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PERMITTEE NAME/ADDRESS pwr~r irWryA+../L«.tron (/DIQLnrQ NATItNJAL PODUTANT DISCHARGE ELIMINATION SYSTEM /INPDESJ <br />NAME DISCHARGE MONITORING REPORT IOMR/ <br />ADDRESS .. a .. ~ _ t. G ~ L ~ . ' .. <br />t7 J t( 1 U .! U PERMIT NUMBER DISCHAADE NUMDER <br />AU ~ C~ MONITORING PERIOD <br />FACiLIIY ~ I ~J I: it CJ k l ii G ~ OU T N ~: I YEAR MO DAY YEAR MO DAY <br />LOCATION p p L j S A U L L (, FROM TO <br />;-n.. f o t f t. v~ a ,, <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION n1O, <br /> <br />EX FREQUENCY <br />of SAMPLE <br /> <br />TYPE <br /> ANAIV~s <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br />t <br /> MEASUREMENT <br /> PERMIT ~ ti. '„ ,.. ~ i i ~ <br /> REQUIREMENT ' <br />i <br />' M U C <br /> : <br />: <br />, <br /> <br />r SAMPLE <br /> MEASUREMENT <br /> PERMIT - ~ ~ ~ :.: ' ~ ., ! _ / _ . . <br /> REQUIREMENT <br /> SAMPLE ~ _ j <br /> MEASUREMENT <br />. ~ i PERMIT • •- .:4" Ya.:•} n . x ~ , i i ~. C D 7I ?~ ~ 1. <br /> <br />` REQUIREMENT _ ~ g ~ Z <br />•, , <br />... SAMPLE <br />~ - _.. <br />MEASUREMENT <br /> PERMIT IjLe".. ~. :~v);''....1 ijl•r:.. ~~:.lJ:; ~..r. ~,~. ~i•_ .:~, <br /> REQUIREMENT <br />~. J ;1 ~, n -t Y ~ .~ <br /> SAMPLE <br /> <br />v MEASUREMENT <br />_ PERMIT .;i'ELF.T x.- y49;. r*+ ~_~r.: 'Jic.t;r. <br /> <br />_ REQUIREMENT - ~ ~ A <br />;~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAME/T1TLE PRINCIPAL EXECUTNE OFFlCER ' «n~tt . rr pen. ry o l.r thu lAN document •nd dl ^uschmenu ren TELEPHONE DATE <br />pnper.d under mf direttlon or wper.hlon in nc[ordence rlth . fTftem defl~nM <br />to af.ure Ih.l qu.Mfkd personnel progtrlf [.Iher end er.hi.te IM Inform.llon <br />fuhmltted. 6~ed on m7 IrputrT of the person nr penom the nun.Re the fyftem, <br />Or Ihox penore dl rectl~ refpemlhk for ~.IheAn~ the Informallo0. the Infortrrlloo <br />whmltted ff, to the hot of m7 knowMd~e .M hcMef. troe. Kcv nle. .rd compkle. <br />nlnc.nl <br />f{ONATVRE OF MINCt/Al EXECVTIVE <br />1 .m...re tha thert.re fl <br />enHtln for whmfltln <br />htfe Infontrtlon <br />TYPED ~ PRINTED E <br />p <br />~ <br />, <br />IrMudln` the poalhllit~ or floe .nd Imprhonment for kno.rlnE HM.tloret OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO OAY <br />t - r'iriA1 <br />EGt.u 1L :C C%nl CFEE.M. <br />NOTE: R~~d Ir»trucNor» b~fw~~o>1rlpbUrty tfiis town. <br />Form Approved. <br />OMB No 2040-0004 <br />COMMENTS AND EXPLANA7IVN vl• ~n T vfvtn I fvrvs frr~»nnci in •rr~cnmmr: n~r~/ <br />... _ ~ r,..~inR FtIiCIF. EYE>aT CCCUnS, .S(ibJFCi iC EGhCEtI CF >•kCCF <br />I EPA Form 3320-t !Rev 3,'99) Previous edi0ons may be used <br />PAGE <br />Thls Is a ~I-part form <br />