Laserfiche WebLink
PERMnTEE NAME)ADDRESS p... F~1YryN~JLera[aw VDbi..v) <br />NAME <br />.i ~ r <br />ADDRESS ' <br />FACILm <br />LOCATION <br />t ; <br />MATIONAI POLLUTANT d9CHARDE EUMINATION S/9fFAI ((NPOf$l <br />DISCHARGE MONITORING REPOIIT (DAIR) <br />PERMIT NUMBER D19LNMDE NUM9ER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM i ~ TO <br />') <br />~. I. <br />NOTE: R~~d knWCNoEr bAlw' -~mpM1Mp thb Iwm. <br /> <br />PARAMETER QUANTITY OR LOADING <br />Quality or Concentration NO. RIEOUENCY SAMPLE <br /> <br />EX of <br /> ANALY99 TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />_ - SAMPLE I i~ <br />_ MEASUREMENT <br /> : . <br />~~ ,: ,.: <br /> <br />,. . <br />. <br />REQUIREMENT. <br /> <br />m . , <br /> SAMPLE <br /> MEASUREMENT - <br /> '~~ .PERMIT ~ ~ .. ~ _ ~ i ~ .. <br />:. <br /> ;REQUIREMENT ~ ~ ~~ ~ ~ ~ ~ ~~~ <br /> SAMPLE <br /> MEASUREMENT <br /> ~ ~ <br />~ ~ ~ ~ <br /> ~REQUIREMEN7:. : ~~.~ : ~ ~ ..: ~. ., ,x r 1\ <br /> SAMPLE ~ .-~ <br />~ ~l <br /> MEASUREMENT i; <br />~ <br /> ~~~ ~~PERMIT ~: <br />.. <br />~ ~~~ <br /> REQUIREMENT ~ ~ ~ . - <br /> SAMPLE <br /> MEASUREMENT ~ <br /> ~;:i~:: PERMI7:'~~~:~. :...: .. ..: .. <br /> AEQUIRENIENT~. <br />... :~:~ .: .. .. .:. ...: ...:. ... <br />.. <br />~~~~ .::, <br />~~: . <br /> SAMPLE <br /> MEASUREMENT <br /> :~~:: ~~::PERMI7:. ~.~ ... ..: :. .: <br />~ .:::.:. .. :. <br />~ .. <br /> ~RE[iuIREMENT. ~. ~ .. ~ ~ . <br /> SAMPLE <br /> MEASUREMENT <br /> '"~~~PERMIT: ~~ <br /> ~ftEQUIREMENT <br />~ <br />~ ~ ~ <br />~ ~ ~ ~ ~~ <br />NAMERITLE PRINCIPAL EXECITTNE OFFlCER °n">'"•.pr"">° <br />..m"°n'°°"'"'"[.ne .u .[[.rnme.~..n <br />[ <br />pop.ne..a.rm>en.coo.o.wwn[yo"i"..~,a.,,n.nn..>.i.m aasE•ed <br />TELEPHONE <br />DATE <br /> to mart [M1m qu•nnM prn°nml pnpetl> p[M1rr nM mNtle Ine Infarm•Ibn ~///// ~ ~ ~ <br />~ <br />W. v.. C:j J.1 :clt ['d w.bMllad.9~d on ml lnqulq°f me pemnmgnprt .no mmge Wr•>f[em, .[~?_ r <br />•~% - <br />'! 'J i[]-i' ~" <br />~ • ' `V •! V <br />(~ ~ / <br />' 1 <br /> <br />~ <br />/ <br />~l <br />~ m [bqf poem dlrn1l> mpenmE4lor plM1Mnp We Inromullen, Ib lnlammlan / // .. _ _ <br />.Ld <br />4~-IP <br />. <br />a.I:~t;cL <br />PL e;~].~ILI1 ~, mbmlurd b,[o[M1e Ee[°fm>kn°wktlp .M Een.f, Ww•.avntr.•nd mmplero. <br /> 1 .m..m utm m.n .n apmnrsl pm.mu ror.unmlmnp n~ inromu[b". SIGNATURE OF pRINCMAI E7(ECUi1VE <br />TYPED OR PRINTED InNwi"Ein. poWbiln>ornm."a impMnmen[r°r M1"o.i"E .Id.u«e_ OFFICER OR AUTHORIZED AOEMT NUMBER YEAR MO DAY <br /> CODE <br />~-vmmcn i a nnv .... _...-.... _.- _. . _.. .. __.... _.-~ ~.....................................r <br />EPA w a2 -I (RCO 3/99)'Previous editions maybe used. ~ This is a 4-pan (orm. PAGE of <br /> <br />