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<br />NATIONAL POLLUTANT DISCHAAOE ELIMINATION SYSTEM //NPDESI
<br />DISCHARGE MONITORING REPORT /DMR)
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<br />YEAR MO DAY YEAR MO DAY
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<br />Form Approved.
<br />OMB No. 2040-0004e
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<br />AMElTiTLE PRINCIPAL EXECUTIVE OFFICER t anur u er pem lr o I~w that thb document and ntl Htaehmenb Overt _ -
<br />TELEPHON
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<br />TMPED OR PRINTED Incluatn` the posrlhllitr of t-ne and ImpAaonmenl for knowln~ viointlom. OFFICER OR AUTHORIZED AOENT CODE NUMEIER YEAR MO DAY
<br />COMMENTS AND EXPLANATION yr nlvT vw~n I Ives /RN~rtrnc~ sn ~tncnmmts n~r~l
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<br />EPA Form 3320.1 (Rev. 3/99) Previous editions maybe used. ~f}~ D 1 ~ ,• ~~~is,al4-parl~ptm. PAGE ~ • .,OF
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