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1[AAMTIEE NANE/ADORESS rT.e-Ari.4ry N~>'tr.nrr ynr/I..W <br />NAME .. , .... . <br />AOOAESS <br />. r', <br />fACILRY <br />LOG TKNI <br />corm APyeved <br />MAnONA[ iOIIUTANT d7q[AAOE fIY[elAT10N ETSTE-[ NPDf$1 ~ Pin 20/60404 <br />DISCNARGE MONITORWO REPORT /OA~RI <br />PERMIT NUMBER psCNAl10[NrJAAQ ~ _ _ tlV <br />MONITOAING PERIOD - '- - ~ ~ ` c • `' <br />YEAR MO pAY YEAR O AY _ _ <br />FROM TO <br />NOTF• R..A Y..1n,r•rIM. h.Itiw n.....wVaMw ,I.V I.rw <br />PARAMETER OUANTITV OR LOADING OUAUTY OR CONCENTRATION NO. NrlOUCNCr SAMPLE <br /> <br />AVERAGE <br />MA%IMUM <br />UNRS <br />MINIMUM <br />AVERAGE <br />MA%IMUM <br />UNRS EX ANA[rms TYPE <br />. _ r . SAMPLE <br />MEASUREMENT <br />~ I ., ~ <br />E^ <br />~~'~ <br />rJi LA! <br /> <br />.. PERMIT <br />REQUIREMENT .,.a-.s pLFak7 <br />1 N~ "! • A X - <br />- - ,sc,. ,aa - rl1 <br />_ . is [an <br /> SAMPLE <br />MEASUREMENT <br /> PERMIT <br />REQUIREMENT -_"- " - <br /> SAMPLE <br />MEASUREMENT <br /> PERMIT <br />REQUIREMEN7 - - <br /> SAMPLE <br />MEASUREMENT - " <br /> PERMR <br />REQUIRfMENT - <br /> SAMPLE <br />MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> <br />--- <br /> SAMP•iE <br />MEASUREMENT <br /> <br /> <br />- - - PERMIT <br />REQUIREMENT <br /> SAMPLE <br />MEASUREMENT -- <br /> PERMIT <br />REQUIREMENT <br /> <br />: <br />NAME/TTTIE PRINCIPAL E7(EC1fT1VE OFFICER r r. nt . . >...n. r. <br />~ u~ ~..o.ru «.u a.n«s.wr..w. <br />Y.o,,.d,,.e,,,,.s,,,a,....,,,r,.,~~r, ,,,,,,a,,,,,, .n~,,,ov,es[,.a <br />, <br />TEIEPNONE <br />DATE <br />+ 1 r _ <br />~. ` I; • - •- <br />' <br />' ~ <br />• • Nrrr. ll.r MMM1J Yr>a.M Ygrrll [«la^ «4 rMr.U rM hM..Yr1A <br />aMrrM [ate w .r. ~.9rrn N W M,a s Ynn~ .M.r..rrM ew n,Mlla <br />m IMr. ~f«« dfn!n....}+.1y le. t«Mnq rM nku....rIM M aMw.r««fe. <br />rlrw <br />M > <br />, n <br />> <br />r <br />e <br />rt <br />~ ' <br />~ ~ I ~ r .) <br /> <br />~ <br /> <br /> <br />~ <br />'' fr <br />K rr <br />. <br />rw. <br />. <br />a c <br />[.WM.f.nw +mm~ Wmp1,Y. <br />r ..~ ...n ra« rM.. «. 4t'rL,« pnrels M w>+waq M1[. rwA.weeea ~IONATVRE OI -RrNCMAI E 1[ECIJTP/E - - ~~~' I <br />TYPFD OR PRJNTED <br /> <br />........... ..... nom ,u•Tanu nc 4uv vrnr rr.wm~y u.y,.Iwr.Ner.r al.~.rr+rra ler [arwlq .a.dmrr. <br /> <br />•rrno~ m________ __ _________._ . .. OFFN:EII OR AVTNORIZ[D AOENT ~ i` NUMBER Y <br />EAR <br />MO <br />DAY <br />v . ' <br />_ _ . _ _ ... l t ~ a a l.. <br />, c .. .. i .. .. _ . r ... ' <br /> ! <br /> ~ . <br /> <br />>A Form 31261 SRw 1991 Prwrroan easNnn> mqy tae uud _ , . . T'~LL I S a ~; L-Rr7[I, (O(7R PAGE OF <br />