Laserfiche WebLink
PERMITTEE NAME/ADDRESS lJnrfttdr h'ttrrGfv .Fame/Loralion ijlhJJrrrnrl NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM ((NPDES) <br />NAME -, ~ ~ DISCHARGE MONfTORING REPORT (DMR) <br />ADDRESS , • • = _;:: i^. <br />j~pjt ~~g PERMIT NUMBER DISCHARGE NUMBER <br />_H ~ MONITORING PERIOD <br />FACILITY i iOR I ZON I`i I I.I~ <br />YEAR MO DAY YEAR MO DAY <br />LOCATION I_A ~ G ~ E' : `-' FROM TO <br />LkNG>= WAKE. MIi~{E MANAGI=R <br />Form Approved. <br />OMB No- 2040.0004 <br />`~ ~ <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ, FREQUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENTI <br /> PERMIT ~ ...... ,.- .... ....... - • ~ . t_•r; ;t•;;.. a:. <br />- ti <br />. .REQUIREMENT - i}ft T L ~ - ( ; <br />~'.f7t~ <br /> SAMPLE ~ <br /> MEASUREMENTI <br /> PERMIT t~~s: A, ,, s.., .., ~rE1=Uti t .Er .t: , <br /> REQUIREMENT : ~., ~%A: ' ~ ~ ;:'• r', ; .. Y "'f y <br /> SAMPLE ' <br /> MEASUREMENT <br /> PERMIT n• ~ # ; c t ;-'r ; Y 1=r tom. <br />~ - <br /> REQUIREMENT _ _ i:;i;ri ~ . : _." . ; ; : . <br /> SAMPLE <br />- .(;;~ MEASUREMENT <br /> <br />-• <br />PERMIT x~:~i r,- r.~.{c.d.~.yc a ~~tr# C t~ ; ~ <br />- ~1'- <br /> <br />~ .t:h. ti <br /> REQUIREMENT ::.-;i~A r~'.,-:, . , i i_ P~ ~: ,_ - . i;~ <br />~•;i <br /> <br />SAMPLE ,- ~_ <br /> MEASUREMENT <br /> PERMIT - .- :• ~ ^~F#t~: ::"->; ~< . C: ~r , .t,. <br />. .REQUIREMENT 't~DA AVG r'.` .-, _ r.:::. <br /> SAMPLE r: _. <br /> MEASUREMENT <br /> PERMIT ~ t. , :. ,. ,. _ , <br />- <br /> REQUIREMENT '~~n A .'^_ , '"'~~tJ <br />t <br /> SAMPLE ~ <br /> MEASUREMENTI <br /> PERMIT .. - . <br /> REQUIREMENT =.'}[;-~ ~ IH! •' ', <br />NAMElfITLE PRINCIPAL EXECUTIVE OFFICER t ~rrtir> under pcmah~ of law that thi. d~KUmcnt and au nuachmrnty wrrc TELEPHONE DATE <br /> prepund under mr dirrctHUt or wpenision in accordance with a y.trm de+iKnrd _ -.. -_ <br /> to u~wrc that yuuli6td prnonmi pn.perly Kathcr and r~uluate thr information <br />~ <br />..---~ ~- -_ eahmiued. Naxd an m~ inyuiry~ of the prrcon or penan. who manuKr thr ..tem. ! <br />~~ <br />" <br /> or thocr prnons dirccth respun.iMr for ~tatlxrintt the information. the informrtion - - - <br />~ . <br />_ -t / <br />. <br /> f me k <br />oxl <br />nd belirf <br />true <br />Vratr <br />and a~m <br />lrte <br />ilt <br />t <br />t <br />nt <br />d <br />a <br />h <br />d i-- <br />th <br />' ~ . <br />f ; <br />~ <br />•"( i , <br />' <br />i I-~ L~'. ' '." ._- -' <br />~ . <br />, <br />p <br />. <br />m <br />i <br />o <br />n <br />y <br />t a <br />. <br />R <br />.u <br />. <br />, <br />o <br />r <br />L SIGNATURE OF PRINCIPAL EXECUTIVE `. - ~ -" <br />• I am aware that thrrc arc si>Znifu~ant penaltir. for whmittinK fal r information, <br />i <br />ti <br />d <br />i <br />f <br />[ <br />i <br />l <br />OFFICER OR AUTHORIZED AGENT AREA <br />NUMBER <br />YEAR <br />MO <br />DAY <br />TYPED OR PRINTED .nnmrm <br />or <br />om. <br />imiidinR the po..ibitih of fine an <br />impr <br />now <br />n~ . <br />o <br />a D <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all aKachmenfs here) <br /> <br />