Laserfiche WebLink
PERMITTEE NAMEiADDRESS ~/nt/udrFacilirvNumr~:L<x•utionilP~rrtintl <br />NAME ~ t'1:J1',~,`_ ~ IVt~, L_i_(_ <br />ADDRESS ~= <br />S7 ~+,i' I I~IJ ROAL) <br />r. Y <br />FACILITY .- ~ .,.~~ <br />LOCATION ` vTV C l7 <br />^t r nf•rrhlr_•TI~r~J. !'kwfd~A <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />F - FINAL. <br />DgMFSTIC SEI <br />Form Approved. <br />OMB No. 2040.0004 <br />D 006 ~~ <br />•- <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREDUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE s: r ~ - <br /> MEASUREMENT <br /> PERMIT ... #:. ,, s:~~r# ~~ ... n # ,. .i:t"tJPt _ I .. _ ;.;j-~: <br />. ~ REQUIREMENT 3i~lir'I r~t:~•:' ";X ~.'•~~ !~'J i'1C!hJTF's <br /> SAMPLE :..- ~ , <br /> MEASUREMENT <br /> PERMIT %r: ... t-- #:id:u## i ter. #ritt.x:: .._ _a-.1 - ,_.. <br />_i't_N ~ REQUIREMENT I'? : ly I Ml!;' Ma Y, d ^i~~M <br /> SAMPLE ~: ~: _ ~ -, <br />~C <br />~ ; ' <br />_ ~ ~ ~ MEASUREMENT ~ <br /> PERMIT <br />~ ` <br />'_, REQUIREMENT , <br />` 30DA A4'G "``, ~ %~ Lt p;'yr t"JNTt-! <br /> SAMPLE ~ ~ r..: , - ..- ..: <br /> MEASUREMENT <br /> PERMIT ' `"r~t~;• .~c•ir # ~# -x k# .. ~Y~ - - <br />,_ . . •-. REQUIREMENT T f ~:i T t`lA =' _ PJT <br /> <br />SAMPLE r t::~ s;~ : r. <br />~-, - r .. MEASUREMENT <br /> PERMIT R E ~ '* 1 3r ~ .. ~ ii- ... °~ . , f.: <br />_= r- ' :-: : r~ '. REQUIREMENT ' -%UA AVG C%F, i L Y' tom? :; •? ;? ~ rr##3~ <br />_ SAMPLE t-##### it i'-~•s5t: , <br />-L: MEASUREMENT <br /> PERMIT w: t .. , r• ~ #-E•# # t- ' ~~ f: . ~: ._. t: t_ ~ ~ . <br />' REQUIREMENT „ 30DRVGEO ~,~ ... `~~a. 1~1UN•(i-i <br /> SAMPLE r .. .. ~ . <br />,'1:. MEASUREMENT <br /> PERMIT ,-~--z~ L, ,_ - _ 1 - .: .. :.. ~_ ,_ ~ ._Ht_ <br />' REQUIREMENT I t`'`-T ' ~ ' <br />NAMETITLE PRINCIPAL EXECUTIVE OFFICER I ceitih under pennl[y of law that this d~xumem and all mtachmena were TELEPHONE DATE <br /> <br />/. Y~ r,~ n '~ ~jr' Sri C_ i e,.~ <br />//Gf 7 <br />w V ~- prcparcd under my direcnon ur supen~ision m accordwrce with a system dcaigned <br />to assure [ha[ yu~liticd perc+mncl properly gnthcr imd evalm[e the inl~~rma[iun <br />submn[nJ. Ha•ed on my myuin of the pcrxm or I~crvms wb.. manage the <ys[em. <br /> <br />- <br /> <br />7~9 $ y~ .. ~, <br />.~ <br />u <br />~ cnons dirKily res!x?nsihlc for gathering the mfortnaucm <br />the mli.mu[unn <br />ur thosr ~ <br />/ <br />` <br />` <br />~ , <br />p <br />t <br />l <br />l <br />d <br />h <br />d ~ <br />~ <br />f'S ~ G1 C ~ ! v_ <br />ct: [roc, uccurutn, an <br />a~mp <br />cte. <br />submalod u, to the Est of my know <br />e <br />ge and SIGNATURE OF PRINCIPAL EXECUTIVE <br /> I nrn aware that these arc sigr[ifiwnt prnalties tiq suhmming fake minrmm:on. OFFICER OR AUTHORIZED AGENT AREA <br />NUMBER <br />YEAR <br />MO <br />DAY <br />TYPED OR PRINTED including thr pourhdny of tine and imprisa«mcm in: knrwing vx4anan+ CODE <br />COMMENTS AND EXPLANA!IVN Ur ANY vwLAI wrvs (rrererence an anacnmenrs here/ <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. : i ~~ i 43 , ~ ~fitS ~ a `}' ~~ •fO <br />