Upload
trinhtuong
View
213
Download
0
Embed Size (px)
Citation preview
PERMITTEE NAME/ADDRESS (IncludE Facility Name/Location If different) Name KING AMERICA FINISHING, INC.
Address 1351 SCARBORO HIGHWAY
SYLVANIA, GEORGIA 30467
Facility KING AMERICA FI:.:N:::IS:,:.,H:.:.:IN:::.G::!,'-:.:I:.,:N.::.C:_· , ~-::-:-:--=-~-
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) DISCHARGE MONITORING REPORT (DMI
Form Approved. OMS No. 2040-0004
001-1 DMR Mailing ZIP CODE: 30467 DISCHARGE NUMBER
MM
MAJOR
Final Discharge External Outfall Location 1351 SCARBORO HIGHWAY, SYLVANIA, GA, 30467
FROM I 09[- -. I __ . . I NO DISCHARGE [:=:J Attn: MR. Robert R. Lanier
PARAMETER
Temperature, water deg. fahrenheit
00011 1 0 ~ffluent Gross Temperature, water deg. fahrenheit DEG. FAHRENHEI 00011 y 0
VALUE 73.40
Req. Mon. MINIMUM
72.00
QUANTITY OR LOADING
V~L~~=c VALUE ***"'** ~- 82.5.:_
**•*** Req. Mon. MAXIMUM
****** I 87.00
NO. FREQUENCY ! SAMPLE EX OF ANALYSIS TYPE
UNITS --·
deg F 0 Daily I GRAB
deg F 5 Days Every ~-GRAB --1---·
Week deg F 0
Continuous I CONTIN
~ffluent Gross (SupplementaiY) ~.:.: Specific conductance - · ---· -
·--' - · Req. Mon. ...... Req. Mo~n - deg F J~ontinuous 1
MINIMUM JYIAXIMUM ___ _ _ I .... -,..--·- 3,230 3,540 umho/cm I 0 Daily I CONTIN I
CONTIN
000951 0 Effluent Gross Hydrogen peroxide
00139 1 0 Effluent Gross Oxygen, dissolved [DO]
00300 1 0 Effluent Gross Oxygen, dissolved [DO]
***"''~~* •••••• Req. Mon.. l umh I
.... · 1 DAILY .. MX
0
em I ...... I 0.00-·j mg/c ·+o J ___ .D __ aily I CONTIN
Req.Mon. 1 -+r=:=f ~--~· 5.53-----~AILY AV j Req. Mon. mg~ - Dally GRAB . I •••••• ---- DAILY MX ..J.. - __ mg/L
0- ' GRAB ' •••••• j Daily •
--- DAILY G~ 5
-r---.-:-:~-+-·DAILY MN ****** mg/L
0 I
-~
5 Days Every I GRAB w~ek
Continuous IRCORDR
Continuous RCORDR -l---·--------1----
00310 1 0
MEASUREMENT . . . . . . 6·00 I •••••• ~--;..;;;;;---l-m9iL--f-:--L- .. -
00300 y 0 ~PERMIT ...... •••••• I •••••• I 5 -j- ...... ± ...... I Effluent Gross (Supplementary) REQUIREMENT ---· ___ !___ _. INST_MN J _ ------l' BOD, 5-day, 20 deg. c SAMPLE 42 67"j lb/d ****** h 4 mg/L 1 0 51 W k I COMPOS
MEASUREMENT , ee -+- 1
PERMIT L 776 1552 lb/d ****** - ~ 60 J mg/L+ 5 Days Every • ---~ffluent Gross ______ _L REQUIR_~MENT DAIL'(~ _ _Q_~~y MX _ __L__ DAILY AV . DAILY M~ ------ __ _ We~~MPOS
I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED ---r TELEPHONE DATE
mg/L
NAMEfTITLE PRINCIPAL EXECUTIVE OFFICER AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND BASED f--------:::-:--..,..-:::-:--:---------I ON MY INQUIRY OF THOSE INDIVIDULES IMMEDIATELY RESPONSIBLE FOR
Robert R. Lanier OBTAINING THE INFORMATION,! BELIEVE THE SUBMITTED INFORMATION IS TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE ~
Manufacturing Manager stGNIFICANTPENALTIEs FOR suBMITTING FALSE INFoRMATtoiN,INcwoiNG 912 10 I 17
I THE POSSIBILITY OF FINE AND IMPRISONMENT. SEE 18 U.S. C. SS1001 AND .
·------,TY~P=-=E=D=-o=R==-=P=R=JN""T=E=D-·------133 U.S.C. SS 1319. (PENALTIES UNOER THESE STATUTES MAY INCLUDE FINES UPTO AREA'-t--;-;;-;;c;:-; MONTH ~ '-::c~:-=:-=-:-:-:-=-:=:-:-:-:=::-=~-=-=-:-"""c:-::-=-:--:-==-:-c:::-:=-- .1.0..0J!JtA~D..QRMAXIMl.!MJME.BJ.:lQNMENI.O.EJlE.!Wffl'!.ll.MQNil:llUN!li..'I'EARS. c_Q ;..J. ____ __, __
COMMENT AND EXPANATION OF ANY VIOLATIONS (Reference all attachments here)
8005: RL(7.6 ppm)
EPA Form 3320-1 (Rev. 8095) Previous editions may be used. PAGE 1 OF 10
PERMITIEE NAME/ADDRESS (IncludE Facility Name/Location if different) Name KING AMERICA FINISHING, INC.
Address 1351 SCARBORO HIGHWAY
SYLVANIA, GEORGIA 30467
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) DISCHARGE MONITORING REPORT (DMI
Form Approved. OMS No.
GA0003280 DMR Mailing ZIP CODE: PERMIT NUMBER MAJOR
2040-0004
30467
Facility KING AMERICA FINISH_IN.,.,G_,_, I_N:-C,.-. --:-:--::--:--=--
Location 1351 SCARBORO HIGHWAY, SYLVANIA, GA, 30467 Final Discharge External Outfall
NO DISCHARGE c=J ----Attn: MR. Robert R. Lanier
------ - --, c---c-
QUANTITY OR LOADING QUANTITY OR LOADING NO. FREQUENCY SAMPLE PARAMETER -- --------------- EX OF ANALYSIS TYPE
VALUE VALUE UNITS VALUE VALUE VALUE UNITS Oxygen demand, chen. [high level] SAMPLE 2,505 4,158 Ibid ****** 183 214 ·-m9tL
[COD] MEASUREMENT 0 5/Week COMPOS
11000 --- t b/d -i-- --e.-------003401 0 PERMIT 5500 ****"'* Req. Mon. Req. Mon. mg/L 5 Days Every COMPOS Effluent Gross REQUIREMENT DAILYAV DAILYMX DAILYAV DAILY MX I
r ---::~: -r~~;-SAMPLE **t<*** **'if*"'* ***"'** --
****** --pH 7.450 7.780 su
0 MEASUREMENT r---------
****** --- ------;;;;;;----
****** £3"" ____ --------
· ~ 5 Days Every T-~RA~-00400 1 0 , PERMIT ****** Effluent Gross REQUIREMENT MINIMUM MAXIMUM ___ Week
SAMPLE -- --1---------------;---· -PH ****** ....... ...... 7.28 ****** 7.98 su
Continuous I RCORDR MEASUREMENT 0
00400 1 0 PREMIT .... .,..;- --•• .,.*; - ****** 6 ... ., .. -- 8 su . C~ntinuous j RCORDR Effluent Gross (Supplementary) REQUIREMENT DAILYMN DAILYMX Solids, total suspended SAMPLE -ND40 ___ r--- 84 lb/d •••••• ND3 5 *""****
MEASUREMENT 1 5/W... !COMPOS 00530 1 0 PERMIT 2140 4280 lb/d ••••••
30 F., ****'~~* 5 Days Every COMP~-; Effluent Gross REQUIREMENT DAILYAV DAILYMX Dail~g_- ~ily ~~- Week __
--1----- SAMPLE -64.10 75.90 --
r--------r-----· Nitrogen, total ****** '~~***** *11**** ****** mg/L ~0-~ ~UREMEN'
~::: -- I ~:,H t--= - 0
006001 0 ERMIT *•**** Req. Mon. r Req. Mo;;:--- ------mg/L
Effluent Gross UIREMENT DAILY AVG DAILY MX Weekly .COMPOS
Nitrogen, ammonia total [as NJ ~--SAMPLE 22.17 - - T59 2.38 mg/L 0 Daily COMPOS . MEASUREMENT
lb/d--1--·----;;;;:;;-·--r-- - --------::------- -- -00610 1 0
I PERMIT 260 520 7 13 mg/L
Effluent Gross REQUIREMENT DAILYAV DAILYMX DAILYAV DAILYMX Daily COMPOS
I
Nitrogen, Kjeldahl, total [as N: SAMPLE ****** ****** "'***** •••••• 11.80 14.40 mg!L 0 1 I Week ' COMP~ MEASUREMENT --r--****** __j_ Weekly } oMPOS
00625 1 0 PERMIT ****** ****** •••••• j Req. Mon. Req. Mon. mg/L Effluent Gross REQUIREMENT l_ DAILY AV DAILY MX
I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMiNED I Qd~ ~- mEPHONE -------- ---
DATE NAMEITITLE PRINCIPAL EXECUTIVE OFFICER AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN: AND BASED -- ------------ ON MY INQUIRY OF THOSE INDIVIDULES IMMEDIATELY RESPONSIBLE FOR
Robert R. Lanier OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE
Manufacturing Manager SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATIOIN, INCLUDING I ~------- 9121
863-4511 14 10 17 THE POSSIBILITY OF FINE AND IMPRISONMENT. SEE 18 U.S.C. SS1001 AND SIGNATU~E CIPAL EXECUTIVE TYPED OR PRINTED 33 U.S.C. SS 1319. (PENALTIES UNDER THESE STATUTES MAY INCLUDE FINES UP TO I OFFICER OR AUTHOJ31ZED AGENT ~~ NUMBER YEAR MONTH DAY
-- SiQJ!OM!SQ..Qfi.Mli)_(IMUMlM~QNMEMI.QE.IlEIW.EE~M:l:!S.At>IO...o..YeAB.S . \ COMMENT AND EXPANATION OF ANY VIOLATIONS (Reference all attachments here)
Ammonia: RL(0.20 ppm)
------------------- (REPLACES EPA FORM T-40 WHICH MAY NOT-BE USED.) -------------PAGE 2 OFW __________________ _ EPA Form 3320-1 (Rev. 8095) Previous editions may be used.
PERMITTEE NAME/ADDRESS (IncludE Facility Name/Location If different)
Name KING AMERICA FINISHING, INC. Address
Facility
Location
Attn:
1351 SCARBORO HIGHWAY
SYLVANIA, GEORGIA 30467
KING AMERICA FINISHING, INC. 1351 SCARBORO HIGHWAY, SYLVANIA, GA, 30467
MR. Robert R. Lanier
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
DISCHARGE MONITORING REPORT (DMI Form Approved. OMB No. 2040-0004
GA0003280 1~01 -1 J DMR Mailing ZIP CODE: 30467 PERMIT NUMBER _j ~GE NUMBE~
MONITORING PERIOC ----, MM
FROMI 09
MAJOR
Final Discharge External Outfall
NO DISCHARGE L I ----------- - QUANTITY OR LOADI-NG QUANTITY OR LOADING _______ NO. p:REQliENC~SAMPLE
PARAMETER -- -- ------ - EX · OF ANALYSIS TYPE VALUE VALUE UNITS VALUE VALUE VALUE I UNITS
Phosphorus, total [asP] · SAMPLE · ****** ••••- •••• ****** 26.8 31.5 - mg/L - 0 ----- ---MEASUREMENT 3 I Week COMPOS
006651 0 Effluent Gross
r--- . ----------- --PERMIT ' •••••• ****** •••• ****** Req. Mon. Req. Mon. mg/L 3 Days Every
REQUIREMENT DAILYAV DAILY MX Week COMPOS Sulfide, total [as S] SAMPLE 13.5B 19.43 lb/d -- ****** 1.00 -· 1.00 ------ mg~ 0 .
MEASUREMENT I Dally GRAB
00745 1 0 PERMIT 24 48 lb/d ****** l 1.5 3 mg/L -----r-----.---· -------· Effluent Gross REQUIREMENT DAILYAV . DAILY MX DAILY AV DAILY MX j Dally GRAB
1sodium, total [as Na] SAMPLE ; . . .. :..,.:..:...__ ----;;;;;;;;------r----....------;;;;;;---- 610 -- ---696 mg/L -6 -----:- ·--- -----MEASUREMENT Dally
00929 1 0 PREMIT ****** ****** **** •••••• Req. Mon. Req. Mon.- mg/L -- . -----Effluent Gross REQUIREMENT DAILY AV DAILY MX Dally COMPOS 1
_____ _t___ ·;---------------- _________ .,_____ - I
Chromium, total [as Cr] SAMPLE · 0.135 0.148 lb/d ****** 0.01 0.01 mg/L 0 ' 1/Week COMPOS
01034 1 0 PERMIT 12 24 lb/d . ****** 1.2 2 - mg/L - -MEASUREME~T
CoiO<[..,ml ""'~I SAMPLE ·-H H .. H H•• 1---::HH• 61 67 ool ""' 0 ;-j; I Effluent Gross REQUIREMENT DAILYAV DAILY MX ___ .DAILYAV _ DAILY MX _ _ __ Wee_~~- CO~~O~
MEASUREMENT 1 I We.;;-~ GRAB
012901 0 _j PERMIT I *"**** _l;:ffluent Gross --- REQUIREMEN! Color [admi units] 1 SAMPLE 1-----;;;;;;;.- ·
MEASUREMENT
****** Req. Mon. j Req. Mon. I col unirlt ' Weekly~RAB DAILYAV DAILYMX 1 ___ ----- __
•• ;;-----j-------;;;;;;;--t-----:rg_75 -----32.00l col unit -a+ 1/Week CALCTD
**it***
******
01290 1 0 I PERMIT *****:__f •••••• •••• +-...... - ~ Req. Mon. Effluent Net REQUIREMENT DAILY AV
1 Discharge flow as % of stream flow - SAMPLE --;;;;;.. --- ****** ---;;;;;- ;;;;;;---- ___ 1 __ _ 80 j col unit ~ ~ Weekly ~ALCTD
DAILYMX __ ----·--- ----·----2------ --------~ O Daily CALCTD
MEASUREMENT
01352 1 0 PERMIT ****** ****** **"'* ****** I Effluent GrOSl!
Req-. Mon. ----"--D_AILYAV
AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN: AND BASED --r·---- ---REQUIREME~--'-----------~ -----l-- - --- ---,-:-ol CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED
NAME/TITLE PRINCIPAL EXECUTIVE OFFICER ON MY INQUIRY OF THOSE INDIVIDULES IMMEDIATELY RESPONSIBLE FOR
--------:=R:-O-:b-e-rt-::R:-.-:L·-a-n-:i-e-r --------jOBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE
ManufaCtUring Manager SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATIOIN, INCLUDING
8 I DAILY MX _j__~_j_ Daily __l:ALCTD c TELEPHONE -----oATE-- ·---
------- -~ ,-----
D
I THE POSSIBILITY OF FINE AND IMPRISONMENT. SEE 18 U.S.C. SS1001 AND I
TYPED OR PRINTED 33 u.s.c. ss 1319. (PENALTIES UNDER THESE STATUTES MAY INCLUDE FINES UP TO I I DAY I '-=:::-:-:c=====:;...--:-=======:;-;==;:;-;;=:-:-:._.clJLQQOA~O.QB..MAXIMUl>UMEBil>OOME.JiLQU!eiWEEfil..M.QNllia.Ail/0...5.YSARS.l__L . . COMMENT AND EXPANATION OF ANY VIOLATIONS (Reference all attachments here)
Sodium: RL(5.0 ppm); Chromium: RL(0.01 ppm); ADM I Color: RL(25 SU); Sulfide: RL(1.0 pprn:
EPA Form 3320-1 (Rev. 6095) Previous editions may be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) ----------· PAGE 3 OF 10
PERMITIEE NAME/ADDRESS (IncludE Facility Name/Location if different)
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
DISCHARGE MONITORING REPORT (DMI Form Approved. OMB No. 2040-0004
Name KING AMERICA FINISHING, INC.
Address 1351 SCARBORO HIGHWAY - ii(i1::"1---, DMR Mailing ZIP CODE: 30467
SYLVANIA, GEORGIA 30467 DISCHARGE NUMBER , MAJOR
FaciiHy KING AMERICA FINISHING, INC. Final Discharge External Outfall Location 1351 SCARBORO HIGHWAY, SYLVANIA, GA, 30467
Attn: MR. Robert R. Lanier 2014 NO DISCHARGE [___ J ---------------r-
QUANTITY OR LOADING ·-~ NO. r FREQUENCYl SAMPLE PARAMETER I
Total phenols
036041 0 Effluent Gross Flow, in conduit or thru treatment plant
QUANTITY OR LOADING ~~~ -- I:--------1 EX ·~ OF ANALYSIS I TYPE
VALUE 1 vALUE ~NITS ~ALUE VALUE -~~LUE UNITS __ I __ SAMPLE 1.2 1.6 lb/d •••••• 0.09 0.11 mg/L '
MEASUREMENT 0 1 I Week GRAB
--RE;:!NT -:I~V --~~;~;--· -Tb/cr-r---~··***-·--·- ~~L~~~· ~-~ ~~1~~~ ___ mg/L __ ----· ·-···-~:;~--- _ G;;~- · SAMPLE 1.628 2.330 MGD i •••••• •••••• t- •••••• •••• ·
MEASUREMENT I 0 Da1ly CONTIN
I---PERMIT 3.1 Req. Mon. MGD I •••••• -· ****** ****** •••• -- --:- -REQUIREMENT DAILY AV DAILY MX + ,. 4,' Dally CONTIN
500501 0 f:ffluent Gross
Phosphorus, ortho ME::~:~=ENT ---:;;;;;;;;---- -----.;;;;.--- -,;;;;;;--·- •••••• 3A86___ -----6.950 --mQ/L-- -~ . . ---;I Wee; - COM~OS
50785 1 0 ~EMIT •••••• ****** -----;;;;;;;--- ******-- -ReQ." Mon. mgiL - 3 Days Every Effluent Gross ~~IREMENT DAILY MX Week
chloride THPC MEASUREMENT O . 2 I Month GRAB Tetrahydroxymethylphosphonium ~ SAMPLE ****** •••••• •••• ****** ****** 4.61 . .mg/L . ~----- .. -
51757 1' 0 --PERMIT - --....-:;;;;;;-- ----:;;;;;:;;;·--·-- - -;;;;;;;;;---- -- Req. Mon.- - mgiL- ---- Twice EVerY- -·GRA;-
IEffluent Gross REQUIREMENT _ ____ ~LV MX + Month _ Solids, total dissolved SAMPLE •••••• •••••• **** •••••• 2,135 2,380 mg/L
702951 0 Effluent Gross Formaldehyde
71880 1 0 Effluent Gross Mercury, total [as Hg)
71900 1 0 ~uentGross I NAMErriTLE PRINCIPAL EXECUTIVE OFFICER
MEASUREMENT 0 5 I Week COMPOS
PERMIT ••••••3=-. .......-------- ---- •••••• -2500 1 --3800 · mg/L 5 Days Every ____ .. REQUIREMENT · DAILYAV DAILY MX Week COMPOS ME::::EL:ENT •• -;;;;;;;;--- --.;;,;;,;-. - ---;;;;;;;;-.---- o-:-28--·- ---0~ -m g/L - -;;--~ Da~~--- GRAB
!-=PeRMIT ----;;;;;;-. ---........ - ****"* Req.Mon. ----:r:Ef-- --mQIL . -- -·---
± I DAILYAV DAILYMX Dally GRAB
- SAMPLE •••• •••••• •••• L •••••• - •••••• N/A ng/L
1 RE;~=~~ENT ---;;;;;;- --;;;;;;;;----L·-,;;;;;--- ~·=•;---- ·--::__[-.;~ MX -~~"---'E.~-t:: -
Rober! R. Lanier OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS j TRUE, ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE
ICERTIFYUNDERPENALTYOFLAWTHATIHAVEPERSONALLYEXAMINED • ~ l TELEPHONE DATE AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN AND BASED J - I 1
dON MY INQUIRY OF THOSE INDIVIDULES IMMEDIATELY RESPONSIBLE FOR ? f'""'' -
Manufacturing Manager SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATIOIN,INCLUDING ·---- ~L______\~ ------ 912 ~- 863-4511 t 14 10 ~ 17 ~ THE POSSIBILITY OF FINE AND IMPRISONMENT. SEE 18 U.S C. SS1001 AND SIGNAT ~ICIPAl EXECUTIVE
f--- TYPED OR PRINTED 33USC SS1319. (PENALTIESUNDERTHESESTATUTESMAYINCLUDEFINESUPTO OFFICERORAUTHORZEDAGENT AREA 1- NUMBER - YEAR - M ONTH - DAY l____c-=-=-=c::-c:--:-:-::::=:-:-::::::-c:-:-:c-:-:-::-=-:-::= _ $.1llOOOAN!l.QRMtlXIMUMJMP.Bill.O.NMENLQE81illllfE/il..MQillllS.MID..5..Y.EARS. --- I C.ODE . ----L---~--' COMMENT AND EXPANATION OF ANY VIOLATIONS (Reference all attachments here)
Formaldehyde: RL(50 ppb); Phenolics: RL(0.05 ppm); Ortho Phosph: RL(0.02 ppm); THPC: RL(10 ppm); Mercury: RL(0.5 ppt
EPA Form 3320-1 (Rev. 8095) Previous editions may be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) PAGE 4 OF 10
/
I PERMITIEE NAME/ADDRESS (lnclud! Facility Name/Location if different)
Name KING AMERICA FINISHING, INC.
Address 1351 SCARBORO HIGHWAY ~------------------
SYLVANIA, GEORGIA 30467
Facility KING AMERICA FINISHING, INC. Location - 1351 SCARBORO HIGHWAY, SYLVANIA, GA, 30467
Attn: MR. Robert R. Lanier
PARAMETER
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
DISCHARGE MONITORING REPORT (DMI Form Approved. OMB No. 2040-0004
I GA0003280 J 001-1 l [ PERMIT NUMBER J DISCHARGE NUMBER]
b MONITORING PERIOC ~~ DO ' - MM DO yyyy
FROM I__?=~' 01 -~ TO l 09 ~~- 2014_
UANTITY OR LOADING QU
DMR Mailing ZIP CODE: 30467
MAJOR
Final Discharge External Outfall
NO DISCHARGE [_ ]
QUANTITY OR LOADING - - f NO. J FREQUENCY ! SAMPLE --------,------------_______j EX OF ANALYSIS TYPE
VALUE VALUE UNITS I VALUE I__ VALUE j_ ... VALUE I UNITS - ___ , --Mercury, total [as Hg] SAMPLE *****"~~
I MEASUREMENT
71900 2 0 ****** --+: """" ~~·· _!=ffluent Net REQUIREMENT
Coliform, fecal general SAMPLE ******
~SUREMENT
74055 1 0 PERMI::T---;:.-;;;;;--
Effluent Gross REQUIREMENT
Solids, sludge, tot, dry weight SAMPLE ****** MEASUREMENT
78477 SL 0 PRE MIT -------
******
I -~-•.•• -. -~----.-,_.,_-1 ::: ~~A~ ~X - ::~ i--'-~--:;;::: --- ::: ~--=--}--: .... : ~-- :~~ +-:;-EO-I DA~~:MX I ::::~Li'~::; ~~~-
"-_574·062:_t _ ,..-=----t__:-•_1_~:__ - ·~_. -- -~ ~~ t~Mo~jC~LCTD . Req Mon + lb ****** ****** : ****** •••• I I TOTAL · 1 1 J · j' j Monthly CALCTD J Sludge REQUIREMENT
LC50 Static 48 Hr Acute Ceriodaphnia SAMPLE ****** MEASUREMENT
TAB3B 1 0 PERMIT •••*** --;;;;;;;- ••••
1
-->1 oo-- - •·•••· j__ ·····~- -o/~~.-~--;-r·- Daily - ~ --~RAB 1
•••••• •••••• % ---=--t-mays E·
Effluent Gross ----------·- ~~QUIREMENT ··~-----
LC50 Static 48 Hr Acute Pimephales SAMPLE ****** MEASUREMENT
TAB6C 1 0 PERMIT **** .
Effluent Gross REQUIREMENT
Noel Statre 7 Day Chronic SAMPLE **** Ceriodaphnia MEASUREMEN.!j_
TBP3B 1 0 PERMIT - ·--•• ;;
Effluent Gross REQUIREMENT
N"l Sial"' 7 Dey Ch"'"'' Plmephelos l SAMPLE ·------
**** MEASUREMENT
TBP6C 1 0 PERMIT ****
Ef!l_uent ~~~---------- REQUIREMENT I
--+--....,.-•• ....,.-•• - ---1--;;;;-- ---100-l---;;;;;;---t---;-.-;;;;---r· --%-~ ~~ --~ L_ I n .... rt .. rl\1 ' ~J;;>At:l
MINIMUM ---1 1 1 • -----· ·-· ., ~ ~· "·~
-=:::-1-:~ j ~N~~~M -~-== f = I ~ -~+ ~=~:;;. --~ ~ .. ~ . I ·~· >tOO =r--..-~· I % 7 t IQ""" ! GRAB •
l-~-------~-----___ ·····~~--1-~~:*-- -l~JNI~u~_L ::·· -=r: __ --:··~~~- --_1-~-- _t~erly_JiRA~ I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED ~ TELEPHONE DATE I I NAMEfTITLE PRINCIPAL EXECUTIVE OFFICER AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN: AND BASED _ ------i
L ON MY INQUIRY OF THOSE INDIVIDULES IMMEDIATELY RESPONSIBLE FOR I '
b---= Rob_e_rt-:R=--c. L,-a- n-:i_e_r -------· oBTAINING THE INFORMATioN, 1 BELIEVE THE suBMITTED INFORMATION 1s L I
TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE Manufacturing Manager siGNIFICANTPENALTIEsFoRsUBMITTINGFALSEINFoRMATIOIN, INcLuDING ___ _ ___ ;a2 863-4511 14 C. 10 I 17 I
THE POSSIBILITY OF FINE AND IMPRISONMENT, SEE 18 u.s.c. SS1001 ANO I SIGNA E OF PRI ~ .. :;;::;
TYPED OR PRJ~~----- 1_~.o~o~~~~-~~~~~:~~~~:~~~~~~~;::~=~~~~~~~~-~~~~---- OFFIC _ AU A~~ N~-~~=~--~R ~~~H__ _ _j_~-COMMENT AND EXPANATION OF ANY VIOLATIONS (Reference all attachments here)
Mercury: RL(0.5 ppt)
EPA Form 3320-1 (Rev.B09S)-------·------· Previous edltlonsmaybeused. ________ (REPLACES EPA F6RM-T-40 WHICH MAY NOT BE USED.)·-------------PAGE 5 OF 10------··-----------
PERMIITEE NAME/ADDRESS (IncludE Facility Name/Location if different)
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
DISCHARGE MONITORING REPORT (OMI Form Approved. OMB No. 2040-0004
Name KING AMERICA FINISHING, INC.
Address 1351 SCARBORO HIGHWAY
SYLVANIA, GEORGIA 30467
DMR Mailing ZIP CODE:
MAJOR
30467
--------------------------------Facility KING AMERICA FINISHING, INC. Source Water
Internal Outfall Location 1351 SCARBORO HIGHWAY, SYLVANIA, GA, 30467
Attn: MR. Robert R. Lanier NO DISCHARGE [ j .. --------------r-:-=-- ---o-:----·-
QUANTITY OR LOADING NO. FREQUENCY SAMPLE
+----!--------.,.------~ -r- EX OF ANALYSIS TYPE
VALUE I VALUE UNITS I VALUE VALUE VALUE I UNITS --SAMPLE! •••••• j ••••••
1 - ••• • i*••••• -- -- N/A i ng/L
~---·- QUANTITY OR LOADING PARAMETER
Mercury, total [as HgJ MEASUREMENT
71900 5 0 I -PERMrr- ••• ••• I •••••• + •••• j •••••• I Req. Mon. I Req. Mon. ng/L 1
_(dpstream Monitori~g RE<~UIREMENT . ___ _ ___ ' .. -----~-- DAIL '( AV DAILY MX _ ' _____!!!_ear
SAMPLE
MEASUREMENT c-:::---1--
REQUIREMENT
SAMPLE
MEASUREMENT ,
PERMIT
REQUIREMENT
----- ---- _ _L __ -· -- --
--~ - =r-= _=J_, =c ---~---+---+
__ __j~:¥~ __l_l_ --=r ___ j~~-~ I --t=· ~------~----_--~ I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED ; 1 TELEPHONE DATE
NAMErriTLE PRINCIPAL EXECUTIVE OFFICER AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN AND BASED r-------- ---- ----ON MY INQUIRY OF THOSE INDIVIDULES IMMEDIATELY RESPONSIBLE FOR ----,::I
Robert R. Lanier . OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS I TRUE, ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE I
Manufacturing Manager SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATIOIN, INCLUDING 912 I 863-4511 14 1 Q 17
=lTHE POSSIBILITY OF FINE AND IMPRISONMENT. SEE 18 u.s.c. SS1001 AND I ~ TYPED OR PRINTED 33 u.s.c. ss 1319. (PENALTIES UNDER THESE STATUTES MAY INCLUDE FINES UP TO AREA NUMBER YEAR MON'i'H"' ---riAY
'-=-=~=:c-:-:=======:-:-:-::-:-:-::-:o-:-==:-=-:-: _ $10Jl.C!l!MlD_QI'UIIAXIMUMJMPBI.S_Q~MEiliLQE.BEJJM:EI'lUtQtru!S.Ali0..5 .. 'iEAiiS~L- ---COMMENT AND EXPANATION OF ANY VIOLATIONS (Reference all attachments here)
Mercury: RL(0.5 ppt)
EPA Form 3320-1 (Rev. 8095) .... ---·--------- · Previous edltiorismay beuseci ___________ (REPLACES- EPA FORM T -40 WHiCH MAYNOTBE USED.) - ·- - - .. ·---------PAGE "6o'F1o ____ --------------·-- .. ---------- -·-
PERMITIEE NAME/ADDRESS (IncludE Facility Name/Location if different)
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) DISCHARGE MONITORING REPORT (DMI
Form Approved. OMB No. 2040-0004
Name KING AMERICA FINISHING, INC. ---Address 1351 SCARBORO HIGHWAY ~ GA0003280--l r-·--001-1 I
t PE~IT NUMB~~ [~ISCHARGE NUMBER
DMR Mailing ZIP CODE: 30467 ----------:-
SYLVANIA, GEORGIA 30467 MAJOR - .
Facility KING AMERICA FINISHING, INC. __ MONITORING PERIOC: :-::-;-1 I - MM TOol' yyYy i m-----------·---,
lnstream Monitoring External Outfall Location 1351 SCARBORO HIGHWAY, SYLVANIA, GA, 30467
FROM ___ 2014 TO [ 0~ I 30 1 2014_j Attn: MR. Robert R. Lanier NO DISCHARGE I _]
00061 z 0 PREMIT f Req. Mon. I Req. Mon. ~ MGD I •••••• ---r--;;;;;-. -~-;;;;;;-- .... o---. ----r:;-!nstream Mo_!lJtorinc_ -~QUJ~MENT DAILYAV DAILY MX_ --------t--------·----~----------r-1
_____ ---If-- -~-~: ··t' INSTAN __ Conductivity SAMPLE •••••• •••••• •••• ****** 118 136 umhos/cm I
MEASUREMENT 0 1 I Month GRAB
00094 5 0 ~-PERMIT . 1- •••••• •••••• I '"""!· IVIVII. ±="'"!· IVIVII. I u 1 Upstream Monitorin_g REQUIREMENT ____
7_ ---------f--,---:------- DAILY AV __ Q_AILY MX ___L__ _ ______ __
Conductivity SAMPLE •••••• •••••• **** ****** 96 150 umhos/cm r ~ MEASUREMENT 0 1 I Month GRAB
1-- PERMIT ****** •••••• •••• ****** · --R- eq ___ M_o_n_- Req-. -M-o-n.-+-u-m-:h_o_s-,/c_m__ . · 1 ---00094 6 0 Downstream M_onitoring_ Hydrogen peroxide
REQUIREMENT DAILYAV DAILY MX Monthly I GRAB I SAMPLE **•••• •••••• •••• •••••• 0.00 0.00 mg/L
MEASUREMENT , 0 1 I Month I GRAB
00139 50 tPERMIT •••••• •••••• **** •••••• 1 Req. Mon. Req. Mon: -mg/L ~~~---j GRAB Upstream Monitoring REQ_UIREMENT __ _ _ DAILY AV DAILY MX ___ on y +----Hydrogen peroxide SAMPLE •••••• •••••• ~ •••••• 0.00 0.00 mg/L
g~~;s!~am Monitorin -:::~=~~::: ---;;;;;;;;,;--1------;,;;;;;;;---j-·--;;;;-------;;;;;;;;--[-~\~~~~- - ~~YM~t~gn_-0 ~ ::
. g --'i'CERTIFYUNDERPENALTYo'FLA'wTHATIHAv'EP'eRsciNA~iNEiJ-_j___I.ID.- -·-------------1--TELEPHONE- ___ L __ DATE ~------NAMEITITLE PRINCIPAL EXECUTIVE OFFICER AND AM FAMILIAR WITH THE INFORMATION SUBMITIED HEREIN AND BASED l
ON MY INQUIRY OF THOSE INDIVIDULES IMMEDIATELY RESPONSIBLE FOR r Robert R, Lanier -- OBTAINING THE INFORMATION, I BELIEVE THE SUBMITIED INFORMATION IS ~
TRUE, ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE "'Il --{: Manufacturing Manager SIGNIFICANT PENALTIES FOR SUBMITIING FALSE INFORMATIOIN,INCLUDING _ --- ---- 91 2 i Q ~7
THE POSSIBILITY OF FINE AND IMPRISONMENT. SEE 16 U S.C SS1001 AND SIGNAT OF PRI I PAL EXECUTIVE TYPED OR PRINTED 33 usc ss 1319 (PENALTIES UNDER THESE STATUTES MAY INCLUDE FINES UP TO OFFICER 0 AGEN AREA NUMBER MONTH DAY
1.Q .l!QO.A~IMUMJMffiiS.Ol'IME~LQE.Jlf.rNEEIV>MOOJlis.A~ll...>..YJUIBS..L HORIZED T lc_o.o . COMMENT AND EXPANATION OF ANY VIOLATIONS (Reference all attachments here)
EPA Form 3320-1 (Rev. 8095) Previous editions may be used. (REPLACES EPA FORM T-40 WHICH.MAY NOT BE USED.) PAGE 7 OF 10 -----·------------
PERMITIEE NAME/ADDRESS (IncludE Facility Name/Location If different)
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) DISCHARGE MONITORING REPORT (DMI
Form Approved. OMB No. . 2040-0004
Name KING AMERICA FINISHING, INC.
Address 1351 SCARBORO HIGHWAY GA0003280 I PERMIT NUMBER _j L ___ _
DMR Mailing ZIP CODE: 30467
SYLVANIA, GEORGIA 30467 MAJOR
Facility ·Location-
KING AMERICA FINISHING, INC. _ lnstream Monitoring External Outfall 1351 SCARBORO HIGHWAY, SYLVANIA, GA, 30467
-------------NO DISCHARGE L ___ _j Attn: MR. Robert R. Lanier
------------------
PARAMETER ~LOADING NO. FREQUENCY ' SAl\ - j EX OF ANALYSIS n
VALUE UNITS -1----..-..;;;;--------::--l---1----.. -- ·---+--
mg/L
MPlel TYPE .
r QUANTITY OR LOADING
L_ ~LU~~-~LUE __ UN!TS 1- VALUE i--_Y.~~~ I
SAMPLE •••••• •••••• •••• 7.20
QUANTITY OR
1 0 1/Mon~ RAB
!,!pstream Monitoring_ Oxygen, dissolved [DO]
-··-·;;;;;;;-~··l------·- --------·~---. -· -t<: _ ~ _ Monthly _
~----;;,;;;;;;--+---=--~~--+-~ -- __ __2!_ Mont_~-
' M::;.::~:: --..... ;;;---- ---;;;;;.--- --..H -~=~~~ -r-.. = ---+- I ___ , ____ ----·-;;;;,;;;;-- ----:;;;;-. ~ 7.40 u ....... .
---;;;;;;;;;------~---;. • .-.J1
1
- ~~~j~~~ -r----;;;;;;;--- --~~'~ I M~_nt_hly __
1
_ GFG_R~AB_j· SAMPLE I ******
00300 6 0 Downstream Monitorin pH
00400 5 0 Upstream Monitorin pH
00400 6 0 Downstrea_!!l M~nitorin_g_ Nitrogen, ammonia tota
00610 50 Upstream M_2nitoring_ Nitrogen, ammonia tota
00610 6 0 Downstream M~nitoring Sulfide, total [as S]
00745 50
-
--------3S 1\
3S 1\
MEASUREMENT PERM~
-----;;;;;;;;---
...... -·-.=.= •• --r: __ 6.980 ___ ! ······ 7.4-:-h u o 11 Month ~A~
~·•••• •••• Req. Mon~ •••••• Req. Mon. ; SU Monthly~' GRAB~· MINIMUM 1 -. MAXIMUM _j --
•*•••• •••• 1 6.740 -- ~-=~=·-- j _____ -7.3:_ ____ J_su __ , ~--~--1' Month GRAB
--•• ;;;;;-- ·--j------;,-.-;;-----j---Req.-Mon.-- - •••••• I Req. Mon.~--~ SU _j 1 Monthly GRAB
i MINIMUM . M~~~~~-l--- mg/L -~--- ----;·;~~~;-t G~---......-.. H•• ·-r---.....-..-·--,--Req.Morl Req.Moo.- · mgJT- --- Monthly--~;~~;-·
DAILYAV I DAILYMX --·-------•••• I ·:-: .. -:-: .. -:-: .. --t--, -_~o--.:;-;.200 r· 0· 2~-~_j_mg/L --1- 0 j 1 I Month --11 GRAB
REQUIREMENT 1----------t--
****** SAMPLE MEASUREMENT
PRE MIT ****** REQUIREMENT
SAMPLE --
****** MEASUREMENTf ~
PERMIT-----.-••• ;:;;--- .
I- REQUIREMENT t=:: --j SAMPLE ••••••
1-~EASUREME~ ___ _j PERMIT •••••• I
REQUIREME~ ± SAMPLE •••••• -MEASUREMENT
PERMIT ****** REQUIREMENT
SAMPLE ****** I MEASUREMENT
Monthly Req. Mon. - Req. Mon. DAILY AV DAILY MX
•••••• 1 •••• I ****** I 1·00 '"1:00~- mg!L 0 1 I Month
****** I ***w ***""" mg/L
PERMIT **"'*** Uostream Monitoring___ l ------ -~EQUIREMENT
- _ H~,.- L±-==1-_i~~ ~~~~OiQil-f~Mo~-:_j G.,.,_ I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED 1- TELEPHONE ,_l__ DATE
NAMEtriTLE PRINCIPAL EXECUTIVE OFFICER ANO AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN: AND BASED l ~---- ---ON MY INQUIRY OF THOSE INDIVIDULES IMMEDIATELY RESPONSIBLE FOR
Robert R, Lanier ------ OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS ~~ TRUE, ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE
Manufacturing Manager SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATIOIN, INCLUDING - --- __ __ ----- ---- 912 I 863-4511 14 10 17 THE POSSIBILITY OF FINE AND IMPRISONMENT SEE 18 USC SS1001 AND SIGNA R PRI IPAL EXECUTIVE
TYPEb OR PRI>ITED '" "'·'· $ "" """'"" ~~"-~'~" ~"~~""" ~m I ~FFICER OR AUTHO,ZEO AG"" I:"~ I- NUMBER IDiR - MoNTH ~Y _l_$1Q..illlJlANP..ORJ.1MIMUMJMEBL!l>lliMENLOE.6EIWEEhtD.MoNlliS.AI!IDJL'iEARS.I_ C -------- oo,e______ -------- ---
COMMENT AND EXPANATION OF ANY VIOLATIONS (Reference all attachments here)
Ammonia: RL(0.20 ppm); Sulfide: RL(1.00 ppm)
EPA Fonn 3320-1 (Rev. 8095) -----·--- PreViouseditions may beused.---------(REPLACES EPA FORM T-40 WHICH MAY NOT BE usffi) __________________ PAGE 8 "i5F'1(}'" ""
PERMITTEE NAME/ADDRESS (IncludE Facility Name/Location if different)
Name KING AMERICA FINISHING, INC.
Address 1351 SCARBORO HIGHWAY
SYLVANIA, GEORGIA 30467
============= Facility KING AMERICA FINISHING, INC.
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
DISCHARGE MONITORING REPORT (DMI Form Approved. OMB No. 2040-0004
GAOoimso--l 1001:-:t __ , DMR Mailing ZIP CODE: 30467
PERMIT NUMBER r -·--· .• --- •. . . MAJOR
Location - 1351 SCARBORO HIGHWAY, SYLVANIA, GA, 30467 lnstream Monitoring
External Outfall
NO DISCHARGE CJ Attn: MR. Robert R. Lanier -- ---------
~-PARAMETER .~-
QUANTITY OR LOADING
VALUE I
VALUE
Sulfide, total [as S] ****** ***'~~**
MEASUREMENT
00745 6 0 r PERMIT ****** I ****** Downstream Monitoring_ REQUIREMENT I
QUANTITY OR LOADING I NO. I FREQUENCY I SAMPLE r -,-- r--- EX OFANALYSIS TYPE
UNITS
1/ Month
VALUE I VALUE .. .. · -+- 1.00 1.00 I mg/L +
----==--+----Req. Mon~---- --ReQ.'Mon.-1-r;;gtL Monthly--
0 GRAB
-·--·i GRAB .
Hardness, total [as CaC03] I SAMPLE --·+=---1 MEASUREMENT
00900 6 0 -} PERMIT ****** ****** Downstream Monitoring EQUIREMENT •••••• ~ •••••• I
DAILYAV DAILYMX ,------~ 53.50 - ! 53.50 I mg/L 0+ 1 1 Month GRAB
--+--;;;;-. --[---;;;-;;;;;----~eq . Mon. 1- Req. Mon. I mg/L ---- Monthly- . GRAB-
DAILYAV I DAILYMX I - ------~-Sodium, total [as Na] SAMPLE
MEASUREMENT
00929 50 I PRE MIT I **"'*** I *'k****
Uestream Monitoring I REQUIREMENT
Sodium, total [as Na] I SAMPLE I '****** ******
MEASUREMENT -·
00929 6 0 PERMIT **"'*** ****** Downstream Monitorin REQUIREMENT
Color [admi units] SAMPLE ,---
****** -----r-- --**"•*** MEASUREMENT
01290 50
Formaldehyde: RL(50 ppb); Sodium: RL(5 .0 ppm); ADMI Color: RL(25 SU); Sulfide: RL(1.00 ppm)
5.00 -~ 5.00 mg/L I o 1 1 Month 1 GRAB
•••• +---:: .. =, ;;;: .. ;-. --t----=---
**** i
I
----- . ~~iL~~~~ ----~--•••••• 50.50
•••••• Req. Mon.
****
**•* DAILYAV
**** ****** I
46
Req. Mon. DAILYMX
mg/L Monthly GRAB
50.50
Req. Mon. DAILYMX
' mg/L l~j__ 1 1 Month
·--~9fLI I Monthly
GRAB
GRAB
68 1/Week I GRAB
j- _I GR~;-1 ---
Weekly
1/Week GRAB ---GRAB
GRAB
EPA Form 3320=l(Rev. 8095)---------·-·--- Previous editions may be used. ·- (REPLACES EPA FOR-M T-40 WHICH MAY NOT BE USED:) ________ _ PAGE 9 OF 10
PERMIITEE NAME/ADDRESS (lnclud! Facility Name/Location if different)
Name KING AMERICA FINISHING, INC.
Address 1351 SCARBORO HIGHWAY
SYLVANIA, GEORGIA 30467
========= Facility KING AMERICA FINISHING, INC. Location 1351 SCARBORO HIGHWAY, SYLVANIA, GA, 30467
Attn: MR. Robert R. Lanier
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
DISCHARGE MONITORING REPORT (DMI Form Approved. OMB No. 2040-0004
~-GA00032ao-- ~-001-1 ___ _ DMR Mailing ZIP CODE: 30467 C. PERMIT NUMBER )ISCHARGE NUMBER
-------
MM FROM I 09 2014_j
MAJOR
lnstream Monitoring External Outfall
NO DISCHARGE II L___j
QUANTITY OR LOAOtNG- -- "j FREQUENcY SAMPLE-
v~~.~; ·=r- ~~s ---- v~!~- ]- VALUE__ VAL_uE _ I !JNITS _""_ OF~LYSIS TYl'E 0.050 0.050 mg/L --
----- ~0 1/ Month GRAB ****-•• --1 ***-· -- -·***·* -- ---- -- -
---~ILY_6'{_ DAILYM~ J J Monthly I GRAB
PARAMETER ·-c -. Formaldehyde ---------- ~ SAMPLE
MEASUREMENT
QUANTITY OR LOADING
VALUE
71880 6 0 Downstream Monitoring_ LC50 Static 96Hr Acute Ceriodaphnia
[
TAB3B 6 0 Downstream Monitoring .
. LC50 Static 96Hr Acute Pimephales
ITAB6C 60 Downstream Mon.itori~--,---f Noel Statre ?Day Chronic I Ceriodaphnia
lrBP386 0
---
--
--NAMErrtTLE PRINCIPAL EXECUTIVE OFFICER
Robert R. Lanier
Manufacturing Manager
TYPED OR PRINTED ~---
SAMPLE - '
MEASUREMENT I P ERMit --
REQUIREMENT
SAMPLE
MEASUREMENT
PREMIT
REQUIREMENT -- SAMPLE
MEASUREMENT
Req. Mon. Req. Mon. mg/L
-------;;·;;;;----... -,-----;;;;;;-------
>100 I ****** ****** ~- Ojc . --
--• ....--.-_j----~------- I I 0 I Req. Mon. ~MUM I . . oo
..0..-'--'-..0• -'- • L --0 I 1/ Month I GRAB
--Monthly I GRAB
;i --1/ Quarter
------Quarterly ____ l ______ ·-----
0 1/ Month GRAB
****** ****** %
~.:::: -+-= -I ~~;:~c':__ __ ·--~ ---..,.,-,----+---,.--."••"·-·---!--*··· 100 I ••••••
***"'**
****** %
PERMIT
REQUIREMENT
SAMPLE I MEASUR. EMENT F
---T Monthly GRAB ----~·~ •H-"=:_T_ H~ ~~~;:~~ ,- ::_" =t=-=- ·I-· · -_'Y<_· ~=--+--t------r--
-----------~-- --------+--- ----1----1--
-~-----t--t-F ~ -~ tEMENT ----
<>AJVIPLE
MEASUREMENT
PER~ -·-··-----REQUIREMENT -------
SAMPLE --. -------r---- E---r------l---------i--~--. -----t--------- --~----· 1 -- --l---------r--1 L_ • •••••• I mn-u
THATIHAVEPERSONAllYEXAMINEO I -. ---- -----:-TELEPHONE -- .
MEASUREMENT
PERMIT ----------
REQUIREMENT r-------
j I CERTIFY UNOER PENALTY OF lA\1\' AND AM FAMILIAR WITH THE INFOR ON MY INQUIRY OF THOSE INDIVIDI
---- ,OBTAINING THE INFORMATION, I BE
MAT ION SUBMITTED HEREIN: AND BASED LES IMMEDIATELY RESPONSIBLE FOR !EVE THE SUBMITTED INFORMATION IS AM AWARE THAT THERE ARE TRUE, ACCURATE ANO COMPLETE.
SIGNIFICANT PENALTIES FOR SUB~ THE POSSIBILITY OF FINE ANO IMPI 33 U.S.C. SS 1319. (PENALTIES UNO S.lQ.QQQAl!ID..QRMAli!MUMJMEBIS.O
TTING FALSE INFORMATIOIN, INCLUDING SONMENT. see 18 U.S.C. SS1001 ANO R THESE STATUTES MAY INCLUOE FINES UP TO MENLQEJlEIWEEI'Ul..M.O.NJ.IiMf>IOJi.YEARS.l~ OFFICER OR ~ORIZEO AGENT 1,
DATE ----,-----------------
863-4511 I 14 I 10 NUMBER ~R MONTH
17
DAY
COMMENT AND EXPANATION OF ANY VIOLATIONS (Reference all attachments here)
Formaldehyde: RL{50 ppb)
EPA Form 3320-1 (Rev. 8095) Previous editions may be used. (REPLACES EPA FORM T-40-WHICH MAY NOT BE USED.) PAGE 10 OF 10