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PERMITTEE NAME/ADDRESS (G~ekrJr F~rrHryNsrwarLoe~rrow I/D(arrens)
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<br />NATIONAL POLLUTANT OISCHAROE ELIMINATION SYSTEM /INPDES/
<br />DISCHARGE MONITORING REPORT /DMR)
<br />PERMIT NUMBER OISCHMOE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM s:; `? :I G' ~ z TO ~');: i.-' ;3
<br />Form Approved.
<br />OMB No. 2040-000
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<br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION Np,
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<br />EX FREOUENCV
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<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
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<br />rITLE PRINCIPAL EXECUTIVE OFFICER ' """y ° er pena ty o Law mat mh doatment and all attachmenb were TELEPHON E DATE
<br />NAMEl prepared under my dlretllon or superrhlon In aeeordantx with ~ system desl`ncd
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<br />{~Y`P j ~ • t-!.`~7~` to assure thtl quaHOed personnel properly plher and eraluale the Informatbn
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<br />TYPED OR pR~~p Includln` the posslDlUty orene and ImpAaortmenl for knowlnc rldaUoln OFFICER OR AUTHORIZED AOENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rtrfir~nc~ sJl ~tbchmmts hay/
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<br />EPA Form 3320-1 (Rev. 3/99) Previous editions maybe used. ;~~i•~ j ~_t .?.r;. ~~8t~4-~~t_~tLrn7. PAGE gOF
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