HYDRO30024

• Permit No: C1981008
• IBM Index Class Name: Hydrology
• Doc Date: 3/12/2001
• Doc Name: 3rd Q 1999 DMRs
• Permit Index Doc Type: DMR’s
• Media Type: D
• Archive: No

PERMITTEE NAME/ADDRESS (Include
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FACILfTY ____________________
LOCATION ____ ___ _ _ ___
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NATIONAL POLLUTANT DIiCNARGE ELIMINATION iY6TEM (NPOFS)
DISCHARGE MONITORING REPORT (OMR)
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MONITORING PERIOD
YEAR MO DAY YEAR MO DAY
FROM J 1 TO
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NAME/TITLE PRINGPAL EXECUTIVE OFFICER " I CEFnFY UNDER PENALTY OF LAW THAr I HwvE PERSDNAUY ExAMINED TELEPHONfi - :' D~A T E
AND AM FAMILWR WriH THE INFORMATON wBMrrTED HERENk AND BASED .
CN MY INOURY CF THOSE WpVpJAL:r IMMEDNTELY RE:fJNSIBLE FOR - 1
OHTAWViG THE WFORMATMJN 1 BELIEVE THE SIBMITTEO INFORMATION LS ~ _
TRUE ACCURATE ANO COMPLETE I AM AWARE THAT THERE ARE
SIGNIFIUNT PENALTES FOR SUBMITTING FALSE INFORMATIg1 INCLUpNG
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COMMENT AND EXPLANATION OF ANY VIOLATIONS (RC(ercnCe 611 61[6[hments here)
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