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PERMITTEE NAME/ADDRESS Qnclude Fanlity Nume4ncahon if Differenp
<br />NAME L: P'f': ~ Y f. - -
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<br />9100 hA ;'i ''I'.ES'L CIfiCL°
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<br />FiTiN: :a-Jrt4I5 51» ~:GLEY_ GENe!!A1. 6T6Y
<br />NATIONAL, POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (DMR)
<br />.(2-161 (tr~ 91
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<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM !'t) Ur '1~ TO UU Ut3 j
<br />(20.211 11223) (2x.251 (28.2 r1 (2&29) (3P3p
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<br />6
<br />5
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<br />(3237) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br />162.631
<br />(64~6a
<br />69J0
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<br />NAME(TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFI' UNDER PENALTY OF
<br />AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSONALLY E%AMINED AND
<br />ATION $DaMITTED HEREIN; AND BlSED ON MV TELEPHONE DATE
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<br />Environmental Manager ACCURATE AND COMPLETE.
<br />FOq SUBMITTIN
<br />NALT I AM AWARE THAT THERE ARE SIGNIFICANT
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<br />(SUNrt NY)
<br />F - FINAL
<br />"INF. 1, PCtiP
<br />Form Approvetl.
<br />OMB No. 2040-0004
<br />Approval expires 05.31-9R
<br />d0U'SS
<br />~ TC fCIDEL ;,PfzR
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<br />ter r.o DISCHARGE I~I • ~ _ '~19
<br />NOTE: Read Instructions before completing this form. X(ji
<br />ONCENTRATION NO. PREOUENC SAMPLE Fj
<br />(5a-sr/ EX oP TYPE ,
<br />ANALYSIS
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<br />EPA Form 3320.1 (DB~95) Previous ediiions may not be used. - - ~ (REPLACES EPA FORM fd0 WHICH MAY N07 BE USED.) C ~~') 7 3 / U 0 J 4 0 5-15 0 I PAGE , OF
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