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PERMRTEE NAME/AODRE55 pw64 FwWryNr~rxo,.l4D10....p <br />NAME ;~-: 2,r~n C~.J?.L LG°.'. Lt <br />ADDRESS C r A w is H U <br />4AYLL!r c:J ylbj~ <br />FAaLm <br />L~~hAf J%7 CU B15 j7 <br />NATIONAL POLLI7TANT DISCMMOE ELIMINATON 4Y4TD,1 /INPOfSI <br />DISCHARGE MONfTORINQ REPORT (DAIRI <br />-,nnnc,~~) nT~, <br />PERMIT NUMBER :,.d.~ •axNAADENUMea <br />MONI7iORING PERIOD <br />YEAR MO DA1'N ~ YEAR MO DAY <br />FROM DD G7 0+~0 OQ 0'1 Jl) <br />(s!~.. ~~u) ~ <br />F - FI`:AL j1~0'fT <br />DISC't.4ifGr '1 r' -iA::F: CHF'BK S' <br />•~~ NO DISCNAPGF ~~~"' <br />NOTE: RArd hl~truederr Mtor! eompMEinp ihN fwm. <br />PARAMETER QUANTITY OR LOADIN.O r~ ~ <br />Quality or Concentration NO. p1ECDENCr <br />P SAMPLE <br /> <br />M Ex D <br />ANKrse TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMU UNfTS <br /> ~. <br />:i1L ANI. G,;EA=: iS <br />~ SAMPLE <br />MEASUREMENT r, rtpy ::: ;i ~ ~ ]q~ ;-+`L.d rttr ;. ~L='f is 1"<r'. ~::..~ / 1/~ <br />V I i U .4 L (J 1 <br />„ <br />~1LbJ L J V .PERMIT.:: ~.. <br />~'. ... .. ~~. ': .~...... .i: <br />~. ...,.-. .F.:.^"~: <br />L'. C: :'., ) <br />1.:.=I ~~;~~=;.rr <br />::~:. <br />,:. :. ,F.._,.~" <br />"'C .:'; .:."~,' <br />': ip„^^• <br />ii. .. <br />,..r't'\. ~~~/:' _ <br />r1JU7,L <br /> <br />PFI Ir F":dr :; R(~;<. V:i 'Ir REQUIREMENT <br />~....:. .. :. .. <br />~~. ~~ ~~~ <br />~~,1,,,. Y•~>1~Y <br />pn=n <br />,:~~:~;..:":~ ::~~::~: <br />.: ~ <br />#~:'# <br /> <br />... <br />:" <br />}~(1~:':I <br /> SAMPLE <br />. <br /> MEASUREMENT <br />~, <br /> PERMIT <br />~~:: ~'~ <br />" <br /> . <br />.REQUIREMENT ~. ~ ~ ~ :. ~~ ~ ~>~ .:.: ~ ~ <br /> SAMPLE 'r <br />' MEASUREMENT <br /> ~ <br /> ~REOUIREMENT~ "~~ ~ . <br />.~ .. ~ :. :.~ . <br />. .. . <br /> . <br /> SAMPLE <br /> MEASUREMENT ~+~~~ <br /> ~~~ "PERMIT ~.~ ". ~ <br />~ <br />~ <br />. <br />:.~. ~ ~ " <br />.. <br /> .REQUIREMENT ~ : ~ ~ ~~ ~ ~ <br /> SAMPLE <br /> MEASUREMENT , <br /> :":~. ~:~PERMIT~ : ~ ~.. .. .. .. . . <br /> .~REQUIRENIEtt1' ~ . <br />.. .. <br />,.. <br />.. .. <br /> <br />,. <br />. <br /> . :.,.:;. <br />. <br />...... <br />~ ~~ ~ ~ ~~ ~ ~ <br /> <br />~ ~~ <br /> <br />~~ <br /> SAMPLE <br /> MEASUREMENT <br /> ~.. PERMIT~.~. .. .... .. ~ .. <br /> .REQUIREMENT. <br /> SAMPLE <br /> MEASUREMENT <br /> ...:~ PERMIT'",.: : ... ~ . " <br />~ ~ : .. .. ~ <br />~ <br />~~~ , . . <br /> REQUIREMENT ~.. <br />. <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER ' nml> a er pne,r o b. me, u b eorvnem ena m mnNmme wen <br />TELEPHONE <br />DATE <br /> PnP•nd unler mT el,..nen e.wp r.laen In .e.e,a.nn.un. <br />.,em aes <br />nw <br /> q <br />L <br />,e.wn ua y..un.a pn.nM r.wenr E.un .na e.mae ue lwrervunon /~~~ <br /> wbml,lad. tlnad w mr I,puln N ue pnw a pnwn.ne m.nep DM.nlen, <br /> or IM1Ue pnm tllncNJ .apMbk ror LnIMAM Ue InAmm~nn, the 1MOrnullan <br /> wbmllled b, le lnebnl of mr Y,pw4tlp and htler.Irve, mtynn.eM nmy4fe. <br /> I nm e..n uel urn enaEannm pn.me for wYmntln <br />m. mre <br />,b 610NATURE OF MIMCIPAL EXECUi1VE <br />TYPED OR PRWTED <br />_.___. _. E <br />rvu <br />n. <br />InelwnmE lnr bn,l n, nnr .ntl lm nwnmem rorYw.InL .Iw.uo <br />~ r o ~ <br />. <br />OFFICER OR AVTHOItIiEO AOENi CODE NUMBER YEAR MO DAY <br />..vmmcn I a nnu cnr~nnn ..vn ..~ ..~.. ..vin nvna rRI/RIOC/ en ~Trscnmmn nny <br />:',~ .. IFL:..h' LI11I'1'_ ~:LL •:~1vEL ,~TTLrAi•LF ;GLi:1~ ,.i:'i, AFPLLi~ 'r'rin <=1 L`i .; F, TJJ is <br />~Y r;R r: cIt' ~vl:hr; <br />Ic;Jh LI'iITS NAIYF.,7 F'Cr: ~1JYi:nltlgP F'~c~IP ';VERY Si!`J'`^T ..Ui::~:: ,'' CF'J^F iti I. 4.~. aIL Gh;A~E - SE!' <br />FPA'ForfnLJ020•I (I~y'3/99~ prei~ous editions may tieeu`sed: ~ ~ This is a 4-pan form. PAGE of <br />00051/ODU'rl )-tole 2 <br />