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PERMITTEE NAME/ADDRESSpweLiF«WryN.+/L«orenl/D~r..nq <br />NAME <br />:~ <br />ADDRESS ~ :.1 .. c ~ •. ~ ~ ... , _ . .. <br />• CvA 14.it} <br />jA~1L CG Ni4 <br />FACILITY r. ., -. r u ~ w <br />_.,tut :~UaTh ~ ~UiJTr. t,1N..~ <br />LocATION ~;~LiSAlic CC; at5 <br />f,u kTI;~Gr. 'r _D_ <br />NATIONAL POLLUTANT DISCHAAOE ELIMINATION SYSTEM /NPDESI <br />DISCHARGE MONITORING REPORT (D R/ <br />PERMIT NUMBER DISCHAAOE Nt1MSER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No 2040-0004 <br />LbAL <br />ii .C CC 41 Cftir <br />i -_ <br />NOTE: R~~d Ir>.tructlon~ b~iwi )~i~tlplrtlrtp this itxm. <br /> <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION -,tQ, fAEOUENCV SAMPLE <br /> <br />EX of <br />Y <br /> ANAa,Yas T <br />PE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br />i <br /> MEASUREMENT <br /> PERMIT - <br />:t,. - <br />.~ <br /> REQUIREMENT <br /> <br /> <br />' - SAMPLE <br />~ <br /> MEASUREMENT <br />. . <br />1 PERMIT - - r '•~ <br /> REQUIREMENT ,, 'r ., 1 :, •, t <br />• <br />r SAMPLE . ' <br /> MEASUREMENT <br /> PERMIT ~ .., ;yl.E~ .-.n:: <br /> REOUIREMENT ~ ~ <br />'- r <br /> -- ~ ; h <br /> <br />' ~ ~ SAMPLE ~ <br /> MEASUREMENT <br />l:, <br />.. , <br />~ 1 <br />PERMIT <br />;,r r. <br />_ ~ ,: U <br />1111: U <br />~ _ _ ~ <br />~ t. r <br /> REOUIREMENT - ,. <br /> ,. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT •, as• - _i .. CRiID FA• <br />t <br /> REQUIREMENT ~ ry <br />~ ~ <br /> n 1 <br />V <br /> SAMPLE <br />.- <br />MEASUREMENT <br /> PERMIT <br />REQUIREMENTC -- ~ .. 1 U k; ~ <br />u <br />° ~ ~ • i ~ .. i <br />` 4 ~; ~ n ~ L ~ X <br />: . <br /> SAMPLE I <br /> MEASUREMENT <br /> <br />REQUIREMENT , <br />« <br />umem •nd .u •u.chmenu .rrne TELEPHONE <br />NAME/T1TLE PRINCIPAL EXECUTIVE OFFICER t renuy u er pen• y o Is. tbsl urh d DATE <br />prep.red order mr dlrectlon or supmhlon In .rcordenr< wlth . f~flem defl~ned <br />_ to a>nrre IhN qu.MMd personnel pn~p.A~ ~Nber .nd ee Nu.lr Ibe Inlnrm.llon <br />ll <br />d <br />m <br />I <br />i <br />f Il. <br />b <br />d <br />ff <br />ue <br />on <br />y <br />nqu <br />ry o <br />e person a persons .ho rrun.~e IM t~firm, <br />sa <br />m <br />te <br />. <br />' or 11ra.r persons dlrectl~ respond bk for ~atAeArq tAe In/orm.tlon, Ibe Inforrrrllon <br /> <br />submllled Is. to Ibe bnl o(mr knowkd~t snd beMef, true, nccsr nle, .nd rnmpMle. _ <br /> <br />~ <br />I .m •.sn U.1 here sre sl <br />Nflr.M <br />mdtle for Hbmlttln <br />610NATURE OF /RINClPAL EXECUTIVE <br />h6e Infonredon ~-` <br />TYPED OR PRINTED ~ <br />p <br />E <br />, <br />InAudl^t Ibf pos.IDllll~ or lion sod ImpMonmrnl fw krro.ln~ .id.Uorr>, OFFICER OR AUTNORIIED AGENT CODE NVMBER YEAR MO DAY <br />I COMMENTS AND EXPLANATION OF ANY VIOLATIONS IRS/~r~nclr sN •tbchmlrnta h~r~l <br />._ -- , .. _ <br />is is a 4- art Conn. <br />EPA Form 3320-1 (Rev 3:99) Previous editions may be used- 4 - / P PAGE Of <br />