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<br />NATIONAL iOLLUTMT OIgCNMOE ELIMINATON sygTM /INPOESI
<br />DISCHARGE MONITORING REPORT lDA1R1
<br />PERMIT NUMSER DISCHMOE NIN4eER
<br />MONITORING PERIOD
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<br />Form Approved.
<br />OMB No. 2040-0004
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