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PERMITfEE NAME/ADDRESS pnrvd. FrWry NrdLeean«l1DISi..mJ
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<br />ADDRESS ~•'~I.-, i,: "?~- .F ~~_:'A`. ~ .
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<br />FACILITY
<br />LOCATION
<br />NATIONAL POLLUtµT DISCNNiGE ELIMINATON SYSTEM INPOE$l
<br />DISCHARGE MONITORING REPORT IDMR1
<br />!J-/61 l/7-191
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<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM '1 ! L TO " ' " . ' .
<br />/JO-J!1 !JJ-J31 111-J51 1J6I71 /36-J91 !36311
<br />Form Approved.
<br />•,Tyc j r O(~4n n rnO1gIB1Noi2040-0004
<br />l;. .,.„ „,l Approve; exDires.05-31-98
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<br />PARAMETER !3 Grd OnlPl QUANTITY OR LOADING !4 Grd Onlyl QUANTITY OR CONCENTRATION NO FREQUENCY SAMPLE
<br /> !46-53 154-6I1 138-451 !4653 154-d Il E OF P,PE
<br />!3?-37I % µALYS15
<br /> AVERAGE MA%IMUM UNITS MINIMUM AVERAGE MA%IMUM UNITS rE1~sa1 164-6g1 !64701
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<br />NAMElTITLE PRINCIPAL E%ECUTNE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I NAVE PERSONALLY E%AMINED µD TELEPHONE DATE
<br /> AM FAMILIµ WITH THE INFORMATION BUBMITTED HEREIN; µ0 BASED ON
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<br />F~ICfTD YC~ ~'I~~S MY INOVIRV OF THOSE INDINDUALS IMMEDIATELY RESPONSIBLE FOR
<br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS J /
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<br />EPA Form 3320.1 108-96) Previous edlUOne mey be used. (REPLACES EPA FORM T~0 WHICH MAV NOT BE U8ED.1 r ~ T 1 ~ / ^ ' r` ,~ ~ ~ _ l ~ ~ n PAGE „ OF
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