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PERMITTEE NAMElADDRESS tlnrfudc FeciluT ,~'amr/Loralinn iJUifjrnnll NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM ((NPDES) <br />NAME DISCHARGE MONITORING REPORT (DMR) <br />'; <br />ADDRESS i i~..iil 1 ~LJfJ f`I i I':L. <br />IiOX ~'`-~~~ PERMIT NUMBER DISCHARGE NUMBER <br />i-.a ~ = ~ MONITORING PERIOD <br />FACILITY <br />~~ I j ~?+`' ~'+ YEAR MO DAY YEAR MO DAY <br />LOCATION `A -~-? T FROM TO <br />Form Approved, <br />OMB No. 20x0-0004 <br />R':I`1I1`i~ DRtv~ TO TUTTLI_ DRHW <br />NOTE: Read Instructions before completing this form. <br />P~ I <br /> <br />PARAMETER ,` <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO, <br /> <br />EX <br />FREQUENCY <br />OF <br />ANALYSIS <br />SAMPLE <br /> <br />TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />:.l_ ~: ; SAMPLE <br /> MEASUREMENT <br />_ <br />' i <br />' tJ~ <br /> PERMIT <br />REQUIREMENT <br />SAMPLE <br />T ~~?: %f~;i .. ,: ~<# ~-'E1'I~tti <br />,CJI?A AVG f2)=PDR T <br />DA 3. t_'~f r~^', -- <br />.. ; ~ `• <br /> MEASUREMEN <br /> <br />' <br />~ _ <br /> PERMIT <br />REQUIREMENT , ~ '~~a'fi# s <br />hEP~~R <br />'301~iA AV'iy PUR i <br />R1` <br />DA I L~J "' <br />' <br /> SAMPLE ' <br />~ MEASUREMENT <br />;:~ 1:.:;:: <br />-: .. Nt;F <br />!-i PERMIT <br />REQUIREMENT ~ `-, ..~ .: ~~~' NEa'ORT <br />:':+. F~,VC, REhGR_ <br />L7i-~T(_.•, ~•:i " <br />. <br />;°~,,.. <br /> SAMPLE <br /> MEASUREMENT <br /> <br />PERMIT <br />REQUIREMENT ~ _ <br /> <br />•- <br /> <br />DF"' <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br />PERMIT <br />REQUIREMENT ' <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I rrr,~n nnarr penalty ..r la» mat mi. anrament and all murhment. »rrr TELEPHONE <br />prrharrd undrr m. dirrrtion or supen9siun in xrurdatxr » ith a s) dem drsiQned <br />_-__ ... _ GATE <br />J <br />to auurr that qualified prrwnnrl pniprrly t;amrr and esaluule thr infnrmation ' <br />_ submitted. Bawd un m~ imtufn of the prrxm ur perwns who manakr the system, <br />-' - - - - - ~ ~ ~ ' ' ur thw persom dirrctly re+pmsibk fnr aathrrin~ thr information. me informaliua ---- ~ - -. - ~ ~ ~ ~ , <br />wbmitt~d K. to thr best of m~ Ann»Irdl;e and belier, trur, accurte, and mmpletn ~ .. ~ ' "i %' 1 <br />;1 t t' <br />~ <br />~ ~ <br />J <br />' <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />t ' <br />~ +- I <br />r, I <br />t <br />~ <br />, t <br />_ <br />f ~~ I am a»nrr that tM•n• are siRnifiaent prnallie. fur submitting fal.e fnfornmtion, ICER OR AUTHORIZED AGENT AR <br />E <br />A NUMBER YEAR MO DAY <br />TYPED OR PRIN D including the {»nsibdin ~~(rinr and imprisnnmem fnr Ano»in><sitdatinm. OFF O <br />D <br />{ COMMENTS AND EXPLANATION OF ANY VIOLAI IUIVS (Hererence au aaacnmenfs nere~ <br />EFA r _ , 3 1 F~-, ._ <br />i 4-pert fa <br />