I'ERMITTEE NAME/ADDRESS (/brd. i:l4ryNsw/IxaNm IJD{Qfmmp
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<br />NATIONAL POLLUTANT OISCNMGE ELIMINATION SYSTEM (NPDESI
<br />DISCNARGE MONITORING REPORT lOMRI
<br />(7-161 l17-I8I
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<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAV
<br />FROM '.~ ')1 J TO `1 .`! '14 ~"-
<br />l1PI1I l12-231 174751 !76171 l18-791 !34311
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<br />Form Approved.
<br />,.-,OdQB~No: 2040-0004- ~~
<br />Approval sxpirea.05-31.98
<br />NOTE: Raed instruellorls balore complatinQ this form.
<br />PARAMETER 13 Grd On/Yl QUANTITY OR LOADING I4 Grd On/yl QUANTITY OR CONCENTRATION N0. FAEOUENCV SAMPLE
<br /> 146-531 (54611 I3B-461 !4653 154-8I1
<br />EX OF
<br />TYPE
<br />137-371 ANALYSIS
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !s]-691 !64681 l69-)Ol
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<br />NAME/I1TLE PRINCIPAL EXECUTNE OFFICER I CERTI
<br />AM FA FY UNDER PENALTY OF
<br />MILIAR WITH THE INFO UW THAT I HAVE PERSONALLY E%AMINED AND
<br />RMATION SUBMITTED HEREIN; AND BASED ON TELEPHONE DATE
<br /> MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR /
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRererencs en srtecnmsnrs nets!
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<br />EPA Form 3320.1 108-95) Previous editions may be used. ~ (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.1 J., . ,. , ~ - T ., .., PAGE . OF
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