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PERMI7TEE NAMFJADDRESS !Include Faciliry• ,\'amdl~+rntian iJlhJrrrent) <br />NAME ~)"), L.LC <br />ADDRESS ~ ~ ~ '~'- <br />431. `aES <br />_H C.Q Oi4~~ <br />.~ <br />FACILITY Y~~SL'L~~ i°7I14E <br />LOCATION L1~ ~~ (] B I n ci <br />i__r;I~;t;,E WADE, P1iNc I"If1~IflOER <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION 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 2040-000a <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREQUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE ~ , ; ) ~, <br /> MEASUREMENT ~ ~Jn • <br /> PERMIT . , - :, r - .. ,. ,_ . - <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT ' <br /> PERMIT ' ' <br /> REQUIREMENT ~•' ` <br /> SAMPLE / ' <br /> MEASUREMENT ~ ~ <br /> PERMIT :, :, :•;..; <br /> REQUIREMENT ~=' <br /> SAMPLE ', ~ <br />, <br /> ~ <br />" <br /> MEASUREMENT <br /> PERMIT ' ,r ... - ,. ~ ,. - - - ~ -- <br /> REQUIREMENT '''~d `./iil_' <br /> SAMPLE <br /> MEASUREMENT <br /> ~ <br />; ~ ~ ., .. .. <br />~- PERMIT <br />REQUIREMENT . <br />. ~ =' r ~ ' - <br /> <br />• SAMPLE <br />J _ <br /> MEASUREMENT <br /> - - -. _, <br /> PERMIT <br /> REQUIREMENT f''it`f ~ <br /> SAMPLE I i ( <br />i (~) ! ~ f <br />- MEASUREMENT _ <br /> PERMIT r;; "' <br />l " <br />` <br />~ - .. z <br /> REQUIREMENT ' " ` ' ' -' <br />- <br />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER Ireniry underpenulty ofluw Ihallhi+d~wunKnlandall,dwc6mrnnwere TELEPHONE DATE <br /> prtpured under nn direction ur +uprn~isi,m in aaeordxnce with x +~ctem de.+itpled <br />~- <br /> to xcwre Itwt qualified prnonnel property yal brr and ceuluule IM• infnrnwtioll { -" '~ <br />i <br />~ <br /> .uAmiltrd. Bu.ed un m~ inyuin ~d Ihr pennn nr pervm+ who mn~c the sy.trm, ~,,- j i <br />~ <br />_ <br />r"-~- ~ '- - or Ihosc proem. dirrcdy rrspimciblr fur KxtM'rink Ihr information. the infarmatlnn - <br />F <br />~ ~ <br />\t 1 1.~ , submluctl ia. a> the tkwl of m. knowledge and t,elirf. Ink, accurate, xnd cumpirte. SIGNATURE OF PRINCIPAL EXECUTIVE ~ ,/ <br />` <br />' 1 am nx are Ihut tln re ore signitkant penalties Grt +ubmitting tutx informxtioa. AREA <br />D riwnmcm for knowing +i,dulinm <br />ox.ibilit <br />of Mr and im <br />the <br />i <br />l <br />di OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY <br />TYPED OR PRINTE p <br />. <br />ng <br />p <br />) <br />nc <br />u O E <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />:EDURE. ~7P <br />~CEPORI "NC2 <br />EPA Form 3320-1 (Rev. 3199) Previous edltlor~ may be used. Tljt~ <br />