Laserfiche WebLink
..- - ,~ Approved <br />PERMITTEE NAME/ADDRESS(InrririrMtry X~rrlorrlon l/D{arwu) NATION/1L POIIUT,WT DISCHMOE ELIMINATION SY9TEAt (NFDESI <br />R <br />NG REPORT <br />DMR <br />T '~'~ NO. 2040-0004 <br />NAME DISCHARGE MONI <br />O <br />I <br />/ <br />I <br />ADDRESS `jN~ l.Ht'J Y UIV I`~1.1 .~UL2R LIW i <br />IiOX 9B PERMIT NUMBER ascHAnoEwuMeEn - ~Zt•IS~I_ ORFLD <br />' -~ `' OR O~c!A <br /> MONITORING PERI00 <br />FAC0.fIY __At'JE CANYON M = YEAR MO DAY YEAR MO DAY <br />LOCATION i FROM ~ TO <br />T FA ldti T TI FTSt~ = I.1 i ; •1 F i•i :~i i; NOTE: Rud k>.ttvctltxw b~tara r pl~tMp thb fos'm. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX FREOVEwcr <br />of SAMPLE <br /> <br />TYPE <br /> ArrALrsls <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE `' i <br />„ MEASUREMENT <br />_ PERMIT •~3rir=;:x# ,'I.~.~.~ ~~~#~# •~#iE#~# ~;-r. ' <br /> REQUIREMENT ~ UE <br />~L ' ' ' <br /> . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT , <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT , <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ' <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER ' r""t` " " Pe""' ° •w tn.t wy documem .nd .u ,tt.rnmenl, veers <br /> <br />rs <br />,red under m( dlreetlon or aper+~lyon in nceord,ncr +Ith , r(,tem de~tnM <br />TELEPHONE <br />DATE <br />~ ` _ <br />'Y \ U ~= t '- <br />~ p <br />p <br />to tm,ere tn,1 ~o,Mfkd personnel PrWed7 L,1Mr ,nd eeJu,te IM Inferm,I1M <br />abmltted. Erea ocr mr {rpulr~ ar ue person a per,au retie trnn,~e IM ryetem, ~ •^ <br /> <br />~ <br />~ <br />~ S <br />~' <br />.. or tho,e prnore d{rMle rapordbk for ~,ueAn~ ue Inform,tlow, the Inform,tlon ` <br />~ ~ / <br />i to ue Eat e! m~ knowkd~e ,nd EeMel <br />true, ,rcvr,te, ,nd complete <br />abmllted b 1 <br />/~ v ~ ~~~J ~ / <br />' , <br />. <br />. fIONATURE OF -RINCt-Al EXECUTTi/E <br />~ / 1 ,m ,.m utl triers ertrtd(rrlfk,nt pen,itla r r aEmittlnj r,be lnforrtodon, A A <br />TYP OR PRINTED Including IM pots{bllitr orllwe,rd Imprlxtnmrnt for knowln~ .id,tlotu OFFICER OR AUTFIORIZED AOEAfT CODE NUMEtER YEAR MO DAY <br />OMMENTS AND EXPLANATION OF ANY VIOLATIONS /Rtrf~rtrnc• s/I itt~cnmtrnti n~r~/ <br />:. _i. ~ _ .:.._ .. _ , <br />QWEST % EFFLUENT AT WHICH STATISTICALLY SIGNIF Dl <br />S". REPORT IC25 USING• TEST CODE "P". IWC=104'1.. <br />Form 3320-1 (Rav. 3199) Previous editions may be used. T S,IS 3-4-~t1 rQI'1i1. <br />4G34L? . <br />