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United tates Environmental Protection Agency Form Approved <br /> �/k Washington,D.C.20460 OMB No.2040-0003 <br /> ILrl1 NPDES Compliance Inspection Report Approval Expires 7-31-85 <br /> Section A: National Data System Coding <br /> Transaction Code NPDEIS, �1 yr/mo/day Inspection Type Inspector Fac Type <br /> 1 BL'I Idol al/K 8111 1aJ41oli� 1=1 e117 1>� 1sLJ zDU <br /> Remarks <br /> Lllilllllllllllllllllllllllllllllllllllllllllll <br /> fleserved Facility Evaluation Rating BI 0.4 ------------------Reserved----------------- <br /> 66 <br /> 6J� <br /> 69 7CU 71u 72u 73W 74 7� I I I l80 <br /> Section B: Facility Data <br /> Name and Location of Facility Inspected Entry Time 12 AM❑ PM Permit Effective Date <br /> Exit Time/Date Permit Expiration Dale <br /> Name(s)of On-Site Representative(s) Titles) Phone Nola) <br /> Name,Address of Responsible Official Title <br /> i <br /> Phone No. Contacted <br /> 09- o ❑ Yes LJ No <br /> Section C: Areas Evaluated During Inspection <br /> IS=Satisfactory,M=Marginal,U=Unsatisfactory,N=Not Evaluated) <br /> 4/1 Permit :� Flow Measurement "41 Pretreatment S Operations&Maintenance <br /> Records/Reports n Laboratory IV I Compliance Schedules < Sludge Disposal <br /> Facility Site Review Effluent/Receiving Waters F—S7 Self-Monitoring Program Other: <br /> Section D:Summary of Findings/Comments(Attach additional sheets it necessary) <br /> Name(s)and Sigeature(s)of Inspector(s) Agency/Office/Telephone Date <br /> 3 esG <br /> Signature of Reviewer Agency/Office Date <br /> Regulatory Office Use Only <br /> Action Taken Date Compliance Status <br /> ❑ Noncompliance <br /> ❑ Compliance <br /> EPA Form 3560-3(Rev. 3-85)Previous editions are obsolete. <br />