Laserfiche WebLink
P[RMITT[[ NAM[/ADDROB (InElude NATIONAL POLLUTANT DISC HARGE ELIMINATION [YBT[M (NPDES') corm Npproveu <br />FRrillry Name/LOrRllon IJ dl~ennl) DISCHARGE MONITORING REPORT (DMR) OMB No. T0440AP4 <br />NAM[ I I I `I 11'.I I' tl :1 ~. I C 'A (~ ( . ) <br />__ __ l+-In) ()7-J7) Ex /res?-?9-84 <br />ADDRE[[_rr .IIE II: ~_-__ _--_-_-- I I b'l'-.' -~~ .~ p. <br />I <br />____' (_ "' L r I ~ PERMIT NUMBER oucHwRDE NUMBER MIN~LnNDIRrv-I~IJA~~UF7AL RC30URCFS <br />r 423 CEL I CL/1MgTION <br />_---LY I r I l I ___r___________ MONITORING PERIOD 7J19 ` ilTFr'i,IIIF.L f 'lll PIING ' <br />L.I. J., fi:I-L)~ ~/1W1.~ ~~ <br />~O~~L--------------------- YEAR MO DAY YEAR MO DAY _ Arrlvt_n, CULQ~ <br />LOCATION FROM I TO v1D0 LIO~(!3 _ <br />rzazn nz_zll rzczn r>a n .zx.zo. nn.U. NOTE:Rs[dIn[truellonB 6Blen DenielBtlnG Mh loml. <br /> (3 Card Only) GDANTITY OR LOADING (I Card Only) OU ALITY OR CONCENTRATION <br />PARAM [T[N (A]-]J) (]Id)) (Jb~]) IAb.TJ) (]IfiJ) NO, FP[OQUF HCr [AM/L[ <br /> <br /> AVERAGE MA%IM UM UNITB MINIMUM AVERAGE MA%IMUM UNITB <br /> 616J) (AI~B) (6V-IB) <br /> [AMPLE <br />L I1 (I ( L I I I I 1 MlA <br />[ <br />U <br />R <br />[M [NT • . ~ ~ . <br /> ..a <br />,, <br />~$ <br />$ <br />. <br />IT R ` e ~`q ..>. <br />~ <br />• 11 (' ~ ~ 1? . <br />ARA <br />"Nt~NilYtylnBT A' • 4 ! • • • A f A a . . • a •~ ~' M ° Y t ~ .f •j <br /> ~ <br /> BAMPL.[ <br />•, I)1 I11 T~,T I '• li•1. MEASUREMENT • r • • • a • a <br /> <br /> ~ <br />a <br />r, l <br />. I) BIZ Nt11 -At~" ~ • f A 1 a • ~ + A T~i J., ~ <br />%S~ t~i'1 <br /> , <br />. <br />. <br /> SAMPLE . <br />1 i ~ 1„ • I I I w l MEABUR[M ENT . ~ • A E • • • <br /> ~-[NM1T /~ ~ ~ ° <br />1 1 0 .1 `. NltgOiN[Y[N'T r. i ~ 4 • ! • f • • • <br />. . <br />' ~ <br />f ~ ()° T~ b' <br /> ~ • , <br />• <br />. <br />BAMPL6 <br />. <br />~1: { (1 I (' <br />• - MEABUREM ENT • • L , • R • I . r <br /> r <br />OU~IID RttlLIN[MWT v # A ~ '>t' B B <br />A . <br />' A i f^{°~ ')~i .n t.{~ x ;~~1f~` <br /> • , <br /> SAMPLE <br />1) ( ~ (, ~, 1 ,, " I MEASUR[M lNT , • a • • . . . <br /> ~ ~ ~ <br /> • w a <br />9 :I n I i 7 N)ZtlU1NHJIpiT • ~ }`. < <br />4 , t v ~x ~R f + • • 1 a + A 4 ~ ~ ~ ~/ ~" ' r.l <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> M <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> " ~SI~R MJTs' ' ~ " ~ ~ <br /> <br />R[4UtN <br />[NT~~ <br />. , <br /> a <br />w A< <br />NAME/TITLE PR NCIPAL 6xECUtIV! OFPIClR I CERTIFY UNDER FENI1LTr OF LAw TNA* I NAVE PEwsDNwuY EAwMINED <br />AND AM FAMILIAR WITH THC INFORMATION SUBMITTED HEREIN AND BASED . . TEL[PNON! D A T [ <br /> ON MY INQUIRY OF TMOSE MpVIWALS IMMEpATCLY RCSFONSBLE Fpi <br />~ OBTAINING THE INFORMATON I BELIEVE THE SUBMITTED INFORMATION <br /> IS TPUE. ACCURATE AND CCMRLR[ I AM AWARC THAT TN[RE ARE SIG <br /> NIFIUNT PENALTIES FOR SUMITTING FwLSE INFpiMATgN INCWdNG <br />A , <br />/- <br />' THE POSSIBILrTV OF FIN[ AHD IMPR50NMENi SEE IB USC 1 1001 AND <br />J3USC 11J19 rPrneltw uMTr IhTW uerulTF nu mNUdn nor. uP rn Jlnwn SIGNATURE OF PRINCIdAL E%ECUTIVE <br />TYPED OR PRINT[D eM ~Il~maxrmum rmnn•onm•vu/A.ru..n6mnnlAx and .c rnP..I OFFIC Ep OR AUTHORIZED AGENT A NUMSER Y[AR MO DAY <br />COM)M ENT ANO E%PLANATION OF ANY VIOLATIONS INE/neon all alm[RmenY Roq <br />I{ )'.1 ~rI rl(.(1 II 1 ~ II .II (1 I i ~ .. <br />:t t r, l: ' l l I .. L 1 .) 1. . II (:.. I N. 1 .I •t l I I I I I'- <br />•E 1 I <br />EPA Form 3320-1 (ReY. 10-79) uNiV1OiUPPLY IB [%MAUBTEDlD (RlPLAC[S EPA FORM T-40 WHICH MAY NOT BE USED.) PAGE OF <br />