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PEIIMTREE NAME)ADDRESS RwrY4FafSryN~wL«m.w UO~...n9 <br />NAME 'd5 i..'.).?. i'i .: ~Sd'i; 1?u i'~. .~,. _,,., `~~~r Vii:,-;° <br />ADDRESS tr •r." -11;i t., <br />FACILITY <br />LOCATION <br />NATIONAL tOLLVTANT DISCNAROE ELIMINATION SYSTEM (rNPDESI <br />DISCHAROEMONITORINO REPORT fOMR1 <br />C` JL ,'1-L~3 43 ;'J u <br />PERMIT NUMBER DISCNA1wE NUMeEa <br />MONITORING PERIOD <br />YEA MO. D Y R MO DAY, <br />FROM 1 -L TO ~ ,z. ~~` <br />Form Approved. <br />OMB No. 2040-0004 <br />/iii;Uti <br />l~LYS : $i .~ . <br />u ...-M ,J i.~~~ `.5'L'.I~!6{j;". m~ .°j.`°.~trj ~l '7,vV <br />NOTE: Reedwlmhucdarr bdlxe comphtinp Ihb lorm. <br />FREQUENCY <br />PARAMETER gUANTITY OR LOADING gUALITY OR CONCENTRATION NO. <br /> <br />EX <br />OF SAMrL.r° <br /> <br />TYPE <br /> ~ ,WKYSIS <br />_ AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNRS <br />E.'a SAMPLE .-:~:~~t..=`= .. :. _.., id <br /> MEASUREMENT <br />1 J 4 ~ .? L ~ Cr L PERMIT I:~; ~\ :y;~sr <br />. 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A <br />~ <br />, , . <br />2 :'..(3.3~ ~: i.'.aA.+ SAMPLE ' <br />(i1 i I' i) MEASUREMENT <br /> <br />A f1Yi %" <br />Uys .. .a 2 G' l7 <br />PERMIT <br />a'.1." ., <br />,~ t,, <br />_.~ <br />.yq. ,• <br />~ <br />L ... ~ <br />- <br />.. - ..w 't <br /> <br />~~'; L <br />~ <br />., <br />,~... <br />. ~ z,u:.:~ ~ ~~)30;~; ~raL[~, :REQUIaErnENT Y ~. <br /> k : . <br />:'1, 1.~1'aF .i L~,)9~u?i - 1t1 SgMPIE - ,S) a iJ .;R.1 •o~v.+..,. <br />`."i~!„t4 . _. $'~1 u:B`.[' '~y'.,, ,a". MEASUREMENT <br />' <br />.3 'U3!v .), x~ O ~ PERMIT Y.... .. , r. _. ~, P :~N ~>: r ~.:, .. ~ en _ <br />.~.. <br />,Ia :,iil3M., `i:a~tF <br />., <br />w1` "REnuIN~MENT y;~ ?eGD <br />. <br />. , <br />,<. <br />.. <br />, .. <br />~ <br />' <br />~ ,~ <br />{ <br />: <br />~ <br />: <br />~ <br />.' <br />' ~ <br />~. <br />v..>. i. :r. s: ,. :; r..>I:. SAMPLE „ <br />,: . ;, : <br />s ..,..,..~..,.. ,, <br />., .., ..: ,..,. <br />;.... .,. <br />`J ;j;JUl i. MEASUREMENT <br /> ~ c <br />~ .. . <br />:1t}()£ifl 1 4r' U PEitN ,. ., . <br />E <br />,; <br />=~ .. -. - .:u. .. <br />IIT :. , . x ~c <br />p <br />zi ii u.+UL Li~ \J Y~, l:.`C 'J4 A~"uU iRfQUIRE <br />. <br />f <br />1 <br />Mr:NT~ 5~+~`~. '4+r' <br /> ~ <br />~ <br />NAMElT(TLE PRINCIPAL EXECUTIVE OFFICER '"'na uh a°""""""a'n'°"""""~"°^ : <br />'°tl"r° rP`"°tr° TELEPHONE DATE <br /> preprea °roer mr alrtctbn orwprr.M°n In Kc°rd°me Mtn • f)11°nt adFnN <br /> m m°.. u.t <br />vYllka <br />n°°nrxr <br />t° <br />rd <br />m„ °ro e.w°t° m.lnrnr <br />tro <br /> <br />~r vf/ CR.,&.nSf» "=~ g <br />p <br />p <br />p <br />r p <br />m. <br />n <br />wnrou.a. e.nxe°n mrl~mrrau. p.mn«P.twm+n°m°n°p tnr,nNm, ~~ <br /> °.Ihoa pen°ru ab°cty rvpoNnle rar E.u.dnE u. mromou°n, tw<Inrnmuu..: <br />y-' +~ <br />L-'A'! /. (.~0-aG~ a +°nMOM N, to Ine not °f mf Lm"kap.M netler. tnu..~°nle..M mmykle. - <br />I °m.w°ne u°t tone °re eMnmt pnNtb ror wnmltnn <br />rWe 1nfoAm°U <br />610NATUNE OF PRINCIPAL EXECUTIVE ~il +,s ~~~ ® .~ <br /> p <br />°n, <br />TYPED OR PRWTm nMUalnE tnepmlMUywnne.ro lmyrl>e.menlf nmwlnS ~a•~. OFFICER OR AUTHORIZED AOEMT CDpF NUMBER YEAR MO DAY <br />f.`~S is i;>T.;., ~e:V+; L:='AIFa IIL;,L E~-.. 'rit.T4;C1F is°.n4; .x,i.';`Lf',~3y~ :>+'.~.~.L.``i 'i,Zi'i}.; r,k;?Lr::A ?'wli: C=."':ti-'i?~2!dili 1'-"i~' tMi <br />"( ~'t'1.'. (s. ~•_ s S: ~ - :: x~mY .y c^ '9 'n 33 r -,nr.:p-., Xrv~y 'r,1l. <br />j '~'F ~.. -1n Zr :r to !F p'~.)zt. _i9 ,i fi i.iS:S.:ld 3i. ~. Y~:1 t'.~1j3 la -?`.... J.°~3" s_j {s ~~~• s. r2 a.1 Jmi AiLS1+,b A9 <br />EPA Form 3320.1 (Rev. 3/99) Previous editions may be used, ~ tiy!) i.=; U. /".'~}1(S!'~~,y.(y`aE~;~O'T'DL PAGE OF <br /> <br />