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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM MPDESJ
<br />DISCHARGE MONITORING REPORT (DMR~
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<br />' PERMIT NUMBER DISCHARGE NUMBER
<br />~ MONITORING PERIOD
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<br />(10.Pi1 (az-z31 (Z4-251 !~&2]I rt&TB) (30.31)
<br />Form Approved.
<br />OMB No. 2040-0004
<br />' ' .• Approval e~ires 05-31-98
<br />/ .~ NOTE: Read Instructions beforemmpleting this form.
<br /> (3 Card ) OQl?1TITY~RLOADING (4 Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER (4653) (54-Bi) (38<5) (4653) (54-81 p( OF TYPE
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<br />NAME/TITLE PRINCIPAL E%ECUTNE OFFICER I CERTIFY UNDER PENALTY OF
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<br />TYPED OR PRINTED § 1319. (Pen9tt/av under Nose smnrtas n,ay Include linai up ro ff0,000 and a
<br />maximum impdsonmenf of benaenemonlhceMSyms.) OFFICER OR AUTHORIZED AGENT
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<br />EPA Form 3320.1 (08~95) Previous editions may not be used. (REPLACES EPA FORM T•40 WHICH MAY NOT BE USED.) n N 9 q / ~ ~ ^ q t ' _ 1 ~ , , PAGE I OF
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