Laserfiche WebLink
PERMITTEE NAME/ADDRESS Uncletdr Facility:\'aetdlaariae if[hfferrnn NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM ((NPDES) <br />NAME - - , ; ., . , . DISCHARGE MONITORING REPORT (DMR) <br />ADDRESS = ~ ' '' ~ <br />r - PERMIT NUMBER DISCHARGE NUMBER <br />"A - ~ MONITORING PERIOD <br />FACILITY ~tUR I ZG=V hi <br />YEAR MO DAY YEAR MO DAY <br />LOCATION ;. A f' (_l FROM TO <br />I utul'~ w~,r,~ ..~ ~'Ir~NA~ <br />Form Approved. <br />OMB No. 2040.0004 <br />~P?°!t'1Iiv3< I~RPJG TG CkLal'1I <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION <br />NO, FREQUENCY <br /> <br />OF <br />SAMPLE <br /> Ex aNaLYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE f~ <br /> <br />:f1AEASUREMENT <br />~o <br /> <br />!/) t 7 <br /> PERMIT <br />' REQUIREMENT - 3Ct'ta A:: ~ :•~;` . <br /> SAMPLE -~ ~ , /'j r~_, <br /> MEASUREMENT ^ <br /> PERMIT mot: -. . ~• ;, ~._ - •-- <br /> REQUIREMENT : n n r ~ . <br /> SAMPLE <br />r-_ ~~-' , <br />~,r <br /> MEASUREMENT <br /> PERMIT ;`'~"" ),.. •_ -ins s<•s.•.; uv ;., .~ <br /> <br />REQUIREMENT r...-. <br />`' ' <br /> SAMPLE _ <br />~; , !',mot:. t' MEASUREMENT i ' ~ ~? .%~~ j <br /> <br />PERMIT <br />f? t_ .t, .u•x <br />•. ,. <br />.. <br />--- -. <br /> REQUIREMENT - ~ ~ .- rf~' ~ Y <br /> SAMPLE ~/~ <br /> <br />' T - <br /> MEASUREMENT <br /> PERMIT - . 1:. __ ,_ c -... _<• .. u ... > <br /> REQUIREMENT I ~Cl <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT <br />NAMElfITLE PRINCIPAL EXECUTIVE OFFICER I arrtifl under Ix•nalt~ Of IYN that thi+d~xument and all atuchmenn were TELEPHONE DATE <br /> pnpurrd umlrr m+ Airea-tiun ur wprnicion in arcordYnce with Y splMtt dreigned <br /> to a++ure thYl yuYlifled prrvmnel prnperl~ kuther and r+alantr tlk infurmatiua ---- -"- ~' <br />_ _ -- whmlurd. RY+rd on ml inyuin o(Ihr prr+~m ur prrcnn+ ehu mYnY~e the +.+tem. ~ ~ <br />- -~ - -' rnrms directly rr+pnn+iMr fnr RatherlnR Ihr inRtrnmtinn. the (nG~rn)YWm <br />nr t6tne --~ ~ - - - <br />- p <br />d <br />kt ~ <br />~ } 7 ~i <br />(i ~ <br />~ ~ <br />~ ; ~ , -" r. <br />cump <br />xubmittrd i+. to the hr+I of m~ knoxirdge Ynd Iw•Ikf. Irvr, rarunle. an <br />SIGNATURE OF PRINCIPAL EXECUTIVE ! <br />- <br />' ~ <br />- ' t ` 1 am Yaun• that there are +igni6cam penultie+ fnr +uhmittinR tali infurn)ulioe, D AGENT <br />H <br />RI ARE <br />A <br />TYPED OR PRINTED including the r)"`dbiliry of fine Ynd impri+mtmrm fnr lnuwing +idatian+. OFFICER OR AUT <br />ZE <br />O D <br />NUMBER YEAR MQ DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />EPA Form 3320-1 IRev 3~99'~ Pre.:cus edltlons may be used. <br />TFtis i~ a 4-part fom <br />