HYDRO27864

• Permit No: C1981018
• IBM Index Class Name: Hydrology
• Doc Date: 7/26/2001
• Doc Name: June 2001 DMRs
• Permit Index Doc Type: DMR’s
• Media Type: D
• Archive: No

PERMITTEE NAME/ADDRESS (/nc(rde Fanliry Name/Lxarion ijOi$erenr)
NAME
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ADDRESSD : g e ki A D D }i I ti ;;
J407 CJIIt:l'T r'CAG 65
NATIONAL POLLIfrANT DISCHARGE ELIMINATION SYSTEM (NPOES)
DISCHARGE MONITORING REPORT (OMRJ
^I~:,~-
ERMIT NUMBER DISCHARGE NUMBER T _ r ~ ,; A L
Form Approved.
OMB No. 2040-0004
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FACWTY tt n n b :. I ` MONITORING PERIOD ~ E D ~: 7 n °; +' p .i :•
LOCATION YEAR MO DAY YEAR MO DAY
FROM Q pc p TO ~i-.;a _~C^. Cs h:~:[ 11 yy~~ ....~
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Read Instructions befofe~bnlpleting this form.
NOTE
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QUANTITY OR LOADIN QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
PARAMETER F,( of TYPE
AVERAGE MAXIMUM MINIMUM AVERAGE MAXIMUM UNITS ~~~/S
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MEASUREMENT 14 '•
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MEASUREMENT
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• MEASUREMENT
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.' I b U n L MEASUREMENT
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NAME/TITLE PRINCIPAL EXECUTIVE OFFICER ICeniy untler penelry of law that Nis document antl ell aitachmenta were
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i TELEPHONE DATE
prepared untler my
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subrtsttetl. Based on my Inquiry of the pareon or person who manage the system,
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/ SIGNATURE OF PRINCIPAL EXECUTIVE / CJ
TYPED PgINTED lam aware that there ere significant penalties ror submitting false intimation.
Inclutlin the sibili of Meand im dsonmenl ror knowin violations OFFICER OR AUTHORIZED AGENT
NUMBER
YEAR
MO
DAY
COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
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EPA Form 3320~T (REV 3/99) Previous editions may be used. THIS IS A 4-PART FORM PAGE OF
00576/000717-1350 ].