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PERMITTEE NAME/ADDRESS (/nclude Faciliry NnmdLucarion ifOderenq
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<br />NATIONAL POLLIRAM DISCHARGE ELIMINATION SYSTEM (NPDESJ Form ApprOVBd.
<br />DISCHARGE MONITORING REPORT (DMRJ If OMB No, 20400004
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<br />YEAR MO DAY YEAR MO DAY
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<br /> QUANTITY OR LOADING QUANTITY OR CONCENTRATION NO. FREOUENf, SAMPLE
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<br />OFFlCER OR AUTHORQED ACENT
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<br />EPA Form 3320-1 (REV 3/99) Previous editions may be used. .. 1 THIS.I~ A 4~PART FORM PAGE OF
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