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PERMIlT'EE NAMElADDRESS pwd11/r ieWgN.w/Lee~tron I/D(Qirrnq
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<br />NATIONAL POLLUTANT DISCHAAOE ELIMINATION SYSTEM NPOES/
<br />DISCHARGE MONITORING REPORT /D R/
<br />PERMIT NUMBER wscHAnoE NuklteER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEA MO DAY
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<br />Form Approved.
<br />OMB No. 2040-00041
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<br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FRECUENCr SAMPLE
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<br />AVERAGE
<br />MAXIMUM
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER ' """r ° er pens ty o law Ih\t NN doavmenl end III ~tl\chmenb were
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<br />~~IQNATURE OF PRINCIPAL EXECUTIVE /
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<br />•TII~\Iw • ' .OFFICER OR AUTHORIZED AOENT CODE NUMBER YEAR MO DAY
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<br />EPA Form 3320-1 (Rev. 399) Previous editions maybe used. .T,t1iS.1S. & 4 ~ ~A('>I F '
<br />.. ;;~:-~ ,'1~±~?ti_~~~r,.~_~arl form. ~!,
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