PERMnTEE NAME/ADDRESS pirib FrWryN~.'/sr.ne" yDls..np
<br />NAME ..~JL~~~_^•O YA;":'X i,04L 'P)xpyr',~~
<br />ADDRESS I 'i ~' i , : ' ; . .'i
<br />., ~ k•
<br />
<br />
<br />FAal.m
<br />
<br />?1',:: YLC`'. 4PL LUL'L;~.', 'cti "ryc• ,y;.{.
<br />NATIONAL FOLIVTANT DIeCHAeOF EVMINATION SY3rFAI ((NPDESI
<br />DISCHARGE MONITORING REPORT (OMRI
<br />•`411"
<br />PERMIT NUMBER plscRMOE NuMeEe c _ c • .• ; C, ,,;;; * ~
<br />MONITr IOD •~ 1 ,,,' ", 1''^I~`'I. CFF?~
<br />YEAR MO DAY EAR MO DAY
<br />FROM 1 U "1 .U1 I):, j,". .: i-; `...--. i~Ap•-- ~__~ .r•,:
<br />NOTE: Rud ImwcHo[r briar. eompMtinp i}rM iam.
<br />
<br />PARAMETER QUANTITY OR LOADING
<br />QUallty Or Concentration NO. FRFOUENCY
<br />of SAMPLE
<br />
<br />AVERAGE MA%IMUM ~^{(~Ij$,
<br />~
<br />MINIMUM AVERAGE MA%IMUM UNRS E%
<br />ANK~R$
<br />TYPE
<br />'7ND~JCTIYITY SAMPLE ..:-, .. ~- .i .. _.. - ( `) ~ :.,
<br /> MEASUREMENT c>l ~ !7 ( ,~ N 3 4 ~ I ~C' .Tk /aY
<br />' :"..,~.a.is h:3~ ~ ~
<br />'
<br />~ ;~..3.}p; ~>r
<br />.;: ~: :.'.".fF,X'~x*~.'.. S:~^?1 .~~ ~~::a:n::.V~.(`y R,;»:;'j u'; ,,~ ~~:'r +i yt j' 7,.
<br />
<br />i'~'LOS' 1' :F %3`> VhLlir: ~REtiUINEMENT;
<br />~.....::.:~ :..:::::... :
<br />.'~;~~
<br />........:T ~::;::::.;.::.::: .
<br />;.;•:
<br />..
<br />~ ..
<br />{(ci.A ...~:y~n..
<br />.GA~7:LY..:~+~~Y..
<br />C'r
<br />jt+}~Y a
<br />+ SAMPLE
<br />E ac4h4d vr.R4714 ••z':"'. .ti
<br />C
<br />( I ,'
<br />~ 1"
<br />I~~
<br />~~I
<br /> M
<br />ASUREMENT p
<br />7 f ~ ~ ;.
<br />"J'J U:) 1 J 7 .,..PERMIT ~.~: ~'='.•; .: ..~,....:..
<br />... ~ •t
<br />
<br />:a.r•, ~:x , ~
<br />
<br />l ....i. r ~z ..y
<br />
<br />Lr
<br />a ~ REQUIREMENT. ~ ~ ~ ~ ,..:..: w r:y ~ ~}; T.,7l~#J tl~.: ~Il
<br />L 7 `_% ": , T') T A L SAMPLE ,. ... ~ .. .. ( I `i )
<br />~ a ~ , .~;, U MEASUREMENT ~}A N~ ~ ~~
<br />:" 5..1 J J 0 :<.:.....PERMIU::;;~:: :: :: ,.,v.. ;.'Yn ~~ ":::: i,•b %: '. •: ~.' :. <p it ~'t :: :- ~ :.~ .. T.:r::~ R +, .'l
<br />,: - . e ~
<br />_ ~ M rs BPLOiI ~~REQUIREMENT
<br />r .. . .:::..........: ~~~~:.
<br />....... ... ~ ..4. ~ ~ ~
<br />' `i~.::k. A.~s' .
<br />':I3:p,. Q Yr..:f!:$:
<br />.". ~/L
<br />"1Q r.:f
<br />Li': S, TOTAL SAMPLE
<br />MEASUREMENT .. -... ..
<br />~
<br />'~ ( 1q)
<br />Z,.
<br />1 R
<br />JSi'::H'JF:D ~ '~
<br />.~•. I r :::r:~:..PERMIT~:. ~ Px",=zo :' :. :. .: .. .. .... .: ~ !~:.x ?: ': -,': ' ~ R
<br />.~ I ,-
<br />r r .. J ~ ~ T ., d J Y A .REQUIREMENT
<br />:.......:.... .... ~
<br />..:
<br />... ~ ~ ~ ~
<br />i , :' .4 `.11:Y "- ~ ~
<br />"~.k.T i;: $ ;?i g': ,, .; ~., r
<br />LE.E3 ALT t
<br />LI I; ;, ;YTTLEA9LP SAMPLE
<br />MEASUREMENT ~
<br />~ ( ~. ~
<br />3
<br />'
<br /> ~ ~ ~~ r
<br />~
<br />; } •a J 0 0 si~::~::;PERMIT: '.:,:. .. ~:.R h~~n:~t a .. .:;Y ~i:'ttx ^:;x.;: ~ ..:. ,. ,~: r::•:.F :_ ~: ~ •-+-~ycs ,Q.:: ~~.*:: ~:
<br />:.::::
<br />"' _ i ~ ~ c 4 T 5 B 6 L O u REQUIREMENT :::: , : ~::: , - ~ 5.r I;.g-:'~IY .'! [. / ;. ".:: ;~4t1i~'Iat
<br />,.: u5, .~.fTLEAHLr SAMPLE }.. ::i:ag ....,r.. ( ,:;)
<br /> MEASUREMENT A)h u^ ~ ~~
<br />']'{': L J O ::iS:i:',PERMIT~~:.~.:..
<br />:.
<br />. ".~. 40Yt#'A~C :: ^. :.~.~•: !X.B ;nh;V ;'~ :.:_. ~. ;, ~~.: ~~~... ., ,. ;. r. {Y n:r i~~'.~~.Q~a ~n~: .:( ~~.I;:f . iY Jail
<br />
<br />r~i.'i"•T GP.JSS Y4LL'C . .
<br />. .
<br />REQUIREMENT .
<br />.: .. :.
<br />: ;.
<br />~°+-
<br />- ;,. rA`1':,
<br />.
<br />:Or~.;r:Ta`: ,H%
<br />"L/?.
<br />-:
<br />::3(K1MX'li
<br /> SAMPLE ?'Y :a `:}., .•,•.n. t ( I ~)
<br />' ~~ r, ~. ;. H C U Y F. H A H L !' MEASUREMENT
<br />E. S7
<br />C~.ZZ sj~~ ,ye /i'~
<br />'
<br />-3 :,r 1 0 U ;,";~.'~PERMIT:~:::~~ :~~##~CO~91 : ~~~:xrt:.„/r'~f: ' fi':(. ~~ !:+;:~:d<-?;. I.:.U ~ :-;icp~num:. iI~:ICF./ ;t'.4d
<br />.
<br />:~L'Jdtii' CRJ Y ~f1EQUIREMENT
<br />.~....:,.: :::.....:::... :~~:?~~,~ ~.. ..
<br />....:..:. :.~:..~:.:~
<br />,~~ ~:~:. .: ::::.~.
<br /><:a•t.
<br />..
<br />.
<br />~.:-S r1.ro.4 :h~Y:.
<br />~:~uA~:L.(.C~ayFY:
<br />yr;/L
<br />~~~:
<br />31.ONT~M
<br />NAMERITLE PRINCIPAL EXECUTNE OFFICER 'aeniry
<br />pnprM un rrp.n..,nl.. u.l ln
<br />uMn ml Elrrdlon o.mw b aorvlnm.na tll.nucnment~.rn
<br />nWen In aaeN.nn d.n uplem id
<br />nad
<br />~1 TELEPHONE DATE
<br /> [
<br />Ip [vun Ibl ~u.XnM wronnel pruprnl plner rM e.b.lr Ine Inlomull"n
<br />n
<br />lu
<br />a
<br />e
<br />e / //
<br />i~ '"1
<br />kichard Mills m
<br />,
<br />,.
<br />.
<br />e.
<br />onm~mymrr~u.wn"nww„nn..n,m...[rllw,nlrm, ,• 0
<br />7
<br />' wm.,rp.nnnal...ry,ew.abwt..[xb.,~n[m.lnro.,.un.n..b.lm.m..n.n / /J :7
<br />8
<br />Q-2712 -
<br />
<br />~IYirern*lerral
<br />•i,insgar
<br />wbminMlAbinebnrnrmrkm.ktl[engMllrr,Irve,wavnlw..~Enmplrlr.
<br />Lm...n ua um.na[Mnnm wnnnn rorwbmlmn
<br />r.~mronulw
<br />V
<br />eIDNATURE OF FRINCN'AL E%ECUTIVE
<br />OI ~`
<br />J
<br />w'
<br /> n,
<br />[
<br />ImrWl
<br />In
<br />dblll
<br />la
<br />TYPED OR PRINTED n[
<br />r p"
<br />l,o
<br />n.M lmpnfon~mnl for Lra.ln[rlq.aui¢ OfflCER OR AIRHORIZEO ADENi CODE NUMy~R YEAR MO DAY
<br />COMMENTS AND tAYLANA11Vrv Vr nnT vIVLA IIVNS /R./.rnc. ~//.ft~cAm.nts ~.rl
<br />._%!~C.;T~ ,. 'iI: •P;. TSS ., ~TTL~dGLF. ~7L':DS (!.7C .') ,:"~LY 7:+LY iF' .- !`-Y3, 'c4-Hk PRECIP RV F,`+'" Iti
<br />'LFI'I C; `_1. i8c C.4.4, P' "., FUR NUR04H ')'' unn^,c ag;:ll .• ;. ^IC ., CFZAS^-SEE I. H.1. D, Pr. I1.
<br />EPA Form 3320-1 (Rev 3/99) Previous editions may be used. PACE
<br />0,02YSF; term. 1
<br />
|