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FORM APPROVED <br /> OMB No. 1118—M100 <br /> OISCMARGE SERIAL,NUMBER FOR AGENCY YSE <br /> It.Additional Wastewater Characteristic <br /> Cheek the pox Mat to each paramster If It Is present In the offlutnt.(fee Instructions) <br /> Parameter Parameter- o Parameter c <br /> (215) _ (215) (215) <br /> Bromide Cobalt Thallium <br /> 71870 01037 01059 <br /> Chloride Chromfum Titanium <br /> 00940 X 01034 01152 <br /> Cyanide Copper Tin <br /> 00720 01042 01102 <br /> Fluoride Iron Zinc <br /> 00951 01045 01092 <br /> Sulfide Lead Algicides• <br /> 00745 01051 74051 <br /> Aluminum Manganese Chlorinated organic compounds" <br /> 01105 01055 74052 <br /> Antimony Mercury Oil and grease <br /> 01097 71900 00550 X <br /> Arsenic Molybdenum Pesticides' <br /> 01002 01062 74053 <br /> Beryllium Nickel Phenols <br /> 01012 01067 32730 <br /> Barium Selenium Surfactants <br /> 01007 01147 38360 <br /> Boron Saver Radioactivity' <br /> 01022 X 01077 74050 <br /> Cadmium <br /> 01027 <br /> t <br /> °Provide specific impound and/or element in)tem 17,if known. <br /> Pesticides(insecticide;fungicides.and rodenticides)must be reported in terms of the acceptable common names speelfled in Acceptable Com- <br /> mon Rama and Oemtoat Nanta for the Ingredient Statement on Pesticide Labels,2nd Edition.Environmental Protection Agency,Washington. <br /> D.C. 20250,June 1972.as required by Subsection 162.7(b)of the Regulations for the Enforcement of the Federal Insecticide.Fungicide,and <br /> Rodenticide Act. <br /> EPA Poem 755022(7-") n'7 <br />