Document DGKmy9DkMoYkRpG5kpmGQ7rdB
NATIONAL emission standards for hazardous air pollutants COMPLIANCE STATUS INFORMATION
Form Approved OMU So. 15S KOIJl
i. sounrr bepobt ySTRUCTIONS i juners or ope I at or \ o! stHirers ol hazardous pollutants su L[es t lo the Nation jl Fm lesion Standards tor Hazardous Atr Pollutants inquired i<> sulmiil the inlotmation eontaincd in Section I to the apptopiute U S, l.nvironmenlal Protection Agency Regional OHicc pttor to I days altar the ctlci live date ol any standards or amendments which require Ilia submission ol suali information.
A lisnny ot regional oltiaas is provided in |6I.04.
PLEASE NOTE: Do not write in shaded areas.
A. sound information
1. IDENTIFICATION/LOCATION Indicate the name and address of each source.
2. CONTACT - Indicate the name and telephone number of the owner or operator or other responsible official whom EPA may contact concerning this report.
DUP 1-14
1 4| 1| IS 20
l Jl .1 Ll i Wi oi ri si ti_.eiJ4.3j i iiii i i i i 1 i
21 NAME
43
13,0,4,
44 46 AREA CODE
47 NUMBtR
II eo
3. SOURCE DESCRIPTION - Briefly state the nature of the source (e.g.. "Chlor-alkali Plant" or "Machine Shop"!.
our i-i e
I 4l2l 10 20
I Pi ii si Pi ei ri si ii oi rn t M it m Vi Ii jR ie p d P i iP |1 iatn it i i i
91 nrcrmPTiPN
KA
1--I _1--1__ 1... 1-1 .1.
S'
-i I I I I
CONTINUED
liiiII i
LJ 79 BeOo
ALTERNATIVE MAILING ADDRESS - Indicate an alternative mailing address if correspondence is to be directed to a location different
tnAn fknt rrSiSAif i4rf iskAun
'Dtrr t-ia
141 3i It 20
I P[ Q I^QXI
number
P p p |4 I I 1 I I I I I I J
STREET OR BOX NUMBER
II
I
DUP 1-14
i--i__ i 10 20
i Si q i Q h ai ri 1| Q s,
* CITY
q r) , ,
tW ,V |
37 *ae-
STATE
|2 15 ,3,0,3J
------
44
0
---------T nn'jXJ' 1 ' 'v "UMiuira MUMI SIMS avuiK Luvom I_PMMIIUI mrct trie emilUll MmncmuiiJ LfUlKmiUU in IHC lT<niOn9l tl
Stendardi prior to 90 days after the effective date of any standards or amendments which require ihe submission of such information
til, t
Signaturtyof Owner, (Operator or Other Responsible Official
N?|TK-: lr -tK Cmisslons from *l,c sourcc will exceed those limits set by the National Inussion Standards I'oi Hazardous Air Pollutants, the source nu I he in violation and subject to Federal enforcement actions unless eranted a waiver ol compliance by the Administrator ut the U.S. Environmental
ro eition Agency 1 he information needed for such waivers is listed in Section 11 ot this lorm.
. Form 7600 1 (9.75)
PAGE I OF 5
UCC 102592