lO 'ln 20NT NA DEG.CENTIGRADE . .~ .. ' ~~ . '* : . " ' . : ,,.;"!. < :n~ ,-, \"' :: ;:'*'* :;\*,, ,,._.:*DEG. C ,.~: 't;*.:~
INFLUENT 00010 1
- .* **it:* * * *.* * ,:*~ *. *:_~..'.
- . ~* .: >
-~*
- ,* * * ,, . coP-tt TEMPERATURE, WATER SAMPLE MEASUREMENT $ * * * * * * * --<\ 23.80 30.20 38.30 O 20NT DEG.CENTIGRADE ***~'*~,.}*,~--*DEG C
/. ; :.: j ..
EFFLUENT GROSS *.* * *' " '.::~ 46i 00 , * * :oNt .*
UOUlb '+
TEMPERATURE SAMPLE MltA9UREMl!NT
- **** 7.Rn 11 L..n ?-:i. ?n 1 20NT NA DIFFERENCE EFFLUENT NET Oli4UO
- 1 9AMPLIE PH MIEA9UREMENT $ $ $ *
- 7.00 7 .10. 7 ?O n 2/7 GR EFFLUENT GROSS 00400 2 PH llAMPLIE MIEA9UREMENT * $ ** * * *
- 6.90 7.04 7.20 2/7 GR
- "'**.* 1')'*7'* ;.:::* ., :
INFLUENT ~r.:: ~ ~ ' ~.
'.'.:JUU.JU 1 FLOW llAMPLI:
MEASUREMENT * ** $ **** 310.80 494.10 532.80 :ALC N
<'~ >
- EFFLUENT GROSS 50060 l CHLORINE, TOTAL O CALC GR RESIDUAL EFFLUENT GROSS 1-----------------1 NAME/TITLE P'RINCIPAL ll:llECUTIVI: Ol"l"ICI:" THiii DOCUMENT Ill lllCINED WITH "ECOCINITION THAT KNOW*
INCILY MAKINO A l"AL9E Cl:.. Tll"ICATION ON THiii REPORT O"
'd ;-,
V _..1..
- f
,_A A
.J'.,
TELIEl"HONIE D A T IE L. K. Miller SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPEAINCI WITH ANY MONITORING DEVICE OR METHOD ARE C"IMINAL 1-~2:..::~:_~~~~~::::..----L 609 I 3 6 5- ~ Q( 82 06 25 1-----------------1 TYPED OR PRINTED OF"l"ENSES, SEE IS u.11.c. I I 00 I AND 33 u.11.c. I 13111.
/mpr/1onrnntl of,,.,,,,_."""" ..
(Pfflll*
llu t1rtdrr IAur lllf*lrt " ' ' ' 6r /llfrt *P lo JU,flf 1ttfl/or llfHlllfullf
,~,_,_,
Ol"l"ICIE" 0" AUTHO .. IZIED ACllENT coci I NUM*IE" YIEA" MO DAY COMMENT AND !EXPLANATION 01" ANY VIOLATIONS (Rr/rrrnrr 1U 1111rArnrnll ArrrJ DIS 4R6 IS CONDENSER COOLING WATER.INTK PH LESS 6.0,0IS PH NOT LESS.INTK PH GRT 9.0,DIS Pl~ NOT GRT.NOT ~r RE THAN 3 CONDENSORS MAY DIS TOT. OR FREE CHLORINE AT ANY TIME,~ND NOT MQR[ THAN 30 MINUTES f:ACH TIME Effluent Temperature Differential - See Cover Sheet 11 17
NAME/ADi>RE~lllL"r'""' ,*iYrm*:s, AFr___________
,. orm "ppro ......
r,llTTEE l'lttrfW/L<<*rlon I/ rllt1*~
- NATIONAL POLLUTANT D1scHARG£ ELIMINATION BYBTEM DISCHARGE MONITO NG REPORT 1DMR) OMB No. ll8- R007J
!L.~~..!...M;R._ _ _ _ (1-16) 17-19)
!*HJSE&<L_ _____ _._.__ __._______ NJ0005622 486 GP.AT-
-~.J>..aP~BOJt-57.Q._.J.OC. __________ _ PERMIT NUMBER 019CHllRGE NUMBf:R 17 2 1
--~----_fil._.Q1.1DL_______ MONITORING PERIOD 1..1.D'_SALEM_GENERATING STATION - - - - - - - - 82 05 01 82 05 31 DEIAWARE RIVER
~TIOf!_~_.Al.LC:MAY$ CREEK---------- FROM YEAR MO Di>.Y TO YEAR MO DAY CCXJLING WATER x
(111-}I) (21-11) (U-1') 1161 ) (1R.J9) ( 111-11) NOTE: Read ln*tructloM betorw completing lhl9 tonn.
(J Cord Onlr) QUANTITY OR LO ... DINO (4 Cttrrf Onlr) OUALlfY OR CONCENTRATION NO. f""EQUICNCY llAMf'LE PARAMETER (41S-'1) (J4-61) (Jll-fJ) (41SJJ) ('4~1) Of" Ell ANAl.Y919 TYPE (JJ-J7) AVERAGE MAXIMUM UNITll MINIMUM AVERAGE MAXIMUM UNIT8
~61~J) (6'-'IW) (69-70) 530 1 SAMPLE LIDS, 'lOl'AL MEASUREMENT **** **** **** 316.00 316.00 1/30 GR SPmDED FLUENr GRJSS Pl!RMIT REQUIREMllH,. * * ** * * ** * **** **** **** M;/L l/30* GR 530 B LIDS, 'lOl'AL SAMPLE MEASUREMENT **** **** **** 252.00 252.00 1/30 GR SPENDED REAM IN'mKE PERMl'f REQUllU'.MCH'I' * .*. "" *
- 64.00 64.00 1 1/30 GR i
- SPENDED 30.00 100.00 1/30 GR
~NET PERMIT llll!QUIREMCNT
- * ** **** M:3/L '
550 1
. AND GRE'.ME SAMf'LE MEASUREMENT **** **** *** * ** ** 5.00 1/30 GR
.uENl' GROOS l"IERMaT llU!QUIREMENT .* ..* * * '* **** * '** ..* **. * * '* ** ***
- K;/L ...
1/30 GR 550 B L AND GREASE llAMf'LE MEAllUREMENT **** **** *** * ** ** 5.00 1/30 GR REAM INTAKE "CRMl'f .
REQUllHMINT *** * **** ** * * * ..* * ** **** MG/L
\
1/30 GR 550 4 llAMf'LE 1/30 GR L AND GREASE MEASUREMENT
- * * ** * * ** **** o.oo 0
- io.oo PIRMaT ;
- M;/L 1/30 GR 4'T Ill<N1' NF.'1' RIQUIREMllNT llAMPLE MEASUIUMENT f'ERMl'f Rl:QUIREMENT ' ...
DATE
~t
.E/TITLE PRINCIPAL IEJIECUTIVE OF'P'ICER THiii DOCUMENT IS SIGNF.0 WITH RECOGNITION THAT KNOW- TELEf'HONE INGLY MAKING A FALSE CERTIFICATION ON THIS REPORT OR SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING ~...
r- ~'1'.&. -
L. K. Miller WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINl>.L OFFEN9E9. SEE IB U.9.C. 'i 1001 AND 33 u.e.c. §1319. 1r,nal- lllGNATURE OF PRINCIPAL EXECUTIVE p09 bGs-1000 82 06 25d Urt 1m1frr rh,.*r Jtar11u.1 n11n* 1,,. fin'*' 11r '" SI0,000 nnd for matlnr11m TYPED OR PRINTED fmprfJonmrnr o/ l*rtwrrn (, muntlo anti j rror.r.) OFFICER OR AUTHORIZED AGENT ~~~~I NUMBER YEAR MC i.:11.:
£NT AND EXPL"N"TION OF ANY VIOLl>.TION9 IR'f"'"" all a11nrl1n,,nl.* ,,,,,,
D:lily Max. (mg/1) tJbnthly Aver. (IllJ/l) 22 0.136 0.120 TSS See Cover Sheet
-5 12 17
__________________ -_-_*:__*:__-:__--:.-___ _ _ _ _'_':n:~:p~**~*:e:":"_:rPA F'ORM T-*o WHICH MAY NOT BE USED.) PAGE OF
F~pr!JVtd .
.o*
- o.151-RWJ
- GP AT M 17 2 .
YEAR DELAWARE RIVER FROM 82 (10*11J NOTE: Read ln.tructlon1 before tompletlng thl1form.
QUANTITY OR LOADING (4 C'*d fl"IJ'J QUALITY OR CONCENTRATION P'ARAMETl:R (.'4*111 (.111-4.~J (41*.UJ (SUI} NO. FM~Y l!IAMPLE (J1*.'7J t---------r----~----.-----t-------"'T""--------.----'---'----.------~ EX ANALY~9 TYPE AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNM (11-tJJ tl44J (lf.1'}
SAMPLE HEAT MILLIONS VF MEASUREMENT etu*s PER HR NET EFFLUENT NET I :
l
- i:.
'..-;
I I
I I
NAME/TITLE PRINCIPAL EXECUTIVE OFFICER THIS DOCUMENT 19 SIGNED WITH RECOGNITION THAT KNOW*
1--------------------1 INGLY MAKINO A FALSE CERTIFICATION ON THIS REPORT OR SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINAL l..-;..-..X:.::...l~~!a.UIOll!!'!!idlMl.._....;.._ _-f L. K. Miller 365-7000 1--------------------1 "
- TYPED OR PRINTED OFFENSES, SEE I 9 U.S.C. I 100 I AND 33 U.S.C, I 1 31 9. (Pmo/.
u"drr lhu *lotutu "'"" 6r /lnu *P to Ill.IOI ond/or ,,. .. ,,,..,,,.
lrnpr/Ja""'" a/ Mfwttrt I monlltt al J ,..,.,,
SIGNATURE 01' PRINCl,.AL EXECUTIVE OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY OMMENT AND EXPLANATION OF ANY VIOLATIONS (R*/"mrr on ollo<llMmlr ,,,.,,
TOTAL OF OlSCH *481,482,483 1 484 1 485 1 486 Effluent Net He.at Release - Due to two unit operation.
Two units _in servtce*at 100% power most of the month.
13 17
*------------------=~=,---~..,.---
lllfr IV*lfffl/Loc*flort 1111181) . blSCHARGE MONIAllNG REPORT (DNlt) VMB& UlJ.*ROO/J.
u~~~rG._-_JlN_AFF~--~~~-~~-~ ,l-111) * (17-1')
PSE&G
~~-----------~-~------~
11
-~.J?...P~oot57].._J.OC. __________ _
. W0005622 I I 48C: GP.AT' P'll:llMIT NUMllEll 018CHAA01: NUM*I:*: 17 2 1
__ .JDlABlt____ .JU__filJ.OL ______ _
MONITORING PERIOD
~m_JiALEM_GENERATm:i~-------- _________ _
DEU\WARE I Rivm WR~~-Al.W'U\YSCRm< l'llOM 1-..U..."'--4-.-1.1:..1...4-~L-~*
NOTE: R"d lnst111ellol* ....._ COR!Dlellna Ille form.
(J C1trfl Onlr) QUANTITY OR LOADING (4 Card 01t1,) QUALIFY OR CONCllNTllATION PAllAMl:Tl:ll (411-JJ) (J4-4ll) (JIJ-4J) ("""-'J) (JUI) NO.
llJI l"HO:::NC'fl ANAL Y81e llAMP'l.I:
TYP'K
(.fJ~7)
AYKflAGI: MAXIMUM UNITll MINIMUM AYKflAGI: MAXIMUM UHlft
- tJ-61)1 (6'41) (,,.,.,,
- AMP'LIE
- - --**-IEMltNT 128.64 **** 81 _Cj(I Rl . 'iO 1 11/30 24 185 24 llAMPLI:
MU*UllltMllNT *** * *** * **** **** 5.00 0 1/30 GR f'Fwmr GROOS
...:u~':.'::l.,.,.,I \ 1::~*<* .*. ft
",j :: *****~.:..... ~-: ..{:;.. * .
- * * *...*.;._.J\:;* :. * :* .* .... -10
- oo*****' . *t-t;,'I 'L
. ' . ~ *. .}. .
J;_*1,,.11jo Q\
0551 1 llAMPLI:
E:l'RJLEUM MllAllUlll:MllNT **** **** **** **** 5.90 1/30 GR BYD~ I'::.i,-...:*:*.
- }:'.:'_ . .ft".* * * .**
- ,;
{:(-t.;.*~;,:1*1~:.:L t-u/L Pl!llUUT .. : :.1.-*
FFWENl' GimS R*QUlllll:MllNT ft " * **
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MEAllUlllllMl:NT 1.25 I 1.25 **** 0.79 o. 79 0 11/30 24 AS FE) ...l'IMIT. 1~95.: .: . I* ..*. l.85 KG/MYI~. <***' * * * ** *******:
.. *1 o**o ..**<:**
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~
FFWENl' ~ "scaun**MINT .. :: :-: .. .-.*. ~ :: *
- I .} ~*: * -~ * * ** *. ~*** * :.: *.-. ~-~. _:: :s .:~_**; h',-"'
0050 1 U:M FFWENl' GlVSS eAMP'LI:
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CONT NA 0610 1 eAMPLll N*A8UllllMllNT
- * *** **** 1/30 GR
~ 10.15 10.15 (I AS N) PlllllMl'f "D:IUll'l*MllNT
- ** * * ** * **** 35.00 * * *. *' ..*M3/L :* .... ~-
1/30 ~
FFWENl' GIUJS _*:--
Ml:/TITLll P'lllNCIPAL K*l:CUTIYI: OP'l'ICIEfl I THiii DOCUMIENT Ill lllGNED WITH RIECOONITION THAT KNOW- ~ TllLIP'HONI: DATI:
L K
M.
].
11 er I INOLY MAKINO A FALSE CERTIFICATION ON THI* REPORT OR l!IUP~ORTINO DOCUMENTS OR INTENTIONALLY TAMPERING WITH ANY MONITORING DEVICE OR METHOD Allll CRIMINAL 1----&ll-J~.._.....;;~-=-~=-~~----1 OFf'IENSEl!I. lllEll tl!I U.11.C. ' 1001 AND 33 U.11.C. lt3te.
llH "rfrr lhri. llolulrJ ..... , ,,, finr* ur lo SI0,000 drtd/M "'o*I"'""'
CPrAol- llllJNATUAI!: OP' P'fllNCIPAL llXl!CUTIYI *...;..,;,n,+;;3;..6,:...:5~-_..;7;...::0....:0::....:~"""---f--~"-+"""'"'--l r
TYPED 0111 PlllNTl:D IMprbonMrnl of br1wrrn ll*murtllu and J J'IPon.) Ol'l'IClllll OA AUTHOlllJ:IED AGllNT NUM*l:l'I MllNT AND EX~LANATION OP' ANY YIOLATION8 (Rrfrrrnn all ollorhmrnlJ hrrr)
TSS - See cover sheet.
14 17
- ......... ..., **-- ........".' PAGE OF
<<1111, ,...,,..,~...
~~~~~--~-_mv_AFF Oft#." __________ _ DISCHARGE (l-16)
MO~RING REPORT (DM1')
'1-19)
-~-*~_.i§B~ROOlJ.
~DR~J~~------------------
--~J>..s.P~ BC>>t' 57-Q._J.OC. __________ _
NJ0005622 l"ERMIT NUMBER DlllCHAAGC NUMllCR GP. AT MI 17 2 1
--~JEiABK. ____ _NI__fil.lQL _ _ _ _ _ _ _ MONITORING PERIOD
~~m_SALEM_GmERATINGSTA~------- F'AOM t--_8_2___0-+-_0_1--1 TO 1-8.:;..2~-f--0.:;..5~1--""-31=-I
.!!C.A.TJ!!.'L.I.!MER_ALUJ'U\YS CREEK - - - - - - - - - - YEAR ... 0 DAY MO DAY
- NOTE: RHd ln1lrucllons belcn completlng lhl9 form .
x (10-ll) (12-ZJ) (U-1') (1H-.l9) (JO II)
(J Card OnlJ') QUANTITY OR LOADING (4 Card Onl1) QUALlfY OR CONCENTRATION (J4~/) ('4-41) NO. P'tlll:OUCNCY *AMP'LE I
PARAMETER (46-JJ) (Jll4J) (46.JJ) OP' EX ANALYll18 TYPE (JJ.J7) AVERAGE MAXIMUM MINIMUM UNIT* AVERAGE MAXIMUM UNIT*
61-4J) (6'-46) (69-70) 00056 1 SAMPLE I
FI.DtJ RATE MEASUREMENT **** **** **** 20100.00 27,500.00 CALC 24 (GM.L<:NS PER DAY) Pl!:RMIT EFFLUENT GRCSS "EQUIREMmNT
- ** * * **** *** **** GPO
- NA 00310 1 HAMPLE BOD, 5-DAY, MEAllUREMENT 2.59 2.59 34.00 34.00 2 1/30 GR 20 DEX;. c. "'ERMIT . ' .,
E'FFWE:m' GroSS llllEQUIREM*NT
- * ***. 0.97 KG/DAY * * * *. 30.00 45.00 . .. l'-1
- ;/I, 1/30 24 00530 1 SAMPLE SOLIDS, rorAL MEASUREMENT
? , ~ ? 1 ~ **** ?Q nn '} 0 n /->n 24 SUSPENDED =**
"" 1
~
Pl!:RMIT IUIQUIREM*NT.
J.~
- *.: * *** KG/[l.t\Y **** 30*.00. 100.00 M;/L 1/30 24 EFFI1JENT GBCSS ... ' . .. '*'
74055 1 SAMPLE COLIFORM-FOCAL MEAl!IUREMl!NT **** * *** **** ?n nn ?n nn n 1 /-:i.n GR
- 1r 200.00 400 .. 00 N/1001"L 1/30' EFFI1JENT GOOSS PERMIT lll*QUIREMENT GR 00010 1 SAMPLE TEMPERA'!URE, WATER Ml!:ABUREMENT 21.00 0 CALC GR
- ~ 43.30 DEG.C 1/30 DEG.CENTRIGRADE mWT 111"1\7T' ~c P*RMIT R£QUIRaM*NT ' * * * * * *** :: *: .:
- * . ** *, **** GR 00400 1 SAMl"LE PH MEASUREMENT **** **** 7.10 7.19 7.40 0 "3/30 GR f'llRMIT . *
- * ** ** 6.00 **** 9.00 SU 1/30 GR EFFWEm' c;Ra;S ll*QUIREMllNT SAMPLE MEASUREMENT
..ERMIT REQUIREMENT ..
~c~
NAME/TITLE PRINCll"AL EXECUTIVE Ol"P'ICER THIS DOCUMENT IS SIGNED WITH RECOGNITION THAT KNOW- TELEPHONE DATE INGLY MAKING A FALSE CERTIFICATION ON THIS REPORT OR SUPPORTING DOCUMENTS OR INTENTIONALLY TAMPERING 6091365-7001* 82 06 25 WITH ANY MONITORING DEVICE OR METHOD ARE CRIMINAL L .* K. Miller OFFENSES. SEE 18 U.S.C. § 1001 AND 33 U.S.C, §13111. (Prnnl- SIGNATURE OF PRINCIPAL EXECUTIVE
'""r fl11*Jf' /inr.t 11r 10 SI0,000 nnd /or ma.dmr"n
~!!~!I lltJ 11at11tr1 ,,,,,,. ,,,. DAY OFFICER OR AUTHORIZED ACJENT NUMBER YEAR MO TYl"ED OR P'RINTED 'mpr1Jonmrn1 n/ brr""" ,_ muntlu and J 1*rar.1.)
OMMENT AND EXPLANATION OF ANY VIOLATIONS (Rr/rrrnrr all t1Uarl1nrrn1J lirrrl DIS 87A IS DISCHARGE 487A. AVERAGE VALUE IS 30 DAY DAILY AVF., MAX VAL IS 7 DAY DAILY AVF.(TSS,BODS). DISCW~ Ml'iI'IOR PRIOR 'ID CX:x-tB WI'IH DIS487. FI.CW MEAS Ol.'JT FOR mNT DIS I 1/30 FOR INTERMI'ITENI' DISCH. '!HIS DISCHARGE.IS FOR 'llIE ow NE.W SEWAGE TRFA'IMENI' PLANT.
BOD - System flow exceeds design capacity. 15 17
-- - ... ** - * * ** *..,. * * - - -..- 11arn ' PAGE OF
'lllr 1"-/1...<<*llOtt II ,.1,9) DISCHARGE MONliA!NG REPORT (DM!t) OMB No. U8-R001J y~~~?-m._:-~_.AFF __________ _ 1-16)
- 11-19 PSE&G
~lllf-----------~--------- 51.Q.._J.OC. __________ _
. NJ0005622 1--------i 487 GP.AT.
-~...J?....P~~ P'l:RMIT NUMlll:lt Dl*CHARQI[ NUM*ll:IO 17 2 1
__ JEiABK. ____ _m__m.uu_ ______ _
PERIOD
~m_SALEM_GFNERATm;~--------
~L1=Q'lER_A!..W'lAYSatm< _________ _
YE:AR MO (10-11) (22- J) NOTE: RHd IMlnlc:tloM befolw C011.ledng Ihle foml.
(J c.,, 01dr) QUANTITY OR LOADING (4 c.,, 011lr) QUALlfY OR CONCl.NTltATION
- J:-"
X (H~f) *AM~U 0
PAltAMKTmll (46-JJ) (Jll-4J) (46...,J) (JUI) NO. '"*
I""---'---'---..,.....---'---'------..-----+---'----'----..,.....-__;:____;;...____.,...........;__~----~--~ all ANALY*l8 TYP'I.
(JJ.J7) AVl:ltAGI: MAXIMUM UNITll MINIMUM AVl:ltAGI: MAXIMUM UNlft 0530 1 *AMP'LE:
Ml.AISUltl.M l!NT 0LlDS, '1UrAI.. 7 00 7.00 USPENDED
(\ ')"'1 (\
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NA 0010 1 EMPERA'I.URE, WATER llAMP'Lll MKA*UIUMl.NT * * * * **** * * ** * * ** 33.00 0 1 rm EXi. CEN.l'RIGIWJE
- * :'*(':*.fr ,,, * ~-* *** ,-, 4J.JC1.,' mx;.c :J/30 FFWENl' GIU5S ~ :. : *... *:: :;. *:. ,:/<<,* ..,.,'.-;_ '** .:;* .. *'**
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0400 1 H
eAMPLI:
Ml:A*Ultl:M*NT * * * * **** 7.50 7.50 7.50 0 1/30 ll'ftMIT 1 ':
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- .' 'j/30 GR
. ~* ... .. '
eAMP'LI.
Ml:AllUllll.Ml:NT PPIMl'f lllQUllllllMllNT
'------.-~~------~~-i.--~----~-L------~~~------..__
M*/TtTI.I. PllllNCIP'AL Ul.CUTIVI. Ol'P'IClllll THI* DOCUMENT 111 lllGNE:D WITH RE:COONITION THAT KNOW- ~
___________ a.._____.._.......
_*~.-"--------**-**-...
Tl.LD'MONI:
.....-----------~
D A T II I
~ ,VJ. - A/J INGLY "'AKINO A l"ALllE: CElllTll'ICATION ON THiii RE:PORT OR
- UP'PORTINO DOCUMENTG OR INTENTIONALLY TAMP'l!ltlNQ ,_ ~ "LI~~ f .Y. I L. K. Miller w1TH ANY MoN1ToR1No DEv1c1: oR METHOD A1111: cR1M1NAL 1--.....Jlt:!..J::::'--~.a.i5.o:::l.i!~~:.._----'
609 1365 _ 7000 flh 1') c;
l TYPED 0111 PllllNTllD Orl'EN9C*. 111!1: Ill U.11.C. ' 1001 AND SS u.11.c. 11318, llrr 11111lrr rltrH 11n1u1u "'"' l>r fi11r.* 11r 10 SI0,000 *nd /Or 11t**f111u"'
1111 prlion,..rnr nl brrwwr 11 11 m., 11 1111 ond J rror*.)
1Pr11nl- *IGNATUltl. OP' P'llllNCIP'AL llXl:CUTIYll OP'l'ICl[llll Olt AUTHORIZED AGENT ~!!~ J NUMllPI Yl:All
~?
hw....-!i-;-::...::-.;....;;..;;....;;:+..-JU..:.-f-.....,,.._-t,~'---f MO DAY MENT AND EXP'LANATION 01' ANY VIOLATION* (fl.r/rrrnrr all 011ocl1111rn1J ltrrr) 16 17
.. -- -.... **---.. ***tr".' PAGE OF
'" N-1Loc*ll011II1111-A~~i M:;R*~JN'l-AFF __________ _ DISCHARGE MONIT l-16)
ING REPORT (Dllllt) 11-19 N.10005622 489
~m_P$~------------------
-~J....Q..Jm 57Jl_J.DC. __________ _ Pl:AMIT NUMBER DleC:HAAGI: NUM*I:"
__ .JEommt ____ JU__fil.10]_ _ _ _ _ _ _ _
MONITORING PERIOD
~m_SALEM_GENERA~~------- A? n i; I ni I To ._.Q .... c;:_b~--,
'>. . _-1h1o1-........
MB~f:Q'IER-~CRme----------
P'"OM YEAR "'o I DAY I YEA" I Mo I DAY (111-11) (2l-2J) (U-IJ) (l6 J7) (211-19) (JO-JI)
(J C*d OlllJ') QUANTITY OA LOADING (4 C*rcl 0111,) QUALlfY 0111 CONCl:NTl'IATION
)0530 PAllAMKT*R (JJJ7) 1 X *AMPLI:
M l:A*U "IEM l:NT (411-JJ)
AYl:"AQI:
('4-61) t----'-~-'----r---~"----r-----t---'-~~--..---'-~....;...--..--.-...~----..-----1 MAXIMUM UNIT8 (Jll-4J)
MINIMUM (46JJ)
AVl:l'IACI*
(U41)
MAXIMUM UNIT8 NO. JIWll.G::NCY all ANALYele 8AMPL*
TTPI:
,.,_70) .
- cn
- ,roo, 'lOTAL 7.42 7.42 aQ nn aA nn 1 1/30 GR 5USPENDED
- .* *..~.*., :;.* ~
PlftMIT R*QUll'l*MllNT ,!' . *. **** KG/MY **** ' . )0.0() *.. 109 ~ 00 ;" t-G/L
~Il14VI' ~C: ~ .... ..
00550 1 eAMPLI:
OIL.AND~
MUeU"IEMl:NT **** **** **** s.nn n 1/30 GR
- ...* * * *.. ., .. ~
- 1/30 GR 00551 1
- * * ;
PE'lroLElM **** **** **** **** 11.40 0 1/30 GR YDRX'.AROCN>
FF.LUENl' GRlSS * * * *.. *. ~ ;:* ... ~=*.... *..
- :* :~ :' .... :* l.\: ~.
~ 1/30
~
50050 l U:M eAMPLI:
MIEAeUMIEMl:NT **** **** **** 0.02 0.02 EST NA
- . :-* **.~.
f
- l/30 '
NA eAMPL*
M*AeU"llMIENT **** **** **** **** 22.00 0 1/30 GR
""MIT "IQUlltl.MCN't
- ' ,. .*.ft * * * * .. *
- ~
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' *. *;* .*
- . ~-
- .. ~ I\. \* ...
. l/JO GR 00400 1 ****
H eAMPLIE MIEAeU"IEMl:NT **** 6.90 6.90 6.90 0 1/30 GR HIUUT ,
ltlOUIROllUfT
- . 1t .ft * ** .'. *.* * * * ..*... * .:' 9.oo*. "*"*..
SU *1/30 GR
.... :::.:. * \:
eAMPLI:
MIEA*U A IEM llNT PIE"MIT "SQUll~lllMl:NT ,.
IE/TITLI: PRINCIPAL *XIECUTIVIE OP'P'ICll"
~
TH1* DOCUMENT 18 &IGNED WITH RECOGNITION THAT KNOW- :fl. . Y° ( 1 - /I A Tl:LIEPHONIE
.. ~--.
D A T IE I~
INGLY MAKll'IG A f'AL&E CERTIFICATION ON THIB AEPOAT OA l----'~:..Jf.._...:::"'..,.,._*\A.c.~!:Ml.1~V~.Y:W'.-!.----I L. K. Miller BUPPORTINO DOCUMENT& OR WITH ANY MONITORING DEVICE OR METHOD ""IE CRIMINAL INTENTIONALLY TAMPERING 1P'""'*
609 365-7000 I 82 06 TYPIED o" Pl'llNT ..D Of'P'ENsEs. &EE 1s u.e.c.' 1001 AND :u u.s.c. t1s1*.
rlrJ 111111,.,, 1'9rJt 11a1urr1 '"" l*r finr1 up ro SI0.000 nr1d/or ma*lmum
"P*l*un'"'"' "' btlWtrft j\ ... unllu 011d ' r*o**.)
e1GNATU"1E OP' P"INCIP'AL 1Ex11:cuT1v1:
Ol"FICll:R DA AUTHOl'llZED AGIENT ;~~ I NUM*P Yl:A" MO : DAY *i IENT AND l:XP'LANATION OP' ANY VIOLATION9 (Rr/t,,11rr oll 011arl1m1n11 llrrr)
TSS - see coversheet.
17 17 PAGE OF