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CRMITT[E NAM [IADDR[!f ()n[lYd[ <br />rdiry NrrnelLonrbn iJdlJJomrJ <br />_ n :. L....~ ~ ~'J . i ::C <br />DDR[f[_!.~ 1- <br />i' . it . i-----1 -- ~-li_n L :: -_ <br />---- <br />OCATION ~ ~ ' <br />.: s- I: ~ C- ----_ <br />nwnonwL PoLwrwNT ouch wwG[ eurmwnoN ErsrEN (NPDESI <br />DISCNARGE MONITORING REPORT /DMRI <br />1-16 ~ 1719 <br />. JG'':Ut: .'JL ~ JJ, d <br />•ERMIT NUM~[R ~ olECwwwcE NUr REw <br />MONITORING PERIOD <br />YE/1 ,: M DAY' YLAR MO DAY, <br />PROM. TO, - - <br />' ~ /70.7Ir./11-131 /N~2IF~ ~ /16- I 178. 91 / 0. Il <br />('J)'i ' ` ~~OMB No. 2040-0004. -' °" <br />' - " ~ "•' Approval expires 6-30-91. <br />i • •-)'. <br />NOTE: Reed inrtructions before eompletinp this form. <br /> (3 Card ONy) QUANTITY OR.LOADING (I.Card Only) QUALITY OR CONOENTRATION Rp [OU Encr <br />PARAMETER (KJ3), _ (316L) - ~ <br />~ (!NS) (16J7) ~ (Jlbl) NO. <br />E% 0R SAMPL¢ <br />TYPE <br />(31-37) ~ ~ wr,ALVSIS <br /> AVERADE MAxIMUM UNITe MINIMUM AVERAGE MAXIMUM UNITB 6767) (NfiM) (69-JU) <br />1 6AMPLE <br />M EABUREM ENT %t o..+s.T:i .'- "i if 1:. <br />~ yyC <br />'/~~~ r .r:..::y <br />~/5...~j)hl- L <br />~~+ ( L s.l <br />.., i~ U I. .J ._. L~ Vic. <br />! pE <br />' <br />5 <br />t <br />~ G .> P <br /> <br />~ ;' ~., <br />- h'4 „, <br />~-~~` <br />~ -.<:f~+g,-~de <br />. <br />- <br />. f•. _ ~.:. ~i r..i I . 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Y+J ~y t!n~i 4 ) <br />' •'+' <br />yylur/!~ E _ y <br />O <br />NAM [/TITLE PRINCIPAL [%lCUTIVE OFFICER I L[ROFY UNOER PENALTY-OF LAW TNAT,LNAVF-~PglONALLY CXAMINCD' <br />ANO AM FAMILUR WRN T11E'1NTONMATION SUeMrtTED HEREIN <br />ANO eAlEO~ ~ `J <br /> <br />, T[LEPHONE D A T E <br />; <br />ON MY INO111RY OR: THOSE 'MdYIdIAL! MMEOIATCLY R[lPONSIeLC~ iOR <br />~'~ ~~~"'{~~ ~ /~~ . ~~ ORfAINING TNC M/tl1MATIGV: I ;eECIEYE TN[' SURMTIED. INiORMATgN ~ ', / <br />/ ~ '~ ~~~__ /~) <br />I ~ ~ I / ~~~ <br />~ <br />, <br />/~ <br />.~.r C, t~ <br />~ <br />' ~ 6 TRUE. ALCURATE,;AND L,ONPLErL J'AM AWARE :THAT TMERC~AwE SIG <br />NIr10ANT PENILTI[! <br />FOR <br />~SUMRTING FALvF' IHFORNATICN <br />INLLUPNG <br />r ~ ~%:% ~~ G' <br />~ <br />~ / .~ <br />~~ <br />/ZC <br />` <br />. <br />. <br />. <br />1 <br />( / <br />ll.//'~A~~: r/,lr~A TNC rorSR11LlTY Or: LINE' ANO INPRGONN[NT..SE[-II -0.SC ! 1001 r.NO <br />]] u5L 11T9 rA <br />dn rArr <br />.Ndrn m mrld• /m.r o <br />r. <br />lIr4RN <br />fn 916HATV RE OF PRINCIPAL E%ECUTIVE ~ i J , <br />, <br />~ <br />p <br />. <br />np <br />e. mr <br />' ~. TYPED'GR PRINTED niW ~••mrr:iwun rinp.r.nn.rn .r/Nruww CwunrA. and .llnr.. r' 'OFFIO ER FOR AUTNORIIED AGENT '~ NUMBER YEAR MO DAY <br />:OMMENT AND EXPLANATION OP ANY V10Lw TIOrvS fAe/rrrnee uu prrrrnmenrE nrrrl <br />cPA Form 3321}7 (Rw. 9-88) P/trvbul editfom may be used. (wvLwco vw FDNM T-AO WNICN MAY NOT e[ UlED.1 . i ~_ 4 / -• . _ PAC[ DR <br />