Laserfiche WebLink
PERMITTEE NAME/ADDRESSpwerfrfwe•WryNw./L«.erowyD(pb.+nq <br />NAME , <br />ADDRESS _ _ .- _ _ _ ~ _ - - <br />• i~oa lrs,iu <br />iAD~: ~:U ~1151D <br />FACtIRY :,I Li I:. l.Vf1'H L 5LU jti Myir;':. <br />locATtoN F'ALISAG~ CO b~~1E, <br />.n.., 1 rrf w ~ .i <br />Form Approved. <br />NATIONAL POLLUTANT OISCHAAOE ELIMINATION SYSTEM /INPOESI OMB NO 2040-0004 <br />DISCHARGE MONITORING REPORT IDMRI <br />•_~ c r. L ~ <br />PERMIT NUMBER ascHAnaE NuMeEx _ r c T x =; <br />MONITORING PERIOD ~ ~ Ir i J ~ ~ <br />YEAR MO DAY YEAR MO DAY <br />FROM TO .. 1 _ <br />NOTE: Reed k»ttuctione b~for~ g6~l~tlny this ftxm. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION n10, <br /> <br />EX iREOUENCY <br />of SAMPLE <br /> <br />TYPE <br /> ANAlysrs <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE _ <br /> MEASUREMENT <br /> PERMIT `, . _ - :. Y ~; <br /> REQUIREMENT <br /> <br /> <br />• SAMPLE , <br /> MEASUREMENT <br />_ PERMIT .. r : '_ / : r, A E <br /> REQUIREMENT l r C <br />1 <br />~ - <br />_ _ SAMPLE <br /> MEASUREMENT <br /> PERMIT : .. .: L t .. ,..r 1 .. ~_ :, '. 1 :. - !~ { •. <br />.. <br />V_ .. REQUIREMENT ~•: n }: G c a "~ <br />.: ~ . SAMPLE ~ , <br />i :~ i. ?.. '. ~ w •ir ~ MEASUREMENT <br />. I 1 iJ U PERMIT r. ~. r v .,'1 . , _ 1_ . . "' - -. x13: - }' [ K I + :, . ; ri <br />v REQUIREMENT ~ L L A f. Y ~., , .= : I <br /> SAMPLE ' <br />,: v: MEASUREMENT <br />_ PERMIT - i~fkUr? ..~FCFZ hE <br /> REQUIREMENT k 2 n n`+' .. ~ •; "i n A F. <br />- <br /> SAMPLE ( • I <br /> MEASUREMENT <br /> PERMIT • Er 0 i; T - : V ; 5 ;~ ,~ <br /> REQUIREMENT '. ~ 3 ",t <br /> . <br /> SAMPLE <br /> MEASUREMENT <br />PER MIT <br />REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER 1 Rf1111 Y n pen. tf o lew Ihu lhh docu menl end ell ^tlerhmenb were <br />TELEPHONE <br />DATE <br />prtpered under mf dirrrtlon a aper+Yfon In eccoroenn rllh . s)sletn dal[ned <br />to mart thH quetlned personnel properlf ce1Mr end ereluele IM Informellon <br />' _ abmllted. Deed on mT inquiry of the person or penoro who nuneRe tM tTslem. ' <br />ersnre dl recti <br />oredble fa <br />IM Inforrrallon - ~ <br />' W Ihwe <br />rts <br />e1hM <br />the Informellon <br />p <br />f <br />p <br />j <br />~ <br />, <br />-_ <br />th <br />b <br />t <br />f m <br />tn <br />w4d <br />tl <br />t <br />d <br />d h <br />d b <br />f <br />l <br />kl <br />~ ! ~ <br />n <br />o <br />t <br />o <br />~e er <br />e, en <br />abmllte <br />• to <br />e <br />e <br />e <br />, <br />rue. ercun <br />camp <br />e. ~ <br />f10NATURE OF -RINCMAI EXECIlT11/E <br />lR <br />l <br />l <br />" - ~ <br /> I em ewert Ihet (here err C~n <br />c.n <br />pendtle for abmlltlnt Pe <br />ee Inforwutlow, <br />TYPED OR PRINTED Includln~ IM podbllllr of nne ^ru1 Ilnprbonrnenl for tnowln~ ridWtrr~ OFFICER OR AUTHORIZED AGENT CODE NUMBfR YEAR MO DAY <br />COMMENTS AND EXPLANATION Vr ~nT vw~n I wns Ixgtrrinc• sn ~rncnmmra n~r~i <br />_ ._ .. ~ . <br />This is a ~- art form. PACE of <br />I EPA Form 3320.1 (Rev. 3199) Previous editions may be used (! ti U tJ - / Q <br />