Laserfiche WebLink
<br />:RMITTEE NAME/ADDRESS (/ntluCe NATIONAL POLLUT4MT DIeCN4gG8 ELIMINATION IYfTEM (NPDES f <br />miliq Nam [ordrioJr i! !/!Moll DISCHARGE MONITORING REPORT (DMR ) <br />4ME__Y Gd Dl.D 7_~a+hL CO_~Ep ECA l11____ (7-Ib) //719) <br />JDRESS 1~~'V SOUTH Y.1Lr:---- - CCJVUULl+ v„v A <br />FL6GST3FF A~i B6U1lL PERMIT NUMBER onc..ROe RU~eeA <br />MONITORING PERIOD <br />4CILRT ~~1 ~f /` YEAR MO DAY YEAR MO DAY <br />')GATgN _aL 11~W~~ G~(y Sc~1.. ____ _ FROM TO <br />:YI1.: . ~ c ~ N. P6ES'ICENT /Ja/u rna)1 rJ1-?bl nb.nl nd.+W rvaul <br />tlltiQtZ <br />F~ F l i~ A L OMB No. 2040-0004 <br />L'ISCtll.itGF. ~f°S~I~i~Y2g?P-Y.4niiK <br />~~~~ tiG DISCHAnGE ~~~ +'~= <br />NOTE: Read instrueliens before DDmDletinD this form. <br /> (J Card Only) ° NTrrY OR LOADING /1 CdRl Only) QUALITY OR CONCENTRATION <br />PARAMETER (16-57) (J1-611 (78-15) (06511 (516 11 NO. FREl~NCY SAMPLE <br /> <br />(JJ J7) EX <br />'u'r'LLYSiS TTPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> fb?bJl 161Ed1 169-101 <br />~Jl iy ~CALUIi Gii <br />1 <br />'MEASUREMENT ~ <br />O D <br />S <br />3 C <br />O <br />C <br />3 v,7 <br />( ~ iYJi':%i;:(: ++##+::: ~'~v~tT /'~ <br />1/ r <br />S~ <br />I ti St. <br />~11::.A T!'1 :, tiT tLAl~ . <br />. O <br />/ („/ ar <br />~v'.J~v ~ 1 G wBwMR::.- :fiEPOAT;' OPTIONAL a~aa~+u #~s414~s #~:~:+~ YYO ONCi/ IHSTB <br />.Fi1'JENL Gfi055 4ELU R6°~"'EA7°+T '; 30DE:^AYG "..;DAILY !1X tIGG ~°u HONT <br /> SAMPLE <br /> MEASUREMENT <br /> `PERMIT <br /> REGUIREMENi: <br /> BAMPLE <br /> MEASUREMENT <br /> PERMR . <br /> RECUIREMENT <br /> SAMPLE <br /> MEASUREMEN7 <br /> PERMR . :' <br />'. <br />. <br /> REGVUdEMENT: . <br />: r. . ,, ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMR ' <br /> REQUIREMENT .. ~ . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT".'. ~~ ~: ~~',~; '- <br /> REQUSiElIEM' .. <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> REQUIREMENT. ` ~ ~ . <br />4ME/TITLE PRINCIPAL E%ECUTIVE OFFICER I CERTFY Vd)ER PENALTY OF Lww THAT I RAVE PERSOw.LLY E%AwMJJ TELEPHONE D A T E <br />I ArO AM FAMLMR WITH TIE YFORMATKN SUBMnTED HEREN. AND BASED <br />Q Ll.hl l\ ~^ <br />~~ vp~ <br />~J ON MY NOllRY aF Tr05E NDVD a PV.IECMTELY RESPONSIBLE FDR <br />OaiN@IG THE IFOfIM/.TgN I ff1EVE TYE SUBWTiED WFORMATKYV IS <br />- TRUE ALCLdiATE A!D COLPLETE I AM AWARE THAT TITRE ARE <br />SK1iFIGHF PENALTIES Fpi SIHRrTd'Xi FALSE WFORMATKYI INCLl1gND. <br /> ~ <br />O THE P05.4BUTY aF FWE AND MPRSONMENr SEE le u5C 1 laor AND <br />» use 1 191Y /R <br />ww <br />l <br />i <br />d <br />n <br />/ <br />f <br />0 <br />' SIGNATURE OF INCIPAL EXECUTIVE 303 276 3777 S ~l <br /> <br />TTPED RINTED rle <br />r <br />n un <br />o r <br />ece <br />m mey nc <br />u <br />e <br />mn up ro <br />f16Rtl dnd w /mrinum imPPOnlrcnr of EereYen b monr6e end JJun/ <br />OFFICER OR UTNORIZED AGENT AREA <br />NUMBER <br />TEAR <br />MO <br />DAY <br />~~ncn•wnY Cn~~w~.nuVn ~r fin. .~w ~a lnnncnw .u .u6WO6uu..o/ <br />IL 6 G&nAS SEP FOOTNOTE F/, PAGE 3. QBTHLY SAtlPLItl~HSThUCTIOtlS--FOOTNOTE D/. • <br />