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pERMITTEE NAME/ADORESS pneYy F~tWryNrw/Loeuron ~/DIQGrwu)
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<br />ADDRESS
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<br />FACILITY ~A~)~~fi~ ~a?^t•`i °r 7{..i-°t (~f;J.y !"1I{~a~~ ,
<br />LOCATION ~~7{'7?~ 1`~ S~ ~ +.: l.: ~=I ~ i6;'~'=~.
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<br />NATIONAL POLLUTANT OISCHAAOE ELIMINATION SYSTEM /INPDESI
<br />DISCHARGE MONITORING REPORT /OMR)
<br />PERMIT NUMBER olscHAROE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM '~.'•1' h:~3 C~1 TO i:i`,' :b r' ;33.
<br />Form Approved.
<br />OMB No. 2040-0004
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<br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO,
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<br />EX FREQUENCY
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<br />TYPE
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<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
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<br />NAME/TiTLE PRINCIPAL EXECUTIVE OFFICER ' «rtur ~ er Pena q o t„w met mh dowment end .u euedtmenb were
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<br />ItMueln` the postlbllity or ene end Imprtaonmenl ror knowln~ vldaUom. OFFICER OR AUTHORIZED AOENT CODE NUMEiER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rs~~rmc~ s/l sttacAmsnts hasl
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<br />EpA Form 3320.1 (Rev. 3)99) Previous editions maybe used. ~4 ;- ~~;r:.. ~^ ? ,J i J3~e~;4- J"~fttl. PAGE ~ ~F
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