Document QkaLxdpxyONgqw70VrrG54wML
Attachment I
There were two excursions in February reported by letter as follows:
February 16, 1986 (+0.3) pH g Outfall 005.
A small
leak
developed in the weld repaired on 1/16/86 on the 50% caustic
transfer line.(see January 22, 1986 Non-Compliance Report) and
allowed material to enter Outfall 005. The failed weld was
repaired and subsequent pH samples on this outfall have been
within the NPDES permit limits.
February 25, 1986 (+1.2) pH Outfall 005. See above -- same line, different place.
Co
o
t uaht) /Vfmj*/Lmutum if (Ufjrrent)
i' ,
NAME _ _ 2?Sk .JNjlsL-________________________________ __________________________
/ 7CHE80 P _Ci^IiUJX_lP_OQ______ ____________ ;_^_J________________
______ UvKt_ C_HARLES______:LA_T060^
l 1 UHAL I'OLLLjTANT DISCHARGE LIM INATION SYSTEM {NPUHS)
DISCHARGE MONITORING REPORT (OMR)
(2 16)
<nm
F - FINAL LIMITS
FINAL OUTFALL
Form Approved OMB No. 2040-000Expires 2-29-84
MONITORING PERIOO
EAQUrllV___________________________ :___________________________________________ LOCATION___________________________________________________ ______ ;____________
ATTN: T. G. Brown, PI ant1 Manager ,>?
YEAR 86 ` tit in
MO 02 tilJl;
DAY
01 .
(14-1*1
YEAR | MO
0286
TO
1
in iT/ tu-iit
DAY
28
itt j/i
NOTE: Read Instruction* before completing IhJs form.
PARAMETER 02-17)
(i Card Only) (46-53)
QUANTITY OR LOADING (54-61)
AVERAGE
MAXIMUM
{4 Curd Only) OS^fS}
MINIMUM
QUALITY OR CONCENTRATION
(46-JJ)
{344!)
AVERAGE
MAXIMUM
UNITS
f n eoucncy OF
A H A LjY S1S
[6243) {644ft)
SAMPLE TYPE
(6V-)o\
TEMPERATURE, WA1ER UcG- FAHRENHEIT
SAMPLE MEASUREMENT
U'JOIl .1 0
c permit
EFFLUENT GROSS VALUffi REQUIREMENT
*** ** *
******
****** njtaic**:;r;c
* ***** *** ** = t
* .'it*#**
******
*8*1 ****
******95 NA CONT RECORD
DEG. F
CON TlfllRCORO
UOUS
'W RATE
SAMPLE MEASUREMENT
U 0 0 !i 0
I
0
' PERMIT
EFFLUENT GROSS VALUE REQUIREMENT
PH
SAMPLE MEASUREMENT
3 04 00 I 0
' PERMIT " -
EFFLUENT GROSS VrtLUl REQUIREMENT
i!79.340
-;-v_ ******
30 DA AV G
******
211*,*31*2*** GPM
DAILY MX * ****
1*0*1**** *****
403 1IN/M0
*****
******
6.0 6,0
MINIMUM
** ****
******
****** ******
=ic Jlfcajc v=^Jc sfr * * **
******
NA
******
CONT RECORD
CONTIliJRCURD
uoys
10.4*
9,0 iU MAXIMUM
CONT RECORD CON TIM RCORD1 UOUS
SAMPLE ! MEASUREMENT
PERMIT RfiOUiREMENT:
SAMPLE i MEASUREMENT
f PHRMJT REQUIREMENT
SAMPLE MEASUREMENT
I PERMIT REQUIREMENT
' SAMPLE MEASUREMENT
PERMIT REQUIREMENT
NAME/TITLE PRINCIPAL EXECUTIVE OFFICER
T. G. Brown Works Manager
TYPED OR PRINTED
I CERTIFY UNOEfl PENALTY OF LAW THAT f HAVE PERSONALLY EXAMINED
ANO AM FAMILIAR WITH THE INFORMATION SU0MITTEO HEREIN ANO 0ASEO
ON MY INOLNRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
OBTAINING THE INFORMATION 1 PEI IEVE THE SUBMITTED INFORMATION
IS TRUE, ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE SIG
NIFlCANT PENALTIES FOR SUBMITTING FALSE INFORMATION INCLUDING
THE POSSIBILITY OF FINE AND IMPRISONMENT SEE 18 U5C 4 10OI ANO
33 USC 4 1319
uufi^f <A-sr HnfuJi IT ifirii r'icJjj.fr (u\rn aft t(t twtuto
and/or mo ximutii imfirttomfirui of {>i Ui-ccn H mmi/im ttmi 5 u^rW
r5X''fiyL tMDAEr p,HGbTiT:jf?F dryi t/etf tii Nt,1
M ,,'j 'w"')
TELEPHONE
DATE
SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT
318
AREA _CQJ5L J
491-4500 86
NUMBER
YEAR
02
MO
28
DAY
THERE SHALL BE NO DISCHARGE OF FLOATING SOLIDS'OR VISIBLE FOAM EXCEPT IN TRACE AMOUNTS.
* Duration of excursion did not exceed 60 minutes and, therefore, did not constitute a violation.
Intr
SL 1278
V Form 3330-1 (F
0-79) PREVIOUS
riON TO BF. llfiFD
rHTPr ATFS FRA TORM"
permittee name/address (intitule
i ticiltly /Vtii'if /Ltittilttm tJ different)
NAME__ PP G INI).__________ PAD DRESS . 0 30 X 10 0 0
LAKE CHARLES
LA 70fa0 2
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM {NPDKS}
DISCHARGE MONITORING REPORT <DM>
(216)
(17)9)
F - FINAL LIMIT fa
LAO000/61
005
faURFACE RUNOFF
PERMIT NUMBEH
DISCHARGE HUMBER
Form Approved 0MB No. 2040-0004 Expires 2-29-84
.MONITORING PERIOD
FACILITY
LOCATION
11 Yrt:
T. G. Brown,
PARAMETER
{32.J?)
YF A FI 86 _
MO
Q2
DAY
YEAR
MO
OA Y
.01-. TO 86 Lq^ __28 J
i
Planb Manager
X (.1 Card Only) QUANTITY OR LOADING
{4d-3J)
(5461)
AVERAGE
MAXIMUM
UNITS
(/ Curd Only)
OS-15)
M 1 N1MUM
NOTH: Read instructions before completing this form.
QUALITY OR CONCENTRATION
{46-5J)
{54-61)
AVERAGE
MAXIMUM
UNITS
NEOX. FAnNEACOLUYFESNISC Y SATYMPPELE
(iW-A,Y>
[6V ?(ti
1 I: UP f: KA I URL , WATER MEASSAUMRPELMEENT l)i:G. FAHRENHEIT
0 0011 1 0 EFFLUENT GROSS
VALUE REQPUEIRREMMITENT
r 'W KATE
MEASSAUMRPELMEENT
0 0 05 SID AFFLUENT GRUSS
VALUi REQPUEIRRMEMITENT
far* H
0 04-00 1 0 LFFLUIHI UR Ufa
MEASSAUMRPELMEENT VnLU! REQPUEIRRMEMITENT
403 30da avg
V -nr'f'
i ^ ^4:44- 4^
680
V- GPH
DAILY M X
-tr-7 ' i
4* V *
*
7.3 6*0
minimum
00
j"-*
cU zn r ii n
jjc >Jc jf: =4=****:fc
:JoJr:<c:fc >|e**fr**
84
10.2* 9*0
MAXIMUM
NA 3/7 GRAB
DEG. F
T HR EE, 'GRAB
WEEK J}a C
NA 3>7 GRAB threeJ 'GRAB
WEEK
0
2 3/7 GRAB
THREE 'GRAB
WEEK
MEASSAUMRPELMEENT - ,
REQPUEIRREMMITENT
M EASSAUMRPELMEENT
REQPUEIRRMEMITENT
' M EASSAUMRPELMEENT REQPUEIRRMEIMTENT
r
MEASSAUMRPELMEENT RttQPUEIRRCMMITENT
----------
NAME/TI tle principal executive officer
I CERTIFY UNOER PENALTY or LAW THAT I tIAVF PERSONALLY EXAMINED AND AM FAMILIAR WITH THE INT f mMA T ION SUBMITTED HEREIN ANO ElASED
TELEPHONE
T. 6. Brown Works Manager
PE^ORR <P .R....I.N.....T. .E....D
ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY FiE SPONSIBLE FOR
OBI MNING THE INFORMATION I Ttft if.VL IMF SUOMITT FO JNFtJFTMAHON
IS TRUE ACCURATE AND COMF1 I TE I AM ft WARE THAI DlERl ARC SIG
NlF 1C AMI r'F.MALDES FOR SUUOUMNG I AIM lNffjHMADON iMCl DOING
33 USC 1319rue PossmiUTY or r inf
$ nriri '<' funxutiutti n>t}Ui*oni\v
and
nHf tuu/i'-Ar*
irlhAn ir'rruis6uo,m4nJRtmmjJ,fOi n>1i \i
ttumtisisfec->ir^ttihitgiorivu(sfUeft
u$p ioTiloJi RMaMndR
l ^-*--
SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT
318
AREA"
-CQ-PE
(T'/fX:
A0YI o'8KAlit!,l('t/P`,'lF Il'fj'W'lT'K'fi ''XL i Ufa UR V^hlLE FOAM EXCEPT IN TR ACL AMOUNTS
491-450C 86 02 28 m MO DAY
47279
* For pH, see letters of 2/26 and 3/5 as noted in Attachment I
/ i i jjiji . .ji-u / t <nutur>\ if fJ tfl i're nt )
*ahe_ ppg_in[l ad pfiess H.__U liU X 1O G U
LHARL E>LA_7JJ6U^
. uui.iiniu.t. lUMihAMUN b^SIEM (iVJVWJj
i-orrn Approved
DISCHARGE MONITORING REPORT (UMfl)
(21C)
117 !!>j
F - FINAL LIMITS
OMB No. 2040-00v< Expires 2-29-84
AREA li UNCONTAMI NATED CTUD
MONITORING PERIOD
FACILITY____________________________________________________________________________________
LOCATION_________________________________ ________________________________________________
'iljj: __T. G. Brown, Plant Manager
YEAR 86.
titi itf
MO
02
a: ib
DAY
YEAR
MO
OIJ TO 86 02
it* tb
m nt on jv
OAT
28 .
ne-.it/
NOTE: Read instructions before completing this form.
PARAMETER
X (3 Cant Only) QU ENTITY OR LOADING
AVERAGE
MAXIMUM
UNITS
{4 Cant Only) {JH-4S)
MINIMUM
QUALITY OR CONCENTRATION
(46~S J)
(54-6t)
AVERAGE
MAXIMUM
UNITS
NO. FREQUENCY
EX
OF AN ALjVSIS
<d4-AA)
SAMPLE TYPE
|697tl)
FLOW HA f It
SAMPLE
measurement
>>iio6G i U
PERMIT
EHtLUENT GROSS VALUl REQUIREMENT
f. '0MJ.UM, total l As Cl!}
SAMPLE MEASUREMENT
0i034 1 0
PERMIT
cFULUlNT
gruss
: * requirement
valu
CHLURlNATbD HYDRO-- CARBONS T GENERAL
SAMPLE MEASUREMENT
10
PERMIT
E F Fl OEM T GRUSS VALU; REQUIREM ENT
SAMPLE MEASUREM ENT
149
*** ***
30DA AVG
.008
b
DAILY AV
*
68 4 DAILY AV
216
***** * GPH
DAILY MX
.002 16 LBS A> '
DAILY MX
*
1368 LbS/D1 ' DAILY MX
***** *
******
s? * * * * *
******
fr- ^ ^
-v*
******
****** ****** ****** ****** ******
******
****** 'Jot':****
**** *? :
NA :*****;
****** ******
*****>
0
*4:**;*:
****** *****? c
C0NT RECORD CON Til iRCQRDUUUS
3/7 24 HC THREEj 'COMPZi
WEEK \
****** *****=
THREE; 'C0MP2 WEEK -----r-----
PERMIT
requirement
SAMPLE M EASUREMENT
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
PERMIT
requirement
SAMPLE MEASUREMENT
>
PERMIT REQUIREMENT
NAME/TITLE PRINCIPAL EXECUTIVE OFFICER
T. G. Brown Works Manager
TYPED OR PRINTED
* See Outfal1 018
I CLW1IFV UNDER PENALTY Or l AW THAT I ISAVt PE USON At L Y EXAMINED
AND AM FAMIUAR WITH THC FNF OHF*1A 1 fON SirfJMirFF.D HEREIN AND OASEO
ON MY INQUIRY OT THOSE INDIVIDUALS IMM EOF A I E l Y R E Sf'ONSlOl. E FOR
OBTAINING THE iNFORMAIlON I flF,( IfV 1 HI SUUMinfD INFORMATION
FS TRUE ACCURATE AND COMI'i ETC I AM AWARF THAT THERE ARE SlC
NIFlCANT PENALTIES FOR S Uf MI I flNG F At SI' INFORMATION ir-JCl UDING
1H POSSiOlUTY OF FINE AND IMPRISONMENT SI I fJ U S C 5 IOO I AND
S3 U SC 4 1319 ft'ei\u!tti-< rrrnRv flnsf sf<itiif> > rum nu huti-
up tit t Hi ttfllf
tintt'nr inn n/uuni tinjm 'itntiurn i >! tutu i ru *< num t '> < tun! 1 krit*. J
WIT1' iV'^nrGr 'Old L 018.
TELEPHONE
318SIGNATURE OF PRINCIPAL EXECUTIVE
orncEn OR AUTHORIZED AGENT
A FI Fa _Q.
491-4500
NUMBER
86
A Form 3320-V (f
IOUS io T
I 0-79) PfJEv
TION TO BE USED
ihfpi acts i:pa ronwl
WHICH MAY Hn I Ti
ur- n o, f, < t}
047280
PERMITTEE NAME /ADDRESS (Include t hi iSiii A'rir ftAt* iiftfn if different)
NAME___ PP G 1 ND__________ ADDneasP> tJ *_j^ux_ iouy_
LAKE CHARLES
LA 7U60 2
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (ATU/..I)
DISCHARGE MONITORING REPORT (l)MH)
(2 1G) ______
(1719)
F - FINAL LIMITS
LAO 000 761
Oil MERCURY CfcLLS SEWER
PERMIT NUMBER
OISCHMIGE NUMBEfl
Farm Approved
OMB No. 2040-0004 Expires 2-29-84
MONITORING PERIOD
EACILHY_ LOCATION
YEAR 86
MO 02
0O1AY j| TO
YEAR 86
MO OAY
02 28
ill n:
T., G. Brown, P ant Manager
t:o in tJJ i if tu Ji)
t2*-W t:>t i*i UOM)
NOTE: Bead Inslruclions before completing this lorm.
PARAMETER
(J Cartl Only) (46-51)
QUANTITY OR LOADING (54-61)
AVERAGE
MAXIM UM
UNITS
H Cartl Only) (3S-45)
MINIMUM
QUALITY OR CONCENTRATION
(46-53)
(54-61)
AVERAGE
MAXIMUM
UNITS
NO.
frequLncV
OF ANALYSIS
[62-61 164-68)
SAMPLE TYPE
169-70}
PU'lN KA1E
SAMPLE MEASUREMENT
187
241
t
NA C0NT
RECORD
lCMjSB
1
0
PERMIT
LFFLUENT GROSS VALU1 REQUIREMENT
* V*
tf
30 DA AVG
Gf*M DAILY MX
c CONTI; JR CORD,
uous
' CURY , lOIAL l AS NO
SAMPLE MEASUREM ENT
.012
.029
* * ** jJC
:
0 3/7,
24 HC
1 L'>U0 1 0
PERMIT
i'LUEM T GROSS VALUi REQUIREMENT
*21
DAILY A V
.42 LfcS/D) DA ILY M x
: THRj EEi 'COMP 2 WEEK
f. A M PL E MEASUREMENT
PERMIT REQUIREMENT
1
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
--
NAME/TITLE PRINCIPAL EXECUTIVE OFFICER
T. G. Brown Works Manager
TYPED OR PRINTED
I CERTIFY UNDER PENALTY OF LAYe fHAf < HAVE f't HSONAL L Y EXAMINED
AND AM FAM<LJAR Wll H tl fE tfff DRM AI lON SUBMITTED HEREIN AND BASED
ON M< INOUIRV OF THOSF fNlH VtfJlJ AL 5 IMM F f >1A T F.l Y Rf S I'ONSlBl E FOR
OOTAfNING THF INFORMATION I UFMCVf Tuf Sl'BMiTlfD INFORMATION
IS TRUE ACCURATE AND COMI'l F IF t AM
THAI 11 if j||' ARE SlG
Nlf 1C ANT PENALTIES FOR SllRMirTINC F Al Rf iNf OJtMA I ifjri iTIt L DOING
1 HE P OSS IBM IT Y OF TINE AND TMRRlSORMI N 1 St C Ifl DSC t 1CK) I AND
33 U SC ^1319
tm.it r tin.,-
........... . m in. fmC'
iu, JFfjfrn/F
f,tlfi^eN%Tpyi!lTltm^ftNt^XUAI19Nf!L!k,CURY",CT:t,L,S',,'SL,:W.R (iEE PPG DWG
TELEPHONE
318SIGNATURE OF PRINCIPAL EXECUTIVE
491-4500
(Ji l ICEli on AUTHORIZED AGENT
aIieTa QDE
NUMBER
2i>A- 1 -- 1 5 77-- P--6 r STRfcAM:* 5,6).
tlll-Rir SHAl^Iit NO DISCHARGE
m NLI 'ill. IS SUM1 Oil AN LI
OF FLOATING
GULIOG'UR VIABLE FUp.M EXCEPT
1R TRACE AMOUNTi
86 02 28
YEAR
047 281
futility i% tim* /Lot mum if {liffrrrnt) NAME_____ fL' k__ IN D __________________
ADDness I1 * 0* tJ UK 1000 LA K Li CHARLES
LA 70bU 2
I ULLUIAH ulbLHAHOL LLIMI^AtlUN bVbltM l A FNL.IJ
DISCHARGE MONITORING REPORT (/JMK)
f 2-JfiJ
f 17 191
F - FINAL LIMITS
LAO 0 00 761
111 MERCURY TRACE hEWER
PERM IT NUMBER
disckaf^Ge NUMeen
roati Mpptoveu
0MB No. 2040-0004 Expires 2-29-84
facility________________________________________________________________
locat;on_______________________________________________________________
vt in: T. G. Brown, Plant Manager
YEAR 86
(;ii in
MONITORING PERIOD
MO DAY
YEAR
MO
02
01 . TO
86 02
m in in hi
ami nmti
DAY 28
iw-.ii/
NOTE: Read inslructions before completing this form.
PARAMETER 02-17)
(f Cnril Only) QUANTITY OH LOADING
146-53)
(54-6!)
average
MAXIMUM
UNITS
LLUW HATE
SAMPLE MEASUREMENT
uOUbL! 1. 0
PERMIT
i- l: ELUENT CKOii. VALU REQUIREM ENT
373
^TY)tr>r -S # Jy
30UA AVC
493'
Jf f
ij; gpm
DAILY MX
(V Ctirtl Only) (JKHJ)
MINIMUM
QUALITY OR CONCENTRATION
(46-5J)
(54-61)
AVERAGE
MAXIMUM
V**:* t)' ^
St:**#**
UNITS
NO. EX
Ffi EQU ENC * OF
ANALYSIS
[62-6J
*
SAMPLE TYPE
-RECORD. CONTI jRCORU uous
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
SAMPLE M EASUREMENT
1
PERMIT REQUIREMENT
SAMPLE M EASUREMENT
j
PERM IT REQUIREMENT
SAMPLE M EASUREMENT
/ PERMIT
REQUIREMENT
SAMPLE M EASUREMENT
PERMIT REQUIREMENT
SAMPLE M EASU R EM ENT
PERMIT
1
REQUIREMENT j
NAME/TITLE PRINCIPAL EXECUTIVE OFFICER
T. G. Brown Works Manager
TYPED OR PRINTED
I CERTIFY UNDER PENALTY or LAW THAT i HAVE PERSONALLY EXAMINED AND AM FAMILIAR WITH THE INFORMATION SUHMiriED HEREIN AND BASED ON MY INQUIRY OF THOSE INDIVIDUALS IMMF >i A1 ELY RESPONSIBLE FOR OBTAINING THE INFORMATION l RELIEVE 7 HT SUBMITTED INTORMANON JS TRUE ACCURATE AND COMPLME | AM AWARE THAT TuFRf ARE SKi NlFICANT PENALTIES FOR SUDMM'IING FAL SF INFORMATION INTI DOING The POSSIBILITY of Fine AND iMPJf ISONMEN T SEE 10 USC 5 I CXI! AND 33 USC S 13 19 (t'fttufiirs innfir On s,' i r rr J11 ^ ^ fun nu'iiutr ftm s u/> In SJliliilii
OMMENT AND EXPLANATION OP ANY VIOLATIONS ilii't*'
nil , riN iiDu mi )u 11 )
|
k-l=L
TELEPHONE
SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT
318
491-4500
86 02 28
DAY
\ form 3320-1 (F
ousiw DON
10-79) PREvi I IMTfl
TO RE US CD
( FT I- PLACES TP A FORM*
WHICH MAY MOT fir II r, [>, i > i
"i -j t -
# 047282'
PERMITTEE NAME/ADORESS {/nctude
Ittdlft} ftamr/tM*aiHm if iitOrrtttt)
ruM fPjG _1 Ni i_!
APDREOg p_._o. _]^ox__io_yy LAKE: CHARLES
LA 7U6U2
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM IA77JL.S)
DISCHARGE MONITORING REPORT
_________________ 1,7191 -
F
LAU 000761
013
SUM
PERMIT NUMBER
DISCHARGE NUMBER
FINmL LIMITS UF 012,016,016
Form Approved
0MB No. 204u-Guo4
Expires 2-29-84
FLOW
MONITORING PERIOO
FASJfcLir______________________________________________________________________________ LOCATION__________________________________ ___________ _________________
YEAH 86
MO 02
DAY 01.
YEAR
MO
TO 86
02
DAY 28.
,1 IN:
T. G. Brown,
PARAMETER
02 *7)
Plant Manager
(J Card Only) (46-SJ)
tin Iti til iff
OUANTITV OR LOADING
04-61)
iU J1/
tit 2 ft
(J Card Only)
AVERAGE
MAXIM UM
UNITS
MINIMUM
f-MMt NOTE: Read instructions before completing Mile form.
DUALITY OR CONCENTRATION
fti-JJ)
O-l-il)
AVERAGE
MAXIMUM
UNITS
NO. EX
FRCQUCNC Y ANAoLYrSIjS
162-61) [64-fiHy
SAMPLE TYPE
169-70)
> i_t.iL) kATL
sample
MEASUREMENT
)i`6U 1 0
PERMIT
n-FLUENT Gktl 2 S VALUl REOUIREM ENT
146.938 it:**)***
30DA AVG
164,589 GlM
DAILY MX
+ * fj ){; ?}: V/:
# * j? * $
=*&***} NA
*
CONT CALC
CQNTI^ ICALLI UQU6
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
sample
MEASUREMENT
_____ i__ i
PERMIT REQUIREMENT
SAMPLE M E ASU REM ENT
PERMIT REQUIREMENT
SAMPLE M EASUREMENT
TERMIT
REQUIREMENT
SAMPLE MEASUREM ENT
PERMIT AEQVHH EM ENT
NAME/TlTLf PRINCIPAL EXECUTIVE OFFICER
T. G. Brown Works Manager
TYPED OR PRINTED
I CFFiriFV UNDER PENALTY or LAW THAT I HAVE! PERSONAL! Y EXAMINED
AND AM FAMILIAR WITH THE INFORMMlON SURMUfEO HEREIN AND DASED
ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIAIELY HE SI lUNSl Ul E TOR
OOTAININt; THE INFORMATION I OFLJEVE 1HF SUBMIT! ED INFORM A MON
IS TRUE ACCURATF. AND COMPLETE J AM AWARE THAT THERE AHF SIG
NIEICANT PENALTIES I OR SUHMII T iNG F At r-.F INT ORM A T ION INCLUDING the rossioiLirv or fumc and uiiMiisoNMrNt si f. m lpsc $ 1001 ano
33 USC $ 1319
utuUt th.s, HiUi.frv rnm im Uut>' ft'"-' "!>
,j ,,,i i,r mnumurn .....................
-f ........... t, i.ni l/^ -in,/ < k.p,, J
tttnuui
: OM MENT AND EXPLANATION OF ANY VIOLATIONS (AY/t'ttnu'ftH nthn htn$ >U s j i )
TELEPHONE
DATE
signature or PRINCIPAL executive OFriCEH OP* authorized agent
318
A f! ETA -CUBE.
491-4500
NUMDER
86
YEAR
02
MO
28
DAY
047284
11TTCE NAME/AODRESS i Include ,< fiame fl fKctuui if (Itftcrtftl)
JNIU_________
as_-_0^ JU >L MUU___ ]_A KE_ ti !A RL fc>____
LA 70602
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM iNt'tU.S)
Fomi Approved
DISCHARGE MONITORING REPORT (M)
(2)6)
117 19)
!` FINAL LIMITS
OMB No. 2340-0004 Expires 2-29-84
LAO 00076I
017
LEAD TREATMENT DISCHARGE
PERMIT NUMBER
OISCHAHCC NUMBEn
NATION_____________________________________________________________
iN: , T. G. Brown. Plant Manager
PARAMETER 01-17)
{i Cunt Only) 06-51)
AVERAGE
YEAR _86_
MONITORING PERIOO
MO DAY
YEAR
.02_. -QI_J
LS6____ 1 TO
QUANTITY OR LOADING 154-61)
MAXIMUM
O C/1/lf Out?) MINIMUM
MO OAY
02 -
NOTE: Read instructions before completing this form.
QUALITY OR CONCENTRATION
AVERAGE
MAXIMUM
UNITS
FREOtl NC Y OF
ANALYSIS
(64-6H)
SAMPLE TYPE
(6V-7U)
,.riW RAIL
SAMPLE MEASUREMENT
uU5 I O' I-FLUH1T GkUSS ' lDSt TOTAL oSPENDED >0530 I 0 FFIUEMT GROSS .. E mD t TUTaL
(AS PD)
1L061 I 0
EFFLUENT GROSS
PERMIT
VALUil REQUIREMENT
SAMPLE MEASUREMENT
PERMIT
VALUfl requirement
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
26
sjc#* >Me
30DA AVG
.001
5. 1
daily av
59
DAILY MX
gpm
4.6
4r
* LBS/DY
.002 IO. 1 LBS /Dsr
daily mx
******
* * *** *
******
#****
****** ****** ******
NA
*****':
****** ******:NA ****** *****.'; ****** *****k
CONT RECORDi
CONT1$RCORDJ UOUS
3/7 24 HC
THR EEfC0MP2 WEEK
3/7 24 HC
THR EE/C0MP2 WEEK
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
PItftMIT REQUIREMENT
7285
0*
PERMITTEE NAMC/ADDnt'SS {hn latte tin till) ,Vnif /t.inaiunt if tii!)lf<tU)
_________
APOflEB8^ ll__ OUX 10 00
LAKE CHARLES
LA 70602
NATIONAL Pol LUTANT DISCHARGE ELIMINATION SYSTEM (A')
DISCHARGE MONITORING REPORT )UMI()
(*16)
(17 19)
F - FINAL
LIMITS
PROCESS WASTEWATER
Form Approved OMB No. 2040 0004 Expires 2 29-84
FACILITY LOCATION
.1 IN:
PARAMETER 02)7)
GLOW LA It
fa AMPLE ME/SUHEMENT
YEAR
. 86_ i.ut u>
MONITORING PERIOD
MO DAY
YEAR
MO
DAY
l.QU
l_28_J
02___
TO 86____ uQ2_
tilth tu t*t
fi*-i?f ti*th riff-1//
NOTE: Reed Instructions before completing this form.
(J Curt/ Onl>)
QUANTITY OH LOADING 04-61)
AVERAGE
MAXIMUM
UNITS
{4 Cant Oniy)
OiMJ)
MINIMUM
QUALITY OR CONCENTRATION
{46-5) J
{54-61)
AVERAGE
MAXIMUM
UNITS
NO.
FDEQUENCY OF
ANALYSIS
IGJ-AJJ
SAMPLE TYPE 1
169-70)
* 4- * ** *
******
jjt***^:* * * * * :'r;
5,608
6,260
NA
CQNT
RECORD
U u'i IJ 1 0
PERMIT
KFPLUkNr GROSS VALU REQU1R EMENT
, b-- DAY t2U DEG. C)
SAMPLE MEASUREMENT
I 0J'J-IO
PERMIT
EFFLUENT GROSS VALlM , REQUIREMENT
jULIDj,
TOTaL
SUSP CRD FI J
CAMPLE MEASUREMENT
JUS30 R 0 SEE: CCMNEm'IS lflow JULIUS. TOTAL SUSPENDLD
PERMIT REQUIREMENT
CAMPLE MEASUREMENT
I 0()0n.M)
PERMIT
i. I-N UfNl GROSS VALU! REQUIREMENT
t'UIAL ORGANIC CARBOi i CAMPLE
n oc)
MEASUREMENT
JOiioU 1
PERMIT
-H-LUGNT GROSS VALUl requirement
:: (JR IN A 1 If U HYDRO 'S. .GUMS, GLUCRAL
SAMPLE M ITASUREMENT
/A032 I 0
PERMIT
t: F FLU; NT GROSS VALU REQUIREMENT
30 UA AVG
309
77 4
daily av
2,011
. 3 10 0 ^ODA AV
2,125
A 50 0 Daily av
823
1210 0 DAILY AV
62
68 6 DAILY AV
tC ** >>* =!c
DAILY MX
g?m
468
129 8 LBS/D " DAILY MX
** '4* *
LBS/D* ** ** *
1r
5,785
b 70 o LBS/01 U/iILY MX
1,021
26-0 0 LBS/D' DAILY MX
184
136 6 LBS/D' DAILY MX
****** >>; * # sfc-J:* * * *$
******
****** 4- 4) * 4 * -r ****** ****** ****** ** * =?o)i * ******
******
%****.:
**-}.***
****** 0
****** *****^ :
C0NTII IRCURD
UOUS
1/7
24 HC
WEfcKL' 'CUMP2
****** ^ * ** *> = 0
****** ** ***?,
****** *****0
sj. a|r jjc fa
LjfC , Jc
y.*-***? 0
t
* J): I-Ic * * * ******
nr ^
`f'
0
* $ >M1: =1-
3/7
24 HC
THREE> XOMP2
WEEK
i
3/7 24 HC
THR EE) 'CDMP2
WEEK
3/7 24 HC
T HR EL; 'COMP2 WEEK
3/7 24 HC
THRtb) 'CUM? 2 WEEK
SAMPLE M EA SU REM ENT
PERMIT REQUIREMENT
NAMC/TITLE PRINCIPAL EXECUTIVE OFFICER
T. G. Brown Works Manager_
TYPED OR PRINTED
I CERTIFY UNDER PENALTY OF LAW THAT i HAVE PERSONALLY EXAMINED AND AM FAMILIAR WITH I HE iNFOHMATfON SUBMITTED HEREIN AND BASED ON MY INQUIRY OF THOSE INDIVIDUALS IMMIDlAIELY RESPONSIBLE FOR OBTAINING THE INFORMATION l flEMEVE Tj IF SUBMITTED INFORMATION IS TRUE ACCURATE AND COMPIFIE I AM AWARE TllAt THFRF ARE SlG NIFICANT PENAk TIES FOR SUBMIT IING FALSF INFORMATION INCI UQING THE. POSSIBILITY OF FINE AN!) fMflilsONM ENI SEC SO USC * IOOI AND 31USC S13I9 Sl\;,uttn,, jjjmRv rA.-.v u.ifuln m.n j ntlu.fr /in, % on U, t to non utui'ttr ............... . ............................. i it, n U ninths miW S n.ir. ;
SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT
ulli AND 01 u. TSS IS ANNUAL AVERAGE.
TELEPHONE
318
All E A
_>J3E.
491-4500
NUMBER
86
02 MO
28
DAY
,m
\
, Pnrtn 3 WO-1 (RbBP|0-79) PnEVltius rniriON to nr. iipf.it
mrn Ai-rr mT rmin
047286
iuttiiix ft a.fn/L.otaiinn 1/
GNAME___ FF 1 HI.1 _______________ adoremP* I-1*_HO X IQOp____ _______ tAJ<e_CHARLt5i________
LA 70602
DISCHARGE MONITORING REPORT (l)Mlt)
(2 16)
(17 19)
LAO 0 00 761
L*1
IJI .ij
P - FINAL LIMITS CUULING WATER
PERMIT NUMBER
OfICHAROE HUMBER
ruutt
VU
OMB No. 20-iO-Uuu-;
Expires 2-29-84
MONITORING PERIOD
EAQatDf---------------------------- -----------
LOCAT1 N_________________ _____________ _________ ]___
,1 fM:
YEAR
MO
DAY
YEAR
MO
OAY
J -OzJ86. QZr. ..QiJ TO .86.
L28J
i: id in ii/ in hi
m i// iu w tu n/
NOTE: Read instructions before completing this form.
PARAMETER {32-1?)
X (J Card Only) QUANTITY OR LOADING
(46-11)
(14-61)
AVERAGE
MAXIMUM
UNITS
(4 Card Only) (iS-45)
MINIMUM
QUALITY OR CONCENTRATION
(46-51)
(14-6!)
AVERAGE
MAXIMUM
units
NO.
FREQUENCY
OF
ANALYSIS
J (AJl-rtSf >
SAMPLE
TYPE
i 69 ^
IEMPERaTUKEI WATbR ULG. FAHRENHEIT
SAMPLE MEASUREMENT
JJOll i 0
PERMIT
i-R-LUENT GROSS VALUf REQUIREMENT
444 44 4 444 if.& ;jc
4 44 44 4 444.44 4 44 'Me 4 -2e.if.lf :}.4
444444 -4s ^ X* ^
76
444444
89 NA CONT RECORD
444444 DLG. F
CONI 1) 1RCUKU
uous
i-' 'W RATE
U0050 1 0 EFFLUENT GROSS
SAMPLE MEASUREMENT
___ U34J____
nrlQU it
444 44 V
VALUF ; REQUIUEMfiNT 30 Da avg
-16 JQQO-- .
4 44 44 4 GPM DalLY MX
444444 44 4444
444444 444444
444444 444444
4444 4-1
na
44444 :
CONT RECORD CONTXI IRCORUi
UOUS
PH
sample
MEASUREMENT
OU4GO 1 0 LFFLULNT GROSS
PERM IT
VALU! REQUIREMENT
SAMPLE MEASUREMENT
444 4* 4 + 444
44444 4 444444c
444 44 C 444 44 j
6.2
444444
MINIMUM
444444 444444
10.6
444444 su
maximum
i
NA CONT RECORD
CONTir IRCORU
UOUS
i
PERMIT REQUIREMENT
SAMPLE M EASUREMENT
'
F'tRMIT REQUIREMENT
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
PERMIT
requirement
NAME/TITt-E PRINCIPAL EXECUTIVE OFFICER
1 CE RTIF Y UNDER PFNAITY OF LAW THAT \ HAVE PERSONALLY EXAMINED AND AM FAMILIAR WITH THE INTOffMA TION SUDMiTTED HEREIN AND BASED
TELEPHONE
ON MY INQUIRY OF THOSE INUfVIDI FAL S IMMEDIATELY RESF'ONSfFJl.E FOR
T. G. Brown
OBTAINING THE (NT OR MAT ION l Itfl lEVE T HE SUBMITTED INFORMA TION IS TRUE ACCURATE AND COMP) E IF I AM AW4KF THAT fHENC A HE SfC.
Works Manager
NlFlCANl PENAl TIES FOR SUDMiTfJNG FAI^r INFORMA rION INCLUDING
THE POS^IRtUlY OF FINE AND IMHRISOHM TN T SEE IB USC * lOOl AND
S3IJSC ' 1119 ffrautl,,.*
4I,,|,,|, , m,.,
f........
fuuuu,
318
SIGNATURE OF PRINCIPAL EXECUTIVE
491-4500
TYPED OR PRINTED
OFFICER OR AUTHORIZED AGENT
"a ft ?a CPP
NUMBER
if *oimwrc&t( wftlr/n'xTm '"si'il ids uu visibLt. kj am lxc epr in trace amounts .
86 YEAR
02 MO
28
\ Form 3320-1
previous edition to nr used
(itrni jrr? fpa ronri '
FWHICH may no-'- nr ineni
104 7288
PERMITTEE NAME/ ADDRESS tlncltnlr t iwtlttt Attmie /i.M ufjim tf itiflrrfnt) NAME___ P.^G it'll'.
AO DRESS f' 0 .___ OX 100 5______________________________________________
______ LAKJL (J-IARLjiS`LA_7_Q60ji
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (Nl'tih.S)
Form Approved
DISCHARGE MONITORING REPORT (OWK)
(2i fi)_________________
mmF - FINAL LIMITS
OMB No. 2040-0004 Expires 2-29-84
LAo uut>761
024
SURFACE DRAINAGE - PRODN *TRG
PERMIT NUMBER
OISCHABOE NUMfiCR
LOCATION
PARAMETER (i 2-J7)
YEAR 86 i:a I//
MONITORING PERIOD
MO DAY
YEAR
MO
02 u.' li)
01 w ist
TO 86 , 02 121 12/ lU-2*/
DAY 28 i.lB-tl)
!{.* Cant Only) (4S-S3)
QUANTITY OR LOADING IU-6I)
(/ Cant Only)
QUALITY OR CONCENTRATION
(V6-JJ)
(S4-6I)
AVERAGE
MAXIMUM
UNITS
MINIMUM
AVERAGE
MAXIMUM
UNITS
NO.
FM EQUENCY OF
ANALYSIS
SAMPLE TYPE
I1 H
SAMPLE MEASUREMENT
UJ4 00 1 0
PERMIT
U-FLUfflT fUUISS VALUl REQUIREMENT
If-*#
#. JScijt
*
7.3 ' 6.0
MINIMUM
aX=S= :Scj9= 5Sf
* CO
11.0
maximum
L =0 H=0 SU
5/7* week
days
GRAB GRAU
sample
MEASUREMENT
PERMIT REQUIREMENT
1
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
i
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
SAMPLE - MEASUREMENT
PERMIT REQUIREMENT
:
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
NAME /TITLE PRINCIPAL EXECUTIVE OFFICER
I. G. Brown Works Manager
TYPED OFT PRINTED
* crnrirv under penalty or law that i havl peftsonally examineo
AND AM fAMILKAR WITH THE JNT OHMA HON SlfOMUTEU HEREIN AND OASEO
ON MY INQUIRY Of THOSE JNDIVIDUAI S IMmF.IISA 1 ELY F^ESPONSlRLE FOP
OBTAINING THE INFORMATION I ClIEVE Tiff SUBMITTED INFORMATION
IS TRUE ACCURATE ANO COMF1 f f F I AM AWAliF THAT THERE ARE SjG
NinCANT PENALTIES FOR SUf'Ml I TING F A L S F INFORMATION INCLUDING
THE POSSimurY or FINE AND IMJ'MISONMIH I SEE 10 USC 5 IOO! AnD
33USC ^ 1319 F/Vmi/fir* muitt
t r i r r m K- y. rurM ifir/iWr f\s\r y up In iiiftuM
mut or /rirri INI II/M oo/iri^o/ioifnf nf Mn IVII H /NrmHiY uruf 1 n'/rfY >
Tftfm AT[tExi|^Trmsf $'"w\'o,rzms (AV/rrc uit allot hm, * Whl^lowing
r)
________
TELEPHONE
(V
SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT
318
"area'
491-4500
DATE
86 02 28 SL 047289
name __ PPG JIM)*.________________
apprebsH 0
L00(>_
J____ LAK _ UMftLLS____
LA 70602
... ----------- i .... . uis^iinnul tLlMIIMI ION SYSTEM [ Hl'tihS)
DISCHARGE MONITORING REPOR T
________ (2 IH)
(1719)
F
-
FINAL
LIMITS
LA0U00761
025
STORM DRaJWaGE 15UU
PERMIT NUMBER
DISCHARGE NUMBER
Form Approved
0MB No. 2u4d-000`f Expires 2-29-84 T/D CHLRH
FiCtLOY_______________________________________ LOCATION_____________________________________
. r rw:
PARAMETER
(37 r?)
MONITORING PERIOD
YEAR
MO
OAY
YEAR
MO
DAY
86. 02 01 TO 86 02 ' 28
ti<* 2lf at 2 */ a* tv
fl* 2Jt a*-tv 1 IS-.II)
NOTE: Read instructions before completing this form.
(J Cart! Otity} QUANTITY OR LOADING
(46-5J)
{54-6! >
AVERAGE
MAXIM UM
UNITS
{*# Card Otiiy)
US-O)
MINIMUM
QUALITY OR CONCENTRATION
{46-55}
[54-6 i)
AVERAGE
MAXIMUM
UNITS
NO.
FREQUENCY OF
ANALYSIS
[62-6J {f/4-6N J
SAMPLE
(V. ?ll)
1- LOW RATE
SAMPLE MEASUREMENT
00050 i 0
PERMIT
GFi-LUiNlr GROSS VA LUf REQUIREMENT
1,406 +-T -i-
30UA AVG
4,067
G P ft DAILY MX
if
5}:#
jjc.
=E 4- **
NA
5/7* GRAB DAILY GRAB
' SAMPLE MEASUREMENT
'-jc XY+ ^j)c 1
8.1
9.6 NA 5/7* GRAB
JOAUO 1 0 EFFLUENT GROSS
HERMIT
VALUt REQUIREMENT
SAMPLE MEASUREM ENT
+ J?.5(C
#
MINIMUM
MAXIMUM
su
DAILY GRAB
\
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
,
--------- f
PERMIT
acquirement
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
tdj;u if REQUIREMENT
name/title principal executive officer
T. G. Brown Works Manager
TYPED 00 PRINTED
I CERTIFY UNDER PENALTY OF LAW THAT f HAVE PERSONALLY EXAMINED
AND AM FAMILIAR WITH THE INFORMATlON SUBMITTED HEREIN AND BASED
ON MY INQUIRY OF THOSE INDIVIDUALS fMMEDlA 1 ELY RESPONSIBLE FOR
OBTAINING THE INF ORMA TlON t nrLIEVF. lllf SUQMIV1EO INFORMATION
IS TRUE ACCURATE AND COMM ETF I AM AWARE THAT THERE ARE SfG
NiFlCANT PENALTIES FOR SUOMI T FING TA1SE INFORMATION INCLUDING
THE POSSIBILITY OF Fltyt AND IMP RlSON Mf NT SEE 10 USC * IOOI AND
33 USC $ 13 19 fl'roofiws mutt r l/n
niniutts Him imiodf fnw% up U> tiltlHtu
o iirl 'or /nn tint uni rmf>rrxomrn-n/ of in Sr, n n A month * iitnf 'i ti'iTri I
';0fniE,TW.D
wPUf6[I'O2N' S (Kf/Tft-
nfi itlNn Jrmrrrt i hi'rr )
TELEPHONE
318 '191-4500SIGNATURE OF PRINCIPAL EXECUTIVE
OFFICER OR AUTHORIZED AGENT
aR^x
.COPE.
NUMBER
fllLKL SHALL lit NO DISCHARGE OF FLOATING SUL I US'OR VISIBLE FOAM LXCCWT IN TK AC b AMOUNT-*.
OUHlVuii WHILE FLUWlntG aLL P>RaMETERc.
* When flowing
DATE
86 YEAR
02 MO
28
SL 047290
\ Form 3320-1 (fit
3-79) PREVIOII*? FlOJTTON TO BE USED
( rrni acts fpa formI
* WHICH MAY r lo->
J I _ F i f 1 J I I l l , , .si.u. / A UCj.< L.S *> l i ttittiiii Stit'u'\f itiQrrrtif )
NAM^_PPA_iyi'_*
NATIONAL POLLUTANT OtSCHAnGK ELIMINATION STSTEM (M/'O/.J)
DISCHARGE MONITORING REPORT i'IMH)
(2-16)
<! SO)
F
-
FINAL
LIMITS
ADDRESS P _U. _EKJ 3i_ I0_00______________________________________________________
LAO 00076I
026
STORM DRAINAGE
_______ LAKE. CHARLES*_________________ LA_")JJ602.____
PERMIT NUMBER
DISCHARGE NUMBER
harm Approved
OMB /Vo. 20-IQ-Ot/d i
Expires 2-29-84
location
\*1N: "
PARAMETER (J7-J7)
F-LUW KATE
0 0 05(1 I
0
lEFLULNI GfUl'.jS
,i
00600 I 0 t: FFLUEUT GRllSS
"
SAMPLE MEASUREMENT
PERMIT
VALlJt REQUIREMENT
CAMPLE MEASUREMENT
PERMIT
V A LU 1 , requirement
CAMPLE MEASUREMENT
FROM
YEAR
86
r.'o ft/
MONITORING PERIOD
MO DAY
YEAR |
02 01 TO 86 |
fliHt 04 JV
O* 2 r/
MO |
L fJK'Jfl
DAY
28
rn-.r/j
NOTE: Read Instructions before completing this form.
(J Card Only) QUANTITY OR LOADING
{46-5))
(54-61)
AVERAGE
MAXIMUM
UNITS
{4 Curd Onty) OS-15)
MINIMUM
QUALITY OR CONCENTRATION
(46 53)
(U-61)
AVERAGE
MAXIMUM
UNITS
NO. FREQUENCY
EX
OF ANALYSIS
Irf 2-b.tt
SAMPLE (6V-7l()
25 64
******
******
****** *****; -
NA
5/7*
GRAB
*** ** *
30DA AVG
i?## ** *
******
DAILY MX
* **** *
gpm
*****;
* **** *
7.4
******
****** ***** C
W EE K- GRAB 6DaY
12.3
NA 5/7* GRAB
*** ** *
* **** * *** *+
* * * ** *
minimum
******
****** su
MAXIMUM
WEEK GRAB DAYS*-------- _j----------
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
SAMPLE MEASUREMENT
PERMIT
requirement
! --------- J------------
SAMPLE MEASUREMENT
PERMIT REQUIREMENT
sample
MEASUREMENT
PERMIT REQUIREMENT
NAME/TITLE PRINCIPAL EXECUTIVE OFFICER
T. G. Brown Works Manager
TYPEO OR PRINTED
I CERTIFY LTNOER PENALTY of LAW THAT I HAVE PERSONALLY EXAMINED
and am Familiar with the information submitted herein and based
ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
OBTAINING THE INFORMATION I RELIEVE THE SUQMITTEO INFORMATION
IS TRUE ACCURATE AND COMPi E l E I AM AWARE THAT THERE ARE SJG
NtFlCANT PENALTIES FOR SUBMITTING FALSE INF ORM A TJON INCLUDING
THE POSSIBILITY OF FINE AND IMPRISONMENT SEE 16 U5C i lOOl AND
33 use 4 1319 fJVfinJftr* muff* iinsr itniutr'.
rMffm/r fttu'* lift fit tt/HHUl
tirtti's if Hitt rtttnirn irnprisniunriil t>{ /ulim ri 0 /uttri th* unit 1 i rum I
ilWffTOK0
PLWS'J^\5a NS (Wr/*'Ffm-f tiff iitfntlriii('/ia firrr)
TELEPHONE
SIGNATURE OF PRINCIPAL. EXECUTIVE OFFICER OR AUTHORIZED AGENT
318
491-450C 86
NUMBER
YEAR
02
MO
28
DAY
\ Form 3320*1 {
* When flowing
0-79) PREVIOUS EDITION TO BE USED
(REPLACES EPA FORM
WHICH MAY MOT PT H^n iVi 00(1 / O /. f> /. O r" .. n ' n -j /><
047291