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NCG080800_2021 DMR_20210820
MIA DivigIgn @f Inmy, Minval and Wn€1 h5ourm 9-wemb -Mor bNehArge MOMOtlrtg lIgporf (OIblf;l) Fot'm for ISIC608000 f T"rangif and i'Caritporf gItIcii - OMplete, qn, wpn and §@brit the- DIVIR via th@ k- gnat "M ftml egify Within 50 days of fmlving §ampling F@Wt§; Mail thB wiglfial, §ign@d hafd E9py @f t.hp 9Mff W the Agwarigha C@Ftlffea€@ of C@V@F? a ft NP508 + -- Mon dell@@tln_ �a��l�� M;srk T: Senior — 1 @iiity l�gn4e; 1 � n L§f hra e11#ill �gWl� DP@Fgflgn@ �@ntgf (TOO) 1; bawgf Nam@, Pow Amlytical — faciiityCaPnty; off �ggFat4ryft, Ne:;37 712 ry . _-.... - -- —-- --- ---- 1aiMchaFQ@ g4i!! If�l3 @lira ; Y@§ frig r�, � 1 to { f1 fil godd0o -- — Ha§ yow fa@113y lmpI@rfi?nt€d mandal afy Tief F@§popes aI ti@n§ th-g gamale pefiod fpf any 1?i- cFO rwk wg@dI@n€@ y@§ No it m Which T-w (1,11, of HQ? — A Popy of Wg p4VlIP has bw upl . ad@d OwFeNgOly via : i3 a : �� .I — Y@§ —NO Date UP14agi@d€ 46 i Part A; VOW@ & Fq uif?ment MairF#anan@@ Area§ w Pen€hrn rk5 in (Red! Para gt@f —Fwanifte ------ OlAthill Imml Outfall w-go OWMIll @w--wa puftl w:%4 Quoit!cod@ N/A It@€@1ving Stfgam f l@§§ WS-V;NSW WS-V;NSW INS-V N yy + (-y;{ yy _ N/A NAN Nam l@ slf@eted MMIOD/YYYY Q710012931 Q7100IN21 071QW2021.___ 9710612921 46320 � 24tHgur WAR in inghe-5 2.2 �.2-- - ff�'9 --i in ni ft loi7 or 5�j f:li 57,E- POS7 Ikon=PP1ar Oil lk gr@a§g in mg/6 (is) Q9df#9 PH In §tandaFd @nits (6-o = om 6:3 - - 6, fV�g16 �stirgat@ New MQtgf/I�ydreyli@f�i1 �...,'{� p§ale In ftPFitl). �� W -- 1 3 1�il�W t€t §@pgIgtor* orr S@cgndary Contain menU is � �f �a!!§ gl atl�rws 11•ermina!@ -den@hrt+ar s 1n (Red j - �� P@r@rn@ter ��- guttall ggtf@ll - Mall — OWMI 9utfal! Dot@ §arnpl@ pe11e€t@€ MM/99/YYYY - - - - 455M Z4=H@vr 10140 in Wh@§ �55 In mg/G (ino be Sri*) -- --- --- ------- l�P`�3�_- 40400 - PH in §tandafd URN (&0 —9.01 gutfall§ to 9ut§tanding ft pur4@ Water§ (9RW), High Quality Water§ 1. 1941r1s Paut Watem (Tr) and Primary Nyf§@ry Aram (PNA) bay@ a W.fWarii TH limit of 5o rng/L, All ether wnt@€ €fa§§i#i€ati©@§ hPV@ a 4@PchMRrft of 164 mg/l. Wag i905na�� i ' Ply gf atm9§Rh�fls A@�F?§itiPM I� �:`i Pqf @4ia=�I�ig M�s$el�f! PF3Ff rmiigl 0V N3tIgMl alMnagphaFlp I?eP451VF?M f F@pfgM MP 4eMgf!MOgrK IgN1§:§ "I Fggify by my §ignatyr@ b@IgWI PndBF w@lty of law, that till§ ftumiant and all atwhrnwt ",ere pr@par@d wider my dlwtion gr §uyp@rt 4igfi in §€gwd@nse Oth a q tafn lhat qualifl@d par§qnn€l pf@perly gather and Qvaival_a tht iriformoV@a §uhmitted: Om' d en my ingWry of th@ per§gn @f P@f§9n§ w W ma>lagH th@ §y§t@rn, eF fh@o @ P@F§e@§ diFeotly rasp@il§if?I@ fir Bath@Frog tfj@ Ie#@Ffrlati@n, file irlfermatlsn §OmMO is, to ft 4§t of my know I cage And 10?110, trye, a€@uratg, and anmpWg; I am aw ep that there are SiPnifigant p@nalU5 (of SO. §hills fal§e inforrgatign, lncl4fig ft Owilpiiity gf fine§ ed Impo5grim@MI ter knowing viglatlgn§,° G�r�3 Signatum of Permlttee gr- Wall Addws-6 Al �Af@ Phone Ntjmb@r f