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PERMITTEE NAMErADDRESS ~lnehrJe <br />NAME <br />ADDRESS ~ - '1 i 1~= <br />•iG1"ON <br />FACILITY =~~ L;, I~~t NE <br />LOCATION ,.Jl'V <br />'~ i~iiliil•,I <br />Form Approved. <br />vme2rxatMn f(DiJJercnU NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) OMB NO. 2040-0004 <br />DISCHARGE MONITORING REPORT (DMR) , <br />.. PERMIT NUMBER DISCHARGE NUMBER F ? PdRL LA1~ <br />~.' ;.`.DIRE RIVER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO ' ~- <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY <br />OF SAMPLE <br /> ~ TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> <br />SAMPLE ,. r:. ~ . <br /> MEASUREMENT <br /> PERMIT ,~ ~ :. ; r # t.- is # ~ _ ~ s- 7 . ~ ~ ~ <br />_,. . <br />- <br />REQUIREMENT <br />:~~-:: <br />L; , .. ;.:..:. <br />M1 ~; t.~'I <br />i; .; <br /> SAMPLE <br />:: MEASUREMENT <br /> PERMIT ~ , _,..IS # : ~ t: s- # r ~ ., s~ :; :• _ - <br />_ - _ REQUIREMENT - - My; ?D r:.',r I`iQNI t-~ <br /> SAMPLE - <br /> MEASUREMENT <br />' PERMIT - :. r;• - t- ~ t- ,: - - ... .. _ t v t:: <br />_ } t .: i _ i i ~ - REQUIREMENT IrH I i_Y i'=i'= f•TDN 7 ~~ <br /> SAMPLE ~ ( / <br />._ MEASUREMENT <br />- PERMIT ~ : u : ~.. F, r- -## <br />' x <br />~ i I~r _ -: <br />. <br />- <br />; <br />_l: ~- ~ REQUIREMENT z-i' . ,,'~. D1a. ~.~x T ,. <br />,Lt <br />MI <br /> SAMPLE ~ . <br /> MEASUREMENT <br /> PERMIT :' kcr# i~r., sr sr 'fi# t. - t tJt Iv. <br />.. '?-,•i;_ <br />_ I l .. REQUIREMENT ,.. ~ ~ ! <br /> SAMPLE ~ ; , r , <br />• ' : + ' .. MEASUREMENT <br /> PERMIT - <br />~. <br />- J ~; .. - x-,< >. ::... :~ ~ , _ -,o , ~ , <br />c_Ir _ :. :_ REQUIREMENT ".`1'r=, AVG i `, : !-,'. .'t' <br /> SAMPLE ~ s; ~ ,. - ~ •... ~- ., <br /> MEASUREMENT <br /> PERMIT t~ ~ st i± _ ~~ t <br />- _ ..- .. .. , _ _ <br /> REQUIREMENT Ii~10T i"1AX ~ <br />NAMErTITLE PRINCIPAL EXECUTIVE OFFICER I ccntl. under penalty o(law that thi. document and all aua.hments was ~ n i' TELEPHONE DATE <br /> prrpared under mp dtrc:uan or svperviyivn m aecardance with a .ystem d~~siKned ///~ <br />_ <br />„~ / <br />1~ ~, ~/ ~ ~ ~ (--~ ~ ~ _- <br />f' <br />~/ to as~urc that ywdificd lxrsonnd properly gethrt .md cF~aluate tlu infonnmwn <br />'h <br />na <br />th <br />st <br />m <br />h <br />f / <br />/// <br />` <br />, <br />v <br />~ <br />[/ <br />i+ <br />~ <br />i/ e lxrxm or pcrsenc v. <br />ge <br />e sy <br />e <br />. <br />t <br />n no <br />submmed 8ascd oo my inquiry o <br />or thou prrarns dira-tly respomit+le i'or ga[hering the in(ortnation, the information ( <br />( <br />/ <br />( <br />/ <br />~ <br />C ~ <br />-~ <br />~' <br />~ t <br />nd <br />m <br />lete <br />h <br />'l <br />d <br />d ML <br />f <br />( <br />k / <br />~ ~ /j <br />~' ~ <br />~ <br />~ ~ <br />~~ C' , rnie, accura <br />co <br />p <br />. <br />now <br />e <br />er an <br />e <br />e. a <br />st,bmnt d is, u~ the <br />est o <br />my SIGNATURE OF PRINCIPAL EXECUTIVE ~l ~/. i <br /> I am aware that there ore suptificant penaltio (or utbmitnng falu infunnutitm, <br />k <br />i <br />l <br />i OFFICER OR AUTHORIZED AGENT AR A <br />NUMBER <br />YEAR <br />MO <br />DAY <br />TYPED OR PRINTED now <br />ng ~to <br />m <br />~~n. <br />including the p~~ahiGry ui fine and impnsonmrnt for CODE <br />COMMENTS AND EXPt.AnAl Ivry ur ArvT vlVt~tl Ivrva Irreverence an a~carnntrnts ncrt:~ <br />IOD REPORTED <br />''~ i : t_ I •' i 7 <br />PAGE _ OF <br />tlIL <br />PPL °-~ <br />I ~D GREASE <br />FOR <_ - SEE I. B 1 D~ F <br />_ , _. ., _ - . T f <br /> <br />---- <br />- - <br />--- ~:: , <br />- t (Ilti 7S A -~-41i1(t fDIl1L - <br />