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<br />PERMITTEE NAME/ADDRESS pnaLb FrWry NrWfxarm dDIDinnO
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<br />ADDRESS Y:1,"_. ,F :;1 jC.`;f°{'/ : .~.. ,•. ~;
<br />FACILITY
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<br />NATIONAL POLLUTANT DISCHAflGE ELIMINATION 9Y9TEM (NPOE$)
<br />DISCHARGE MONITORING REPORT (DMRI
<br />!I-I61 l17-I91
<br />PERMIT NUMBER DISCHMOE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM 1 ~ 'll 'J . TO ~ .. ` .1.
<br />Un.J ll UJ-031 IJ4J51 116-DI /JB-191 130-311
<br />Form Approved.
<br />..-.•-. - ,-OMB~No.,2040-0004-.
<br />r~ , ~ 1 Approval expires 05-31-98
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<br />NOTE: Raed InstrucTlons bsfor~ com IstinO thu form.
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<br />RMATION SUBMITTED HEREIN: AMD BASED ON TELEPHONE DATE
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<br />~ MV INQUIRY OF THOSE INDIVIDUMS IMMEDIATELY RESPONSIBLE FOR
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<br />COMMENTS AND EXPLANATION O~IF ANY VIOLATIONS lRe/ersncs sll errscnmenrs Osrsl
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<br />EPA Form 3320-1 (08.95) Previous editions may be used. (REPLACES EPA FORM T40 WNICN MAY NOT BE USED.( n - - < .1 /„ ^ I _ T ; _ ~ - PAGE ~ OF
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