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PERMITTEE NAME/ADDRESS(IaaYJeParWryNaar/Loes+Honl/D(Qbrmr)
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<br />NATIONAL POLLUTANT aSCHAROE ELIMINATION SYSTEM //NPDESI
<br />DISCHARGE MONITORIN4 REPORT IDMR)
<br />PERMIT NUMBER ascHAnaE NuMaEn
<br />MONITORING PERIOD
<br />YEAR MO DAY YEA MO DAY
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<br />Form Approved.
<br />OMB No. 2040.0004+
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<br />• PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION Np, FREOUENCr SAMPLE
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFlCER t «rmy u er pens ty o law tnat thb document and all attachmenU were
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<br />COMMENTS AND EXPLANATIVN yr nnT vlv~n nvNS /Refaenc~ M/ atticnm~nts h~rtrl
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<br />EPq Form 3320-1 (Rev. 3/99) Previous editions maybe used. ~~;.c'f.?nss,f s~}'p~~'~-~~a~t¢p~;.~{'O~, PAGE~OF
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