PERMITTEE NAME/ADDRESS p•~N Fs=IIryNa/Loc•uol =/D,p...nq
<br />NAME ',YPRI!" v, ~•. .,.• y '. .?At. '.'7D~
<br />ADDRESS rtIl1 ,j .'y t~ )Cv t .i U'I°,~~ ^av>i ~, nv(
<br />4"LUil Ei;'' 'T1pRP'.. ~;~'Lt.
<br />FACILITY
<br />LOCATION
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<br />NATIONAL POLLUTANT DIBCHAROE ELIMINATION SyBTEM lIYPOE$1
<br />DISCHARGE MONITORING REPORT (OMRI
<br />lI-161 17-191
<br />"~~)~/1~4 Ct'17 a
<br />PERMIT NUMBER DIBCHARDE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAV
<br />FROM ~ .' ,: TO `_ ° I I i
<br />116111 l11-131 !14151 /16-171 !IB-191 !34311
<br />Form Approved.
<br />* ~~ r ' c T„)OMB1No:, 2040-0009--
<br />F Approvey exp~{ea 05-31-98
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<br />NOTE: Reed instructions befor com latinp this Corm.
<br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING !I Grd Onlyl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE
<br /> !46531 !54611 l38J51 !4653 154611 DF
<br />l3I-371
<br />AVERAGE
<br />MAXIMUM
<br />UNITS
<br />MINIMUM
<br />AVERAGE
<br />MAXIMUM
<br />UNITS EX
<br />
<br />Is]-s31
<br />ANALVSIs
<br />!54581 TYPE
<br />
<br />169-701
<br />,U :i UCi:lITY SAMPLE .. ". t:.°rre .~: •: ~~n:~y ~; ~ i.)
<br /> MEASUREMENT
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<br />3U4PBNDP.'i MEASUREMENT
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<br /> MEASUREMENT
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<br />NAMEf{ITLE PRINCIPAL El(ECUTR/E OFFICER I cERnFr UNDER PENUTr DF uw THAT I HAVE PERSONAUY ExAMINEO AND
<br />AM FAMILIAR WITH THE INFORMATION BUBMITTED HEREIN; AND 9ABED ON TELEPHONE DATE
<br />Richard Mllls OBTNN MO THE NFORMATI MDINBE EVBE THE SUBMETTED EINORMATION~B ,
<br />
<br />Environmental P+4a^ager TRUE. ACCURATE AND COMRETF. I AM AWARE THAT THERE ARE
<br />9GNIHCANT PENALTIES FOR aUBMITTING FN
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<br />OFFICER OR AUTHORRED AGENT AREA
<br />CODE
<br />NUMBER
<br />YEAR
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<br />DAV
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS !Reference ell ettschmsn(s here)
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<br />EPA Form 3320-1 108.951 Previous editions mey be used. (REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.( ,. /
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