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PERMITTEE NAMElADDRESS rlndude Faritifr .~'emdlaration ijlhjjerrafl NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDESJ <br />NAME ~. ;; r~_' jn . DISCHARGE MONITORING REPORT (O R) <br />ADDRESS _w _' ~ i. t'_i~'1 i'i ~ i <br />t7 l3~~:{ v23 PERMIT NUMBER DISCHARGE NUMBER <br />' - LA } ~' - MONITORING PERIOD <br />FACILITY .; HOR I Z[~N M ; ' YEAR MO DAY YEAR MO DAY <br />LOCATION - LA E; ; FROM TO <br />: ert,r~ L,art:- ~~ ~~~ r~lar~~rcr~'• <br />Form A:_ ~ •.:;, ed <br />OMB ~•:.. _, .,;•-0O~J4 <br />f'f I fdE TRNG TR T S TO ". <br />~~ <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ, FREOUENCV <br />OF SAMPLE <br /> EX ALYSIS TYPE <br /> AN <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENTi <br /> PERMIT .~ , ., , ,,.:- , , - - ~- . _ <br /> REQUIREMENT =:`~ ^ DA t LY ~ i'~ ~ i <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT = ;~ _, > ~ I r - , _. <br />. REQUIREMENT - ...,;,;.; A,~i - -. _:..'r 1') j. <br /> SAMPLE <br />Ji MEASUREMENT <br />_ PERMIT x : :: - ,- .... ; . ~.. ; ..; ,, . <br /> T <br />ME ' ` ~- <br /> REQUIRE <br />N <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT -. a- ,r•~ ~ : .. , . •. , .: ;; .. <br /> jirl I i_ `- <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~..~ :~#x' ~- ~ _ ... <br /> 3:)DA raVC DAILY h'X <br /> REQUIREMENT <br />• SAMPLE <br /> MEASUREMENT <br /> <br />. <br />PERMIT <br />~_.... -, <br />_r~ <br />-, <br />' <br /> REQUIREMENT _ ~~:: ' MX <br />I)r~ `l- l' <br /> SAMPLE <br /> MEASUREMENTI <br /> PERMIT t::. :.. - - ~ t ,,,.,•_ <br /> REQUIREMENT `' ~ ~' ~ ~~-~ ' - <br />NAMElfITLE PRINCIPAL EXECUTIVE OFFICER I .enif~ under petu.lt~ of taw tent thi4 d11eU7t1e01 and aU attychments aerr TELEPHONE DATE <br /> prepared uttder m+ dirrstiun or supcrri+i~m in att•ordance with a y Nam de.i¢ncd _ <br />. _ <br /> to assure tbat yualified p•twnnel pr~~perly gather and e+altwte Itre information - <br />_ -___ _ _ __ - - <br />- <br />- submitted. Bused on m~ inquire or the person or prrsrat+ ~~bo mawge the +rstem. <br />nsiMe for Gathering the infornuuiun, the information <br />erwm+dinrtl <br />res <br />t6mc / '-_ <br />( ~ - -~ <br />, - ~ ~ <br />~ <br />~ <br />, -> <br />-~- <br /> p <br />~ <br />p <br />w <br />le ~ i ; •~ , <br />~ _ <br />~ . _ ~. <br />~ te. <br />wbmiu d is, w the best of ms knnutrdgr and bellrf. trot. accurate, and comp SIGNATURE OF PRINCIPAL EXECUTIVE <br />-`-~ I am aware that thrre arc signifkam prnultles for wbmiuing fal.e information. NT <br />I <br />ED AREA <br />TYPED OR PRINTED indtaling the pu+sibilits of fine and imprrmsmrm fur knowing siolntions. Z <br />AGE <br />OFFICER OR AUTHOR NUMBER <br />D YEAR MO DAY <br />COMMENTS AIVU tAF'LArvAllvlsf yr Mtvr YIlJLN11V1~J Inuvc~c.n-c o~. ossos.~....~,..,~ ..~...~ <br />PAGE CF <br />EPA. Farm 3320-t +Rev 3x'99) Previous editions may n•. _~ec I !i~~ ;. ,t -1 {gar! I~inii <br />~ - - <br />