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<br />NAME ^TU ~ ~ ~r.1 r ~~
<br />ADDRESS " L t' ~ - r ~. - . ~ r - _ •' .Z
<br />FACILITY
<br />LOCATION
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<br />NATIONAL POLLUTMT DISCNMOE ELIMINATION SYSTEM (NPDESI
<br />DISCHARGE MONITORING REPORT IDMR1
<br />1-761 !17-191
<br />_~'")7.71>4 'n7 i
<br />PERMIT NUMBER DISCHMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAV YEAR MO DAV
<br />FROM ~I '; I TO
<br />!26111 l12-131 114251 116-271 118-191 !36311
<br />Form Approved.
<br />w^~ r 7 ^nvn c •r r`OMBrNoo 2040-OOOA~•~~
<br />/ ~ . , _ r : , Approve( e><pireF OS-31-98
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<br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING !~ G/d On/yl QUANTITY OR CONCENTRATION ND FREOUENLY SAMPLE
<br /> !44531 1546/1 13851 14653 1546/ OF
<br />l31-371 EX
<br />MALr515 TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS lee-esl l645B1 159-701
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<br />NAMERRLE PRINCIPAL EXECUTIVE OFFICER I cERnFV uNOER PENALTY of L
<br />AM FAMIUM WITH THE INFOR ww THAT I NAVE PERSONALLr ExAMINED MD
<br />MATION SUBMITTED HEREIN
<br />MD BARED ON - TELEPHONE DATE
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<br />Mr INQUIRY OF THOSE IN :
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<br />I/. OBTNNINO THE INFORMATION , I BELIEVE THE SUBMITTED INFORMATION IS ~ ~
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<br />MPW SONMENT. SEE le U.S.O. E 1001 MD 3J SIGNATURE OF PIIINCIPAL EXECUTIVE
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<br />TYPED OR PRINTED .
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<br />OFFICER OR AUTHORIZED AGENT AREA
<br />CODE
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<br />EPA Form 3320-1 108.951 Previous editions mey be used. (REPLACES EPA FORM TalO WHICH MAV NOT BE USED.) f. „ r ~ ~ /: .. ~ ;,) .~ PAGE r OF
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