ACCEI ERA D DOCUMENT DIST UTION SYSTEMREGULA< Y INFORMATION DISTRIBUTI SYSTEM (RIDS)

,4

ACCEc3sjON NBR:9308230147 DOC.DATE:.93/08/16 'NOTARIZED: NO DOCKETFACIL:50-387 Susquehanna Steam Electric Station, Unit 1, Pennsylva 05000387

50-388 Susquehanna Steam Electric Station, Unit 2, Pennsylva 05000388AUTH.NAME AUTHOR AFFILIATION

FIELDS,J.S. Pennsylvania Power & Light Co.RECIP.NAME RECIPIENT AFFILIATION

CROWLEY,K. Pennsylvania, Commonwealth of

SUBJECT: Forwards "NPDES Discharge Monitoring Rept for Jul 1993...."& PA Dept of Environ Resources monthly facility rept. Informsthat during month of Jul,sewage treatment plant Outfall 079total suspended solid sample exceeded monthly average.

DISTRIBUTION CODE: IE23D COPIES RECEIVED:LTR I ENCL ] SIZE:TITLE: Environmental Event Report (per Tech Specs)

NOTES:

RECIPIENTID CODE/NAME

PD1-2 LACLARKgR

INTERNAL: ACRSNRR/PMAS/ILRB

EG FI% Ol

EXTERNAL: NRC PDR

COPIESLTTR ENCL,3 '

1 1

5 51 11 1

1 1

RECIPIENTID CODE/NAME

PD1-2 PD

NRR/DRSS/PEPBOGC/HDS2-RGN1

NSIC

COPIESLTTR ENCL

1 1

1 11 11 1

1 1

NOTE TO ALL"RIDS" RECIPIENTS:

PLEASE HELP US TO REDUCE WASTE! CONTACT THE DOCUMENT CONTROL DESK,

ROOM Pl-37 (EXT. 504.2065) TO ELIMINATEYOUR NAME FROM DISTRIBUTIONLISTS FOR DOCUMENTS YOU DON'T NEED!

TOTAL NUMBER OF COPIES REQUIRED: LTTR 17 ENCL 17 gj~/

0 ~ ~

August 16, 1993

Pennsylvania Power 8 Light CompanyTwo North Ninth Street ~AIlentown, PA 18101-1179 ~ 215/774-5151

Ms. Kate CrowleyWater Quality Regional ManagerBureau ofWater Quality ManagementPennsylvania Department ofEnvironmental Resources90 East Union Street, 2nd FloorWilkes-Barre, PA 18701-3296

SUSQUEHANNA STEAMELECTRIC STATIONDISCHARGE MONITOMNGREPORT - JULY 1993

NPDES PERMIT No. PA 0047325CCN 741326 FILER9-8APLE- 17125

Dear Ms. Crowley:

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

There was one noncompliance in July. During July, the Sewage Treatment Plant (Outfall 079)total suspended solid (TSS) sample exceeded the TSS monthly average of30 mg/1. This TSS

sample was recorded at 38 mg/1. Normally, additional samples for TSS are taken in order to meet

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

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

Respectfully yours,

iJ P~J ome S.FieldsS 'or Environmental Scientist - Nuclear

Enclosures

<300 ~gCopies to:EPA Region IIINRC'DocumentControLDeslaNRC Region IMr. R. J. Clark, NRC Sr. Project Manager

9308230i47 9308ih)~tr32t~g6) PDR ADOCK 05000387-~R PDR

I01-11?

t ATTACHMENT 1

PA OEPARTMENT OF ENVIRONMENTAL RESOURCES Month July 1993

MONTHLY FACILITY REPORT pate Prepared 8/17/93

Facility Name Sus uehanna Steam Electric Station PWS IO NO. 24pp994. Box 467

Facility Address Berwick PA 18603 NPOES Permit No. PA 0047325

Municipality Salem Townshi

County Luzerne

Incinerator Perm)t Number(s) N/A

Telephone Number (215) 774-7889

Person Completing Form Jerome S. FieldsP int Name

SignatureY )Title Sr. Envh tJnmental Scientist

1. Total Hours Incinerator Operated

2. Type of Fuel

3. Total Fuel Usage

4. Supplier of Fuel

5. Estimated Amount of Sludge Incinerated

N A

N/A

N/A

N/A

6. Incinerator Ash Disposal N/A

(a) How Much (Tons)(b) Where(c) When (Last ccurrence(d) Hauler(e) Receipts: es no

8. Other Wastes (Gr1ts, Barscreen1ng, etc.)

(a) How Much (Tons)(b) Where(c) When (Last ccurrenci(d) Hauler(e) Receipts: es o

9. Septic Tank Masts Accapten: Yes Ro

7. Sludge Disposal Water Treatment

a) How Much (Tons)b) Vh Jh

(c) Mken (~st ccurrence I~egg(d) Hauler(e) Receipts: Yes No

*Republic Environmental SystemsHatfield, PA

10. If yes:(a) Volume(b) Hauler(s Percent (%) Hauled

11. Analys1s Performed to ensure tank waste conta1ns no 1ndustr1al wastea) Yes

(o) It yves, requency

12. Addit1onal Cotancnts: 2,000 allons of septic tank waste taken offsite and

treated at the Hazl eton Sewer Authority (Permi t PPA0026921)

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TYPED OR PRINTED

I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMWCDAND AM FAMILIAR WITH THE INFORMATION SUSMtlTED HCRCIN. AND SASCDON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RCSPONSISLE FORDSTAWWC THK WFDRMAYIOV. 1 SELIKVE THE SUSMITTCD WFDRMAYIDNIS TRUE. ACCURATC AND COMPLETE. 1 AM AWARE THAT THCRC ARC SIC-taFICANT PENALTICS FOR SUSMfYTWC FALSE INFDRMATON. WCLUCNNCYHK PDsststLFIY CF FINc AND tMPRtsDNMENT sKc ls Usc I 1001 AND33 USC I 1310. Iprnaltirr anarr thrrr rlatrlrr may tnrltrtr /mrr ap lo Stajttrtancf or marimam nnpnronmrnl ol hrtorrn d month r and 5 pram l

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( 12)

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(dtt.re)

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lVV~pg. DPaA.A-WICl(25

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FLOII AIID PH SHALL BE tlEASURED DAILY lIHZNDISCHARGING':PA

Form 3320-t (Rev. (HIS) Previous edt'lions may te used. (RCPLACCS CPA FORM TAO WHICH MAY HOT SC USCD.I005B1/930611 1625 PAOC OF

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(12)„

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(6648)

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PH

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( 12)

NbrEX

FRKOUCNCYOF

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(69-10)

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I CCRYIFY UNDCR PCNAI.TY OF LAW THAT I HAVC PCRSONALLY EXAMINEDAND AM FAMtLIAR WITH THK INFORMATION SUSMITTCD HCRKIN. AND SASCDON MY INOU1RY OF THDSC INDIVIDUALS IMMEDIATCLY RCSPONSISLC FOROSYAININO THK INFORMATIOY. I SCLIKVE THC SUSMITtED INFORMATIONIS TRUE. ACCURATE AND COMPLETE. I AM AWARC THAT THERE ARK SIOtarcANT PKNALTICS Fon SUSMITTINO FALSC INFORMATXW. INcLUDINoTHC POSSISILITY OF FtNC AND lMPRISONMCNT SEC IS USC I lOOI AND3S USC I 1$ 1S. tPrnaltirs sndrr shear ttatstrs may snrlsdr /tars ap la Stttlsstand sc masimsm tmpnsvnmrnt s/hrtsvrn S mnntha and S swrs.t

SI A R 0 IsRINCI AL EXECUTIVEOFI'ICKR OR AUTHORIZED AOENT

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DATE

DAYOMMKNTAND EXPLANATION OF ANY VIOLATIDNs (Rc/crcncc vtl vuvchmcnts crc)

=CPA Form 3320.1 (Rev. Ms) Ptevlous ed/Vena may be used. (RKPI ACES KPA FORM TWO WHICH MAY NOT SE USED.)00584/930611 1625

PAOK OF

PERMITTEE NAME/ADDRKss ((nc(udc8'acdlty I(amcllocatbn (fdlffcrantI

LLSQ9~~ADDR~XQCL3KB~JkXliT~ST~ZT

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PCRMIT NUMSCR c>lacHAR44 HU>a ~ cn

MONITORING PERIOD

NATloNALPOLLUTANTDlscHARoc ELIMINAYIDHCYCTcM (NPDErlDISCHARGE MONIYOltINOItKI>OItY(Dh(RI

2.16 MAJOR

I'ACIUTYI OCATION

"CHN

YEAR MO DAY VCAR MO 'DAYFROM V TO

(20.211 (22.2 1 ( I 1 ( ~ 1 ( 1

¹¹¹ NO DATANOTE: Read Instructions before completlnIItlsls form.

PARAMETER(1247) AVCRAOE MAXIMUM

(S Card Only) QUANTITY OR LOADINO(4M)) (sdar)

UNITS MINIMUM AVERAOC MAXIMUM

(d Card Only) QUALITY OR CONCENTRATION(NAS) (ddt), (Sddll)

UNITS

NO.CX

6243)

FRCDUENCYOF

ANALYSIS

(dd48)

SAMPLETYPE

(69-70)

SOLIDSF TOTALSUSPENDED00530 1 0 0

SAMPLEMEASUREMENT

;".;4> PERMIT.n.. 4

¹¹¹¹¹¹3- "¹ISK -44¹"~ . ".'~'" '$(r g~'"+~r)c,';30

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( 19) CyrLIs8

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a 1N COIIDUIZ ORTHRU TREATMENT PLAN50050 1 0 0

SAMtLKM CASU R EMCNT

;:;:~marks'V4'.',L""-R8POgkj '=~,gRgPORT;":;,'AMPLE

MEASURKMCNT

( 03) ¹¹¹¹¹¹g6/~,

kX,LV',4> ST>.g~~>;~ 0'>"...;>r a'>i"."rr

SAMPLCM CASU R KMCNT

RKQS)IISOECSSTc'r'",,".~~;i.''.i'."r>""'q>,: '>> 'Wq~~~."'>'j~'> 4'g:."'d',

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SAMPLEMEASUREMCNT

SAMPLEMKASUREMENT

NAME/TITLEPRINCIPAL EXECUTIVE OFFICER

R.6 Bwp.~ Sg. VP

N~C OPGLM'1 W5TYtKD OR tRINTKD

I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINEDAND AH FAMILIAR WITH THE INFORMATION SUS>a>TFED HKREIN; AND CASEDON MY INQIRRY OF THOSE n>DIVIDUALS IMMEDIATELY IIKSPDNSISLE FOllDSTNN>HG YHC n>FORMAT>OY. I SELCVE THE SUS>a>TYED INFORMATIONIS TRUE ACCURATE'HD CDMPLCTC I AM AWARE THAT THERE ARE S>C.taF>CAHY PEHALT>ES FOR SUS>a>TT>NG FALSE IHFDRMAT>OH. IHCLUDIHOTHE PDSS>S>LITY OF FINK AND IMPR>SDHMKHT SEC IS USC S 1001 AHD33 USC S 1310. >t>rnattirr andrr thrrr rtatrtrr may >nrlrdr finrr ap to staler>and or mariman»n>pnn>nmrt>t o(h> >arm a mon>ha ands tram>

COMMCNT AND CXPLANATION OF ANY VIOLATIONS (Rc(crcncc au attachmcntt crc)

FLON SHALL BE MEASURED DAELY MHEN DXS™HARGING~

TCLKtHONC ~

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

SIO AT R 0 RINCIP EXECUTIVEOFFICER OR AUTHORIZED AOCNT

DATE

S > IfMO L DA.Y

o

-PA Form 3320-t (Rev. 048) Previous edillona may be used. IRcPI Aces KPA FDRM T.40 wHlcH MAY NoT sc UscD.I00586/930611 1625

~ AOC Olr1

>ERMITTEE HAMc/ADDftcss /lncltldaaa/tlsy Nama/Locct lan (Idl//erontJum MULES.XLS~~~~MJLSJKM~LDDRCSS

FACILITY'CATION

ATTN: R ~ L ~ DOZY SUPV OPER TECHNOL

NATIDNAI PDLLUTANTDtscHARoE ELIMINATION%TOTEM /JVPDESJDISCHAR4K MONITORING RCPORT /Dtt/RJ

2.16 J>t Jlt

0047325 271 APERMIT NUMSCR DtacHnnoc NUMaan

MONITORING PERIODYEAR MO DAY YCAFI MO 'OAY

FI%OM I/ TO

/ 21/ /2r2/ l ~ J / ~ J /

Form Approved.(SO B R 02) OMB No. 2040-0004.F - FINAL Approvalexplres6-30-IIASTE FILTER BYPA'SS

NO DATANOTE: Read Instructions bsforicompIatIIIlItIIls firm.

PARAMETER(1247)

SOLIDSF TOTALSUSPENDED00530 1 0 0

FLUEN GROSS VALU

~AMPLEMEASUREMENT

AVERAOC

n:n.y>:u:I>"-0

MAXIMUM

Frt ">II>: I>: n- 4

3<'.~Mr'iTS~I';:;,'~>>>+>k,'~k

(J Card Only) QUANTITY OR LOADINO(6tws) ($64/)

(6 Cord Only)(Ndf)

MINIMUM

" F 4 I(tQ~

AVERAOK MAXIMUM

QUALITY OR CONCENTRATION(6642) (SAf1)

UNITS

( 19)

MG L

NO>KX

FRCDUENCYOF

ANAIYSIS

(66'/a)

'N,CE'j~',$HOSf H

SAMPLETYPE

(69 10)

OIL AND GREASEFREON EXTR-GRAV MET00556 1 0 0

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V G 0 V LU

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( 03)

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HAMKJT ITLE PRINCIPAL EXECUTIVE OFFICER

R.. Cr . $3@,~ S('Pg Vu~A- Oft.Ih«ogg

TYPED OR PRINTED

I CERTIFY UNDCR PENALTY OF LAW THAT I HAVE PERSONALLY CXAMOIEDAND AM FAMILIAR WITH THE INFORMATION SUOMITTED HCREIN. AND SASCDON MY INDIXRY OF THOSE INDIVIDUALS IMMKKXATELYRKSPONSISLE FOROSThotatth THK RIFDRMATIO'4. I BCLTEVC THE SUSMITTED INFORMATIONIS TRUE. ACCURATE AND CDMPLETc I AM AwARE THAT THcRE ARE sus.taFICANT PENALTICS FOR SUSMITTVIG FALSE RIFORMATION. VICLUDINGTHE Possto>LITT oF Fate AND IMPRtsDNMKNT sKE Ie Usc I tool AN33 USC I I3IO. tyrnatticr u>utrr thrrr rlatutrr may inrtudr />nrr up I» Sttt/urtand u> matimum tmpnrnnmrnl u/hrturrn 6 mnnlhr

units�

>rara ISIO A R OF PRINCIP EXECUTIVC

OFFICER OR AUTHORIZED AOENT

TELEPHONE

'/

7 ~tr - 5golZ)NUMSER YEAR

DATC

DAY:OMMENT AND CXPLANATION OF ANY VIOI.ATIONS (Rctcrcncc au attachments herc)

FLOII SHALL BE IIEASORED DAILY IIHENDISCHARGING'.PA

Form 3320.1 (Rsv. 048) Plsvtoua ed/I/one may be used, (REPLACES CPA FORM? 60 WHICH MAY HOT ~ C USCD.)00588/930611-.16 25

PAGE OF

FERMITTEE NAME/ADDRE55 /IndudcYoct/ttyI/ctnc/Local/on /Idlfjcrcntl~M M~~UJIM~?~~TADDR~ZXO 2LK~3DJkZH SZ~LX

«««II«— PCRMIT NUMSCIE Dtvcknnoc HUMscn

MONITORING PERIOD

NATIONALI«OLLVTANTDISCHAROC ELIMINATIONSYSTSM /IIPDESIDISCHARGE MONITORING REPORT /DIdRI

2/6 /7 /tt Form Approved.(SU BR 02) OMB No. 2040-0004.F -, FZ HAL Approval expires 6-30-91.NEUTRALIZATION BASIN DISCHARGE

I'ACILITT'LOCATION

TT i: R ~ L ~ 'OZY SUPV OPER T ECHNOL

YEAR~'ROM

/20 2/I /22.2 I ~ I I /2 ~ I /

MO DAY YEAFI MO 'AYTO ¹¹¹ HO DATA I I

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

I ARAMSTER

(3247) AVCRAOC MAXIMUM

(3 Card Only) OUANTITY OR LOADINO(dtW3) (5'/)

UNITS MINIMUM AVCRAOC MAXIMUM

(d Cord Only) DUALITYOR CONCCNTRATION(3aA5) (d6»53) (5Afl)

UNITS

NO.CX

FRCOUCNCYOF

ANALYSIS

(6C48)

SAMPLETYPE

(60rre)

SOLIDSF TOTALSUSPENDED00530 1 0 0

OIL AHD GREASEFREON ZXTRGRAV MET00556 1 0 0

(I U

SAMPLEMEASURCMKNT

.",~%3PCRISITL ';«'IEKEIUIRKMKIA';

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SAMPLEM CASU REM CNT

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vS

NAMC/TITLE tRINCIPAI EXECUTIVE OFFICER

g, G, ~IRa~ SR. YP

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

I TYtCD OR thlNTCD

I CERTIFY VNDCR PENALTY OF LAW THAT I HAVC FCRSONALLY CXAMtNCDAND AM FAMILIAR WITH THC INFORMATION SIISMITTCD HCRKIN. AND SASCDOM MY INQIRRY OF THOSE INDIVIDUALS IMMEDIATELY RKSFONSISLC FORDSTAINNG THK RIFDRMATIOM. I SELltVK THC SUbMITTED IMFQltMATIONIS TRUE ACCURATE AND CDMFLETE I AM AWARE THAT THERE ARE SloICFICANT FCNALTIKS FOR SUSMITTINO FALSC INFORMATION. IMCLIIDINOTHC FOSSIbtLITY OF FINE AND IMFRISDNMENT Stt Ib USC I 1001 AND33 USC I 1315. IPrnvltirv vrvtrr thrrr Itvtvtrv mvp tnrtvdr /tnrv vp ln ltotttvtvrvt nr movimvm tmpnvunntrt«t «>/hrtvrrn d mvnttlv cnit 53rvrv I

SIONAT R OF RINCII A EXECUTIVEOIFFICCR OR AUTHORIZED AOCNT

TELEPHONE

'I

7 ZQ-3NUMSCR,

DATE

YEAR MO D/IV=OMMCNT AND CXPLANATION OF ANY VIOLATIONS (Rr/rrrncc all auuchrncntc crc)

FLOM SHALL BE MEASURED DAILY MHEH DISCHARGIHG ~ ¹EM ~ FLOM SHALL BE MEASURED DAIL'Y¹HEN DISCHARGIHG ~ THERE SHALl BE H¹ DISCHARGE OF POLYCHLORIHATED BIPH¹llYL COMPOUHDS ~ SEE PERMIT FOR.O'I'H

0 8) Ptsvtoud ddltlons may be used. (RCFLACCS CPA FORM 7 de WHICH MAY NOT ~ C USED.) PAOC OF00593/930611 1625 1

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

~~LkSYJJfJ'd~?~~ - cglSQ933~\ODRCSS~i

PERMIT NUMSCR cnacHAR46 HUMaaR

MONITORING PERIOD

NATIDNALPOLLUTANTDISCHARGE ELIMINATIONSYSTEM (I(PDE5/DISCHARGE MONITORINQ RCPORT /DHRI

2./6 I7.19r

N AJO R Form Approved.(SDBR 02) OMB Nor 2040-0004.F -. FINAL Approvalexptres6-30-91.. ~

IIASTE FILTER EFFL'DENTFACILITY'CATION

UP

YEAR MO DAY YCAR MO DAYFROM TO

(20 2II (22.2 I ( d. I(2 I ( INO DATA

NOTE: Road Inctructloiss before compl ettlsII wIIIS fortran

PARAMETER(5247) AVERAGE MAXIMUM

(5 Card Only) QUANTITY OR LOADING(dtw5) (5dnll )

UNITS MINIMUM AVERAGE MAXIMUM

(6 Card Only) QUALITYOR CONCtNTRATION(5%45) (dtS45) (5Afl)

UNITS 62'))

FREDUKHCYOF

ANALYSIS

(664')

SAMI'LKTY PC

(69-10)

SOLIDSF TOTAL"SUSPENDED*00530 1 0 0

I OIL AND GREASEIFREON EXTR-GRAY MET'00556 1 0 0

SAMPLEMEASUREMENT

SAMPLEMCASUREMENT

A 'hydr

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

( 19)

( 19)

na.4')CE//:;

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H,eE/'. RjB„r.';.„,

«<Vrtr Wi", Lr

IFLOWF IN CONDUIT OR'HRU TREATIIEtlT PLAt):50050 1 0 0

SAMPLEMCASU REM CNT

)SITS .;;,Q4',~ RF,PORT,~4»

«AD�REPORT;":

2> Lrr

( 03) h"C:SIC:(I

;LOX,tID

SAMPLEMEASUREMENT

~ltegUSRKgKNg '.Sr4"<g>~~".+Xe'gr-+'P'AM

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ISCQUIRKMKNI;y .'!'. ".O'"".",~„;;~"'„';"~Y~'. r")+'4'" d >rd<'+j~'"gc',q(n",r@ „",„q

SAMPLEMKASURtMCNT

SAMPLEMKASUREMCNT

, r,,rq«,re It>N

RCQUSREMCNTl jI NAMC/TITLEPRINCIPAL EXECUTIVE OFFICER l CERTIFY UNDKII PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED

AHD AM FAMR.IAR WITH THC INFORMATION SUSMITTED HCRKIN. AND CASEDON MY NOU1RY OF THOSE NDIVIDUALS IMMEDIATELY RKSPOHSISLE FDROSTANNG THC NFDRMATIOV. I SCLIKVC THE SUSMITTED IHFDRMAYONIS TRUE. ACCURATE AHD COMPLETE. I AM AWARE THAT THCRC ARE SIGtaFICAHT PKHALYICS FOR SUSMllTNG FALSE INFORMATION. NCLUDIHGTHK Possl&LITY of PINE AHD IMPRICDHMKHT scc Ie Uac S IDDI AND$ 3 USC $ lolo. tyrnattirr andrr three ~ lalalrr may <nrtrdr /inrr ap ln ltv/amand ur marimam tmpnvmmrnt n(hrtarrn 6 menthe and I yearn.t

. A ~ &iG'tRASI 5p gPH'44IR A(L 0 f'~

TYPCD OR PRINTEDOMMENT AND EXPLANATION OF ANY VIOLATIONS (Rt(erenee att vnvehrntnlc here)

FLOII SFALL BE MEASURED DAILY IIHEN DISCHARGING~

SIO A U C I'RINC AL KXCCUTIVCOFFICER OR AUTHORIZED AGENT

Fa~ Qc r

TCLKPHONC '

I7 Wg-3oQNUMSER

DATE

8YEAR MO DAY

-:PA Form 8320-1 (Rev. 948) P(svtous edl(lone may be used. IRCPL*CCS CPA FORM T 60 WHICH MAY NOT ~ C USED,)00595/930611-1625 F'AGC Olr

FcRMITTEE NAMEIADDRcss (lnclttdr"acdlfy Jfdrnr/Cocefbn lfdfffrrrnt/mu ~~Jf~~M~~ZSMXUMODR~

FACILITnF

I OCATION

ATTN: RE L DOTY SUPV OPER TECHNOL

MONITORING PERIODYEAR MO DAY YEAR MO 'DAY

FROM TO

I 02IJ (2 ~ J ~ J I f I

HATIDHALPOLLUTANT DISCHAROE ELIMINATIONSYSTEM iNPDESJDISCHARGE MONITORINO RCPORT ID)fRI

2 Id I1./9

P 5PERMIT NUMSCR DNCHAROS HUM San

Form Approved.(SU BR 02) OMB No. 2040-0004." FI NAL Approval expires 6-30-91.571 CIRC IfIIATER PUNPHOUSE SUHP

NO DATA ). )44'~I

NOTE: Read Inetructlons before complstIIIIIXIIIIform.

PARAMETER(5241) AVKRAOE MAXIMUM

(5 Card Only) OUANTITY OR LOADINO(4M5) (545l)

UNITS MINI MUM AVKRAOE MAXIMUM

(d Card Only) DUALITYOR CONCENTRATION(W45) (4145) (Seal )

UNITS

NOrKX

FRCDUENCYOF'NALYSI~

(dolt)

SAMPLETYPC

(d9.10)

SOLIDSF TOTALSUSPENDED00530 1 0 0

SS VA 0OIL AND GREASEFREON EXTR 'GRAV tlET

I00556 1 0 0V 0

I F LOII a IN COIIDUIT OR1HRU TREATHENZ PLAN50050 1 0 0

~AMPLEMCASVREMENT

SAMPLEMCASUREMtNT

SAMPLEMEASUREMENT

wKKIUIRtrdc)dt;"

SAMPLKMEASUREMENT

0 ""ifEP.QR'f,'„',

A+I% ngoal

Q. 6'9Q ( 03)

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4 lit>iIlr"44

1,7 I.7i60a 0'-",4~

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Qj'~gW„~-

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6 'I~) C ~~53( 19)

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h'XX"Y',I,

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SAMPLEMEASUREMKNT

, RKOUIRCMCIIT;;

NAME/TITLEPRINCIPAL EXCCLITIVKOIPFICKR

8 (In S.~1I.W~ SI. Vf'

N IJ~o,g &P~A-r(clueTYPED OR PRINTED

I CERTIFY UNDER PENALTY OF LAW THAT I HAVC PKRSONALLY EXAMINEDAND AM FAMILIAR WITH THC INFORMATION SUSMITTED HKRCIH. AND SASCDOtt MY INDUIRY OF THOSK INDIVIDUALS IMMCCXATELY RKSFONSISLC FOROSTAININC YHC INFDRMATID'N. I SCLIKVE THK SUSMITCED INF'DRMAYIONIS TRIIK. ACCURATE AND COMFLCTC I AM AWARC THAT THERE ARE SICNIFIC*NT PCNALTIES FOR SUSMITTINO FALSE INFORMATION. IHCLIIIXNQYHK PDSSIStLITY OF ABC AND IMPRISONMENT SCC IS USC I IDDI AND33 VSC I ISIS. IPrnaltirr arvfrr thrrr rtatatrr may tnrfrdr finn ap ln dltlfrrand nr rnarimarn tntpnvrtntrnt nf hrtarrn d manthr anif 5 lraral

SIO A VR 0 PRINCIP L EXECUTIVEOIFFICCR OR AUTHORIZED AOENT

TELEPNONC ~

7/ egg- egaNUMSCR

DATE

YEAR MO n DPrtfOMMCNT AND CXI'LANATIONOF ANY VIOLATIONS IRrlrrrnrr au vttvc manta rrr)

FLOII SHALL BE IIEASURED DAILY IIHEN DISCHARGING'~

-:PA Form 8320 1 (Rev. M8) Pfsvtoua &If(onemay I)e uaed. (RtPI ACES CPA FORM T dO WHICH MAY NOT SC UatD,I00599/930611-1625 ~AOC OF