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PERMITTEE NAME/ADDRESS rLa•IteJr Fwriliw:Yome'Lrx•mion r Dr en~nri <br />C Il <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved. <br />NAME ,,~t.lt . >:_ ;, .~ I t,J~~ DISCHARGE MONITORING REPORT (DMR) OMB No. 2040.0004 <br />ADDRESS- __. ;"i1.i.aG` .i;; .. <br />rr` ?'~ A^~ `:TRT- rf~t'J F; !-,, PERMIT NUMBER DISCHARGE NUMBER ~ - FINAL LAMA <br />'~w TON - WET TESTING F~':? 'i.'`?A <br /> MONITORING PERIOD <br />FACILITY _~i f~ ~ ; <br />f• <br /> <br />LocaT!oN ; • . YEAR MO DAY YEAR MO OAY <br />?N FROM TO - <br />~ A'DC~ .. - .. NOTE: Read Instructions before cnmoletina this form <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION Np, ~ FREQUENCY SAMPLE <br /> <br />~ OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS , <br />' SAMPLE ~ ~ f +::: _- + . <br />C. - MEASUREMENT i <br /> PERMIT z't-i': ### s: ; , , •. =~# V. 4+ , :r, u. _ <br /> REQUIREMENT ~ I"iN VA1_tJ:= <br /> SAMPLE t; .... .. <br />' MEASUREMENT <br />, PERMIT k~~~•fikir #;:=ri:~~t~ ~ :#S,'- -~~.. _ .. .. x _ _c~. ~,Lr ' <br />F T~ L ;~I , .. REQUIREMENT = ~ . !~?: ; ' ~ ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT ~/f <br />SAMPLE `~ <br />MEASUREMENT ~` <br />// <br />PERMIT n v <br />REQUIREMENT V <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAMErTITLE PRINCIPAL EXECUTIVE OFFICER I ~'rrtiFc imdcr penali~• of Ina that ih~s dcxument wed oll anarhmont., were TELEPHONE DATE <br /> prepared under my direction or sulxnision m accordance with a rystem designed ~ <br />/', <br />~Y Y~ '~- '~- t.-' L! ~ ; ~ ~/ i rt -' to u~curc thnt qualified pcraonncl propr:Iq gnther and c.~uluste the information h/ <br />I <br />~ <br />- subnuucd Based on my mywn~ of the pen. n or persons wh.~ numege the system, / 1M <br />{! <br />, <br />~ ar ihi+x per_4+ns ducctk rcxpoasiblc for gathcnng the minmunon. the mtortna[IOR ~'` <br />~ ~ <br />l ~` <br />~ +uhminrd a <br />to the lxet of my knnwled a and Ixhef <br />true <br />accurate <br />and cam Iete <br />g p ~ K/ <br /> <br />! <br />- , <br />. <br />, <br />. <br />I <br />f <br />h <br />h <br />f <br />l <br />f <br />SIGNATURE OF PRINCIPAL XECUTIVE <br />~ <br />(/T> h <br /> <br /> <br />TYPED OR PRINTED <br />..:r..n+,trc t <br />at t <br />iamt pcna <br />ere are stgni <br />ua <br />ee eu <br />~mmine i.dx mformap+ro, <br />~~,r.:du:~ the p,rieihilny oC~in~ mW impnsonmcnt for Ana+ung ciolationv. <br />OFFICER OR AUTHORIZED AGENT <br />AR <br />NUMBER <br />CO <br /> <br />YEAR !/ <br /> <br />O <br /> <br />DAY <br /> DE <br />i L <br />PAGE OF <br />REPOPT L.C50 - ~;TATISTICA~. POINT ESTIMATE WI <br />-' `':' ` `:: ' ' - - F'EFORT FORM 1-O DI"ER. <br />- - This i'; f~ d-part f~ :r;i i <br />