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PERMRTEE NAMFIADDRESS pwrbifKNpNrr/elmrr yDrplrwv/ <br />NAME ~~71.~~'ADJ Y3°?A CrgL '~"PA`~Y <br />ADDRESS°~Lh: `.- I,1`:3 =. :1,';'+, ECK~?': po- <br />1'x51` 'iCP. 4~I <br />(l 1, v " !. P F :. , ; , y ~ li q ) <br />FAaLm <br />NATIONAL FOLLI/TANT DI9CHAROE ELIMINATION 4YBTEM ((NPDE$I <br />DISCHARGE MONITORING REPORT (DAARI <br />. Iw ,. ~ I S'1 n ~: i <br />PERMIT NUMBER ~- '.. axHAADE NUMeEA <br />MO RIOD <br />YEAR NIO DA YEAR MO DAY <br />,FROM ~~ D - ~ ], O "~ 1 ' 1 <br />(_ . 1 <br />[nF. 1, r'^ND B TO FOICE:1. CA°:'• <br />~~' 0 .DISCHABGF ~ I ' <br />NOT e~~~4 Mptruptlo/r b•Ip[g compl•Elnp~thb lam. <br />PARAMETER QUANTITY OR t: %; e ~ <br />Quality <br />or Concentra NO. FTEOUENCr SAMPLE <br /> . <br />EX of <br />TYPE <br /> ANALyse <br /> AVERAGE MAXIMUM S MINIMUM AVERAGE MAXIMUM. 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OFFICER OR AUTHORIZED ADENT CODE NUMBER YEAR MO DAY <br />GUMMCN 1 J ANU CAr'L/.Iq/L I r V R V r' nn . r r V LP1 I I V NJ (/r•IIlIOCI N/ RE•C/101/nt1 AI/I/ <br />~.-~. i.:'•1r .T.. ~C~.~ ; .i: °L'F.'i.;. '".7 !. C'_ (r fir' r':'1 '. ^!~LY :': 1.3 1'' ~= t-~_(:,-II:-!?P i'HcCIP Y!..!l T. ..A ~~,, ~.'. <br />~-. {'.4" 1..4.s., ?:,. " `~U`! bU!.,. :. I~ ;~ r.')~~r _ •I, ~, rr+.~, !!IL c", !. •i P:A`:~ - ..~Th?x.:1.1.. n, FG. 1?. <br />EPA Form 3320-1 ~y 3/99) Previous editions may be used. G 0 D 9 9 / O L U~~' ~'4-+~fgfln. PAGE i F <br />l <br />