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RAMRTEF NAMEIAOd1ESS fl.ii 7ralgN~./fMrrr«/q/1.'y <br />NAME - . .. ~ . <br />AOORf bS - .. _ _ .. - .., _. <br />~~~~ ~iGdral lc <br />;~a 6U btUS <br />Pacam i,;;11U CAMiGa i-E <br />LouTtoN. - CO tl 1 U y <br />- - •,. dUUCsGCti9a t1IaY CAMitie.t: <br />MAT+f.WK IOlIVfaMT fXXJfMOI (tIMWAItpN fYRW rrNPDF$) <br />DISCHARGE MONRORWO REPORT lDAIR1 <br />PERMR NVMBER dY_NM6t w•.A.sLn <br />MONRDRRVG PERIOD <br />Y R MO DAY YEAR MO DAY <br />PROM - 70 _ <br />.a„t Apportd <br />dab I:o 2GbO0De <br />{SU <br />t' 6R OK) <br />- FIiAi <br />OCti ~d~eG: 7C Jf.fF CA6YG- <br />i y` <br />NOTE: Mb -rbuctlorr M(on ~orrpMtinp dde lfxfn <br /> <br />PARAMETER QUANTTfY OR LOADING QUALITY OR CONCENTRATION NO. dto~R~• SAMPLE <br /> or <br /> E% a <br />r TYPE <br /> AVERAGE MA%IMUM UNITS MINIMUM AVERAGE MA%IMUM UNITS NAt <br />9s <br /> SAMPLE <br />MEASUREMENT <br />- <br /> <br /> REQUIREMENT ~. iI Nf. " • r I 4R <br />. _ „ i :.:. SAMPLE - - <br />. MEASUREMENT ' <br />~ v PERMIT - - _ ~ ; I J , ~ / -- 2 r -- <br />;.1 unC.: _. REQUIREMENT ~.1-A EVo i.vi: % 1x C : <br />- i:! <br /> _ _ <br /> MEASUREMENT <br />~ <br />1 U L PEAMIT ..,. -_. -::_ r; ~ :iGYOh: .:_r:. .. / , -._ <br />- :. i uriUS.j 'y .. - REQUIREMENT ~LiE i'1~ ~di : Y .. <br />i L 1 _. SAMPLE <br />~R ~ MEASUREMENT <br />__. v ' <br />... . L PERMIT - _ n _ _ - <br />+i REQUIREMENT <br />-- I• i. Y <br />_- MX <br />... .. ~ G (, r : SAMPLE ~ ~ <br /> MEASUREMENT ~ .. _ _ <br />U J jC L 1 PERMIT - - <br />r,ft'LUtii? ~ REQUtREMENT <br />_ A~ <br />•i <br />'l Lilwr 111 L•,+~G1. SAMPLE 1 _ <br />'i .t ..J 1'h4A i P. `~'f I .. MEASUREMENT <br />7 U'JJU l .. PERMIT ..._~.:: .:V.. •-.i ~ .r••.- - if iuSlR <br />EYfLU~h'1' -.kU>; ':~~.. REOUIREMEN7 ;,h -_Y .L7 .'x <br />-- <br />---i• <br />U 1 ~ A R ~~ r. t, d:; L SAMPLE - -- <br />'~ - ,~ ,; i, MEASUREMENT <br /> __- - <br />,.- t:;d .i +e .- s• .. <br />PERMIT L ] e <br />REQUIREMENT _ MAX _ <br />NAME/ITTLE PRINCIPAL EJ(EClli1VE OPf7CEfl ~" •+` r r....:. e.. gyn., w. aTO,~~ w a.,.rednu .~ <br />TELEPHONE <br />.. <br />a <br />DATE <br />pq <br />. <br />..•e.. . ,u..r„ r .,r..+w......n.dw. ,m~ . pns4rrra <br />• w.w... n.: µ.R+,.,f ,...wn,.f I.y.n. pu.. W ..d„«. M fnl.n.w. <br />W <br />~ <br />+ <br />rW <br />w <br />rrlenn„y.,.~.rw p.v,w P•+sA .r ..wle ur pwr~ <br />~ ~ ~ - <br />r O~ I+.'^A MmrJ• •^MM W fr ~.+IU.1nt U. G(rru.tl., W IIMw.W W <br />~ _ <br />~MII,N`M,MYe,Nw•.lra~Ml~MI.M.I~,..tfvW.WmwYYr- <br />:I. <br />!~ /:..i <br />':' <br />' <br />1 r •-... wi Wn .n M~NM1'u•I a,umn W ws.,Mny fN. i+N.rwn f10MATV1IE OI IRMK/Al [1QClffIV[ <br />~ ~ <br />.: <br />TYPED OII PRINTED '-' -y W lerwy/n~ wny.a,..~.,+yv ~..-ty .Nl.er. OPIICER OR AVTIIOMZED AGENT A NUMEER YEAR MO DAY <br />_ ~. .. -i <br />PA FfNT 7.A24t (Rev 599) Prevvows emLU.n rtuy De uiaA TIL+S 19 a,4•Pml (Otto. PAGE OF <br />