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PERMITTEE NAME/ --- RESS(bfe6JdeFacility NwWLocanon)jDWFrew) <br />NAME "; A :; 3, ": F ., F!, I ;, ' <br />ADDRESS C R `si d J ti 7 J ii i 1 7 i K I It <br />27U SAW Yi,P DhIVL <br />C)I1t.nIG3 z0 (1:3)I <br />FACILITY <br />LOCATION <br />A'fi1= 0-!y r: 1. 1)Afl, 'P'-c.'r :•PF torr?',1' <br />NATIONAL POLLUTA SCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHAR ONITORING REPORT /DMR) <br />12-1 17-19) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAYYEAR MO DAY <br />FROM o,) (il ) t I TO I N;I "rt ' 1 <br />120-21) (22-23) 124-251 12&271 /2R-291 r3r13r1 <br />Form ved. <br />0004 <br />A prov— xp1� s 05 31-98 <br />F — F7iv!tL <br />NOTE: Read instructions before zTomDletina this form. <br />PARAMETER <br />(3 Card Only) QUANTITY OR LOADING <br />(4 Card Only) QUANTITY OR CONCENTRATION <br />NO. <br />FREQUENCY <br />SAMPLE <br />(46-53) 154-61 <br />(38-45) 146-53 /5461 <br />OF <br />(32-37) <br />L2 <br />EX <br />ANALYSIS <br />TYPE <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS <br />— <br />162-631 <br />(6¢66) <br />169-701 <br />•: 1,L A N iJ � N }; f4 ;i El <br />SAMPLE <br />'dLSUAL <br />MEASUREMENT <br />5 U u 6 6 I J 7 <br />E � =1 <br />PERMIT <br />;) r P POR T i <br />:� : >; �: ;.. <br />;,�:.:, - <br />� :; ", :;::, ., <br />r. y <br />,. <br />I r ei n <br />F F L. U E N' ; i 1� r V 1 1 I) l- <br />REQUIREMENT <br />r r« ) <br />N• 1 <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />x,. <br />PERMIT <br />r rf <br />REQUIREMENT <br />SAMPLE <br />, <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER <br />I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED AND <br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND BASED ON <br />MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br />TELEPHONE <br />DATE <br />OBTAINING THE INFORMATION, 1 BELIEVE THE SUBMITTED INFORMATION IS <br />TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE <br />SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING <br />f <br />THE POSSIBILITY OF FINE AND IMPRISONMENT. SEE 18 U.S.C. 1 1001 AND 33 <br />Yi!' / (1112 <br />U.S.C. S 1318. (PwwbW*s u dor theme sbfubs msy kwkJds isws up to $ 10,000 <br />.nd ormulmum lmpisonnrsnt ofbsrwssn 6 months and 6 ysara) <br />SIGNATURE OF PRtACIPAL EXECUTIVE <br />OFFICER OR AUTHORIZED AGENT <br />TYPED OR PRINTED <br />AREA NUMBER <br />YEAR <br />MO DAY <br />CODE <br />--ve— J v ^Ivw u^r u^�lnrT• �'wev yr r•lv I v w�^ 1 w.l a fnafaiaflca an auacunian•s flora/ / <br />i. !' 1 L P., A B L i. J✓ 1, 1 1� .3 f j f i F /» – 'l � r � N, <br />LIh'I APc LIt lI Ei LY IF 117—Y:1, l4 tic, Pfi ii , VLri t C1...I <br />T"Ai G IR')!l LI'T.;; WILL vats' !?1? ;i?PLIFD PD %EFCNi�.i? `t P.r►�Uitt.tii+'i':,--� F: I.� .iA, P. <br />1 , <br />EPA Form 320=1 108-95) Previous editio*rtiay be used. '' (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) PAGE OF <br />