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PERMITTEE NAME/ADDRESS (lnclrrde Facility Name/Latafion i/D~ercnq
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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM MRDES)
<br />DISCHARGE MONITORING REPORT (DMRJ
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<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM )1 ~ 1 D 1 TO :) : 0 1 J 1
<br />Form Approved.
<br />OMB No. 2040-0004
<br />~1":711
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference ell attachments here)
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