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PERMII'TEE NAME/ADDRESS Qnc(ude Facll/ry NmndLocunon if Di$erenr)
<br />NAME ~ypyUa ve ,-, ~ _. ^., .,~
<br />ADDRESS"ItlF.S LrT:T -^„-,ue ~ -;{':AK 'a>,
<br />4100 P1'i "i1"T',r rr~
<br />FACILITY
<br />LOCATION
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (DMR~
<br />(1161 If ]- Bl
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM ., . .. . 1 TO ,. r I
<br />(2421) r22-231 (20.25) 842]1 T2B-29) (30)1)
<br />Form Approved.
<br />„ ~ T , .; OMB No. 2040-0004
<br />Approval expires OS31-98
<br />~NOTE: Read Instructions befor~'c~eting this form.
<br /> (3 Curd OnN1 QUANTITY OR LOADING (4 Card OnN) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER (4G53) 54-61) (38.45) (46-53 54-81) EX OF TYPE
<br />~2~n AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ~/v-ySIS
<br />70
<br />9
<br /> (62.63) (64-68) 6
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<br />NAME/TfTLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSO
<br />ATION SUBMITTED HERE NALLY EXAMINED AND
<br />IN; AND BASED ON MY TELEPHONE DATE
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<br />IL INQUIRY OF THOSE INDIVIDUAL
<br />THE INFORMATION
<br />I BELIEV S IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />E THE SUBMITTED INFORMATION I$ TRUE
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<br />PENALTIES FOR SUBMITTING ,
<br />1 AM AWAflE THAT 7HEflE ARE SIGNIFICANT
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<br />EPA Form 3320.1 (08A6) Previous editions may not be used. (REPLACES EPA FORM T~0 WHICH MAY NOT BE USED.) ~ ~ 1 : c / ~ 1 ~ !11 ~-1 r ~'I PAGE OF
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