Laserfiche WebLink
PERMITTEE NAMEIADDRESS perL4 fsWryNaw/Lam«!/DlO rwrJ <br />NAME ., :... ..'.; , t ~ ~ L.',' <br />ADDRESS J,1 A ,r I- n <br />FAaLm <br />LOCATION (;, '-,. CU ~1 F, I ; <br />_... _ :, G~dCdAL t1AHAC... <br />NATIONAL POLLUTMT DIBCHMOE FLMINATON 9rBTEM (NPDESI <br />DISCHARGE MONITORING REPORT DMRI <br />lZ-I51 E7-f9 <br />CJD )OG.._: OO~s t <br />PERMIT NUMBER DISCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAV <br />FROM i .i 1'./ U TO ' 7 L t ' <br />rzazD rzz-z3r vi-zsr rzs-vl rze-zsl r3asn <br />Form Approved. `- , <br />- . ~'„ ; ~ 4 ~ ~~ .. 'r r 4Me NGf 2ono-.94D9 <br />-~ f ~ , y r, ~ APProvel eltpi ~ e.05-31-SB '~„ <br />F' - c{NAL ! <br />NOTE: Reed Irutructlons bslws complstin0 thin form. <br />PARAMETER !3 Grd OnlYl QUANTITY OR LOADING !~ Grd Ontyl QUANTITY OR CONCENTRATION NO. FREnuENCr SAMPLE <br />!32.371 l46-531 /5b611 /38-451 r4G53 /6451 EX OF TYPE <br /> <br />AVERAGE MAXIMUM UNITS <br />MINIMUM AVERAGE MAXIMUM UNITS <br />/si.e,Tl MALrsls <br />/6.~-6a1 <br />I6&701 <br />_t;:~:.:i ..$Ta:: i .. SAMPLE :CJRi ~?:~: ;: .- ~ .. •. 7i <br />, <br />~; MEASUREMENT I <br />. i.r ~ ~ 1 U ~ PERMIT ~ <br />-.. .l <br />.- :>_#.'Y . <br />~ .,..~........,`«. <br /> <br />~ ~ 1.v-^ ~ ., :. ...:.. _ <br />;; :; dl:l.:: REQUIREMENT. ~.~. ~ .~: <br />.. . <br /> <br />.. . <br /><< <br /> <br />. <br />... „ ' = * it ~ .; .. ':' <br />' SAMPLE - ... ~ ~ Y <br />.. <br />~ ~ ~ ~ <br />.. .. <br />... <br />{ <br />` :.1 <br />J <br />`. <br />~ <br />~ <br />g <br />,.. ~' 1 .. . a L L MEASUREMENT I L) ` <br />- - ~ .+ J ~ PERM17. ~ <br />.,,:.; .. <br />~%=~;~~ ~ <br />~ <br />~ ~R~...Kiv~t4 <br /> <br />~ <br />: <br />. .. IT~6.. '. <br /> <br />~ ~t,Y:?: .r;: rSZ#~.~~~~.j :~4LT.~_ :R.i~~:;.~. <br />::- ~ir'4Jr .REQUIREMENT ~~ '., <br />~. .. <br />.. <br />~ .~. ~ <br />~...:.~ <br /> SAMPLE <br /> MEASUREMENT <br /> ~~ PERMIT. ~~ ~ ~ ~ ~ ~ ~ ~ ~ ~ <br />~ ~ ~ ~~ <br /> REQUIREMENT: <br />:... .. ..: .: .: ~. ~ . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT: .~ ... .:.. <br />:. .. <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> ~~PERMIT ... ~~. ... <br />: .., ... ... ... . <br /> <br />~RpQUIREMENT ~ .:. <br />. ~ <br />.. ~ <br />~ ~ <br />~ ~: ~ <br />. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~~ <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/I1TLE PRINCIPAL EXECVTNE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMILIM WITH THE INFO UW THAT I HAVE PERBONKLr ERAMINED MD <br />RMATION SUBMITTED HERON MD BASED ON ~ i ~ TELEPHONE DATE <br /> Mr INOUIIIY OF THOSE INDINDUALS IMMEDIATELY RESPoNSIBLE FOR <br />1 <br /> OBTNNINO THE INFORMATION. I BELIEVE THE SUBMITTED INFORMATION IS <br />TRUE <br />I AM AWME THAT THERE ME <br />ACCUMTE MD COMRETE <br />Y <br />~ 1 <br /> . <br />. <br />SIONIRCMT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING L~.-~~r <br />L~ ~~ ~ ~ tL~ <br /> <br />, <br />THE P05981LITY OF RNE MD IM%UBONMENT. BEE 1B U.S.C. 1 1001 MD ]] <br />T <br />E <br />F <br />E i <br /> U.S.C. 1 1]10. lFrWlM/ IIWI eN« enema mry AICAd. (xw. w ro t 10,000 SIGNA <br />UR <br />O <br />PIIINCIPAL EXECIRR/ <br />TYPED OR PRINTED w>m.rbwnAro.iswrwrn oYMlw«ce~m.wewzl OFFICER Op AUAIORIZED AGENT cooE NUMEIER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRSfsrencs sl/ etteeemenn Asrel <br />EPA Form 3320.1 (08.961 Previous editions mey be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE U6ED.1 I? 00 3 7 / y 9 17'1 L U- U 9 2 3 PAGE } OF <br />