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PERMITTEE NAME/ADDRESS ilndade Facility :\'amdlncatian i~f)ifferrMl NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM ((NPDES) <br />NAME ~ ~ ,-- ,- DISCHARGE MONITORING REPORT (DMR) <br />ADDRESS <br />Ct -' PERMIT NUMBER DISCHARGE NUMBER <br />~ f^ - <br />FACwrr Hi_~r'; I ~ ; < ,•~; i i :.• MONITORING PERIOD <br />LOCATION __p ,-G ,_ YEAR MO DAY YEAR MO DAY <br />`pp~i~+r _ FROM TO <br />~.-1'17Y~+L `~IaD~ ~ I`'f 1 rYC ~ ~!1~><i~i. <br />Form Approved. <br />oMe No 2aaaoooa <br /> <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION (~~, FREQUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE ' ' ' <br /> MEASUREMENT <br /> PERMIT :E ..} "~ ;` ` ,." ~ _. <br /> `REQUIREMENT F i I~:. f ii, t^ 1'1^, •` ~:'-'~'~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT .. _ , <br /> .REQUIREMENT - ~ i. ~' ;; A V v I'! ?i :.i A'.% <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT . _ ~ _ ;~ :~ • , ,. ... <br /> REQUIREMENT `=~ ~ '" <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~..t .. x _, _ , <br /> REQUIREMENT <br /> SAMPLE <br />• .~ MEASUREMENT <br /> PERMIT ~'' <br /> REQUIREMENT ,_ ,- ~ •'Y :~ , I l.'C ^1~ ' il': <br /> SAMPLE _ .. - <br /> MEASUREMENT <br /> PERMIT ~, , , ". ., .. .. _ , ,.~ <br /> REQUIREMENT ~ ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT .. . ~- - ,. <br /> REQUIREMENT ' <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I ,errr. under q•mdt~ ..r lam mat mis d~aanx•nt and all mwchmem+ sere <br />ared under m. diratition nr +u <br />re <br />rn ishm in uccurdancr with a + <br />drm devl <br />ned - - <br />(' TELEPHONE DATE <br /> p <br />p <br />p <br />~ <br />>; _ <br />~ <br /> d. u wrr that ywdifiad permnnel pr:yx•ri~ >:uthrr and e+uluute the information <br />_r_ -- +uhmittad. Rued un m. Inyuiry :d the Ir rum or Iw•rvms oho mamltr the +y+tem. -~ / \ ' <br />" <br /> ur those peAUU directly nrpumihle G:r ¢utla:rinK the informwtion. thr information _.- <br />i // .~ -~ - - <br />I F .~ ~ ,`1>>. ~ wbmitird h, n: the best of m~ AnowledKr and heiirf, true, accurate. and ar~mplete. <br />m <br />e <br />I <br />th <br />t th <br />i <br />ilk <br />t <br />W <br />fo <br />h <br />itti <br />f <br />l <br />e I <br />f <br />ti <br />SIGNATURE OF PRINCIPAL EXECUTIVE ' ~ - -'i / -_- ' . <br />~ ~ - , . - - <br /> <br />TYPED OR PRINTED a <br />a <br />ure <br />a <br />ere are s <br />gn <br />an <br />pena <br />es <br />r +u <br />m <br />a <br />+ <br />n <br />orma <br />on. <br />ng <br />ine9uding the nsihility of fine uud im nsunmeN for Anowinq eiuluUun+. <br />w P ' OFFICER OR AUTHORIZED AGENT CRpE NUMBER YEAR MQ DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />i_ 7 <br />::T7 <br />i~Va~ i-~t tR ; Pai~ Fi-=2 ~ ilt'? ;[F=t'C1ft Tail <br />~4HR PRFC IP EVEI`JT -- <br />3G DAY AV6 IS Hi6hIE <br />EPA Form 332x1 (Rev. 3r99) Previous editions may be used. ~'G`- This is a ~3-dart farm. <br />