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<br />PERMITTEE NAME/ADDRESS (Include FaeiGrv A'nme/Location fDi$ereno
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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDESJ Form Approved.
<br />DISCHARGE MONITORING REPORT (OMR~ OMB NO. 2040-0004
<br />rzas! n7- P7 !! A J 0 °. Approval expires OS-31-9R
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<br />PERMIT NUMBER DISCHARGE NUMBER F- F 13'. A L A D C;
<br />MONITORING PERIOD CIYE 1 ~ PGI:D H 1C hI PC'Lr CHEEK
<br />YEAR MO DAY YEAR MO DAY
<br />FROM Dr Uh JL TO Uii Uh 3 i ~ '~" hn CI SCHA3G E; ~--~ ~'~'`•`'
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<br /> (3 Card Ony) QUANTITY OR LOADING (4 Card ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER (46-53J (54-61) (3845) (46-53J (54-67/ E% OF TYPE
<br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br />(6z-6J1 ANALYSIS
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<br />69-70
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF
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<br />Richard Mills INQUIRY OF THOSE INDNIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference ell attachments here)
<br />-.'fTLE6aLls SOLIDS LIMIT IS wAIYLG (LOC 'P') OkLY IF >10-Y d, 24-`ifl ~aiCIP SYt.•11 i5 C16;M4C. 3c2 I.A.'l,
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<br />EPA Form,7320-1 (08.95) Previous editions may not~be used ~ e ~ (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) L, ~ i ~ ,_ / J (l U I .J r- I ~ V 1 PAGE 1 OF
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