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PERMITTEE NAME/ADDRESS Ilnrfudr facility .1'amr/Lararian if DifJrrrnt) <br />NAME L i_ t_. <br />r <br />ADDRESS " <br />hc::i <br />Vn g1~.~4 <br />FACILITY ; ii L LiiJ P`, ~ ~~' <br />LOCATION '•-~ ~~ C ~ 14c~ <br />L.hi;l:=E WADE. '1 i id)r PiAfJAG~r~ <br />NATIONAL POLLUTANT DISCHARGE ELIMINAT70N SYSTEM NPDES) <br />DISCHARGE MONITORING REPORT (D R) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <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 Y <br />S TYPE <br /> ANAL <br />SI <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT iz • ;t :; , :~ -• -- <br /> REQUIREMENT ~' ~ :•• . . <br /> SAMPLE ~ <br /> MEASUREMENT <br /> PERMIT .,.,,;. ~.;r ~ <br /> <br />REQUIREMENT <br />~ <br />. ' .. <br />~~I ` . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~` ~ . <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~• J <br /> <br />' <br />REQUIREMENT .-, <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ .. , <br />tiA i I_'~( <br /> REQUIREMENT - <br />' SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />- ~ .~ <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT , -_ <br /> REQUIREMENT -~ -- -~ ' T'- ' <br />NAMElfITLE PRINCIPAL EXECUTIVE OFFICER I certify under pennR~ ..r IoM mgt mi+eocnnxnt and nli mtinhmrnt+ were TELEPHONE DATE <br /> prepyrrd under my dirrrtion or sopen~isinn in m'cordnnce t•ilh u systrm designed __ ___ _~_ _ <br /> to mwrt that yunlified pctwnnd pmperl~ yuther and erahtnlr the indmmntiw <br />~ <br />-- - ._ ~ _ +uhmiued. Bnvd wt m. iuyuln rd the person or per+ons who munrkr dr +cstrm. _e~ <br /> nr lho+c prnon+direcUy resp.m•iAle for ~theriny, tlx infurmution, the Information <br />'~ { <br />t <br />ccuratr <br />a <br />d a <br />kt <br />h <br />f <br />- <br />d <br />d h <br />fi <br />f ` i~ <br />~ <br />~ ~ ~ Z ~ r <br />I ~ ~ { <br />j~~ ~ i •, ~ ~~ <br />~ - now <br />ote, u <br />, <br />n <br />vmp <br />e. <br />.ubmitted i . to t <br />e be+t o <br />r <br />gr att <br />r <br />r <br />, <br />m~ SIGNATURE OF PRINCIPAL EXECUTIVE - <br />- <br />~ <br />, <br />I ~ 1 nm aware that them arr si~nificxm pcnultie+ for +uhmittinR fal+e informntiun, AREA <br /> rtw,nment for ICnOwInR+iolw0otu <br />the <br />ossihilit. of fine and im <br />inct <br />di OFFICER OR AUTHORIZED AGENT NUMBER YEAR MQ DAY <br />TYPED OR PRINTED p <br />. <br />u <br />n_ <br />p <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS {Reference all attachments here) <br />~iS <br />. - ~- - i;U <br />-<,r. s^.t tri -a,i• rt C:U ::1i'\ i3L-. i~.iLJ i'F-"t <br />Er'~ c~,~ 3320-' iRe, i,.. ,.. I I-i, i~ ,. ;,.n'f lntni. <br />