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PERMITTEE NAME/ADDRESS (Include Fac~hry Namr/Locmion iJDiBerenr)
<br />NAME SEYE;CA CCAL CClI/NT
<br />ADDRESSD i3 A Y E: R D
<br />NAroeY Co 91639
<br />FACILITY
<br />LOCATIONNAYUEN CO 61630
<br />ATTN: G. t7UD 660YN, GENEkAL MAY~GEE
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDESJ
<br />DISCHARGE MONITORING REPORT (OMR;
<br />(2-I61 (I7- 91
<br />C00 21 0 A
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONkTO ~NG PERIOD
<br />YEAR MO ~ YEAR MO DAY
<br />FROM (~.TO Y ~
<br />(10-21) (25231 (2 (2627{ (2H-29) (3031)
<br />
<br />Farm Approved.
<br />:" I N V h OMB No. 2040-0004
<br />A?proval expires OS-31-98 ~- .i
<br />(SUER Yi)
<br />- YII11 FCU47
<br />DI5CE1A~6E TC G619SY CSEEM
<br />NOTE: Read Instructions liefofla Completing this form.
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<br />PARAMETER (46-53) .($4-67) (38-05) (46-53) (54-61) ',,, ''~X ' OF TYPE
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<br />NAME/TITLE PRINCIPAL E%ECUTIVE OFFICER
<br />I CERTIFY UNDER PENALTY OR
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<br />i SIGNATURE OF PRII IPAL E%ECUTIVE . Y
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<br />COMMENTS AND E%PLANATION OF ANY VIOLATIONS (Reference all attachments here)
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