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<br />NAME ,3L'J°_ yOUgTAIA E9rPGY, IY~.
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<br />NATIONAL POLLIlrANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form ApprOVed.
<br />DISCHARGE MONITORING REPORT (OMRJ OMB No. 2040-0004
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<br /> PERMIT NUMBER DISCHARGE
<br />NUMBER _ ~ I ., A I ~t' ,
<br /> MONITORING PERIOD ~tP-~'~~ { =~-~~DI P?`iD TC) P':D KF'i lr.
<br /> YEAR MO DAY YEAR MO DAY _
<br />FROM ^1 r'I ')1 TO Ol 0' Ji - ~' r 1
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<br /> NOTE: Read Instructions befOre'CDFnpleting this form.
<br /> QUANTITY OR LOADING QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br /> EX OF TYPE
<br />PARAMETER AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ~'''~~/9
<br />Fn SAMPLE .:~ ~;: +: -t*::*~+7 .. ( 1~)
<br /> MEASUREMENT
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<br /> MEASUREMENT
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<br /> MEASUREMENT
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<br />(q ~~ ~ ~) MEASUREMENT
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<br />NAME?ITLE PRINCIPAL EXECUTIVE OFFICER ICerory antler penalty of law that Nls tlocument antl all anachments ware TELEPHONE DATE
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<br />~~ ~'*f `L,~ r l ~ ~ eu ( prepare0 antler my tlaection or supervision .n accortlance wdh a s}stem oeslgnetl
<br />to assure that quaifietl personnel properly gelhar antl evaluate Ne inbimaaon -
<br /> submihetl. Bnsetl on my inquiry of the poreon or persons who menage the system,
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<br />SIGNATURE OF PRINCIPAL EXECUTIVE >
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<br />TYPED OR PRINTED lam aware that there are sign cant penalties for submining talso inbrmation,
<br />inGUd'n the ssibili of ins and lm risonment for knowin viOlaliona. OFFICER OR AUTHORIZED AGENT
<br />OE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Aelerence all attachments here)
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