Laserfiche WebLink
PERMITTEE NAMEIADDRESS r/nrlude Ftrrilih :\'amclLnrnriun iJlb%JertnU NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDES) <br />NAME DISCHARGE MONITORING REPORT (D R) <br />ADDRESS <br />fi U X • ~ PERMIT NUMBER DISCHARGE NUMBER <br />'JIA <br />FACILITY , ~ Np • ,-, :,~ ;,;_~_.•_, MONITORING PERIOD <br />LOCATION ~ YEAR MO DAY YEAR MO DAY <br />'~~ I A FROM TO <br />AULEY r . HANSEN, VFW <br />Form Approved. <br />C1I!'dQl~ OMB No 2040-0004 <br />(Sl.Jii'r' ?'it <br />fi - F I ^dAL D1=1 <br />CC7AL. FiTC'P,Ar~ 7ri UNNAMED BITCH <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ, FREQUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE ! <br /> MEASUREMENT i { <br />~ <br />~ <br /> c <br />~C <br />n ~ <br /> PERMIT -.. - ... .. _+.:.~•• ,.. -. ~„ ,~~ <br /> REQUIREMENT - ~ + ' ~ ,. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - ¢ °` '` : _. __ _- . - .. _, <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br />NAMElfITLE PRINCIPAL EXECUTIVE OFFICER I <<+'t+t> under {xnalt~ or las. that This d~ximu•m undrll utlxs-hments were <br />r <br />r• <br />isiu <br />asro <br />cr with a s <br />r <br />d u <br />d <br />n di <br />rti <br />n <br />i <br />l <br />tr <br />d <br />. i <br />d TELEPHONE DATE <br /> prepa <br />e <br />n <br />e <br />n <br />n <br />o <br />or wp <br />n <br />n <br />n <br />n <br />un <br />~s <br />m <br />a <br />Rrx ~ <br />/ <br />~ <br />tY)+ f r a• yr, / r <br />i ~/ 'J h+ a u+rr that yuufified personnel puprrl~ Rather and esuluatr the inrorn,xlion <br />whmitu~l. Rusrd nn nn myuin of the ps•r~.m ..r pen+ms who manat;a• tM• sestrm. ~ <br />G' ~ Y ~ <br /> <br />I 1 <br />'. <br />ur Ih,wc pr~ans dirn~tl~ rrspmsddr (or gxthrrin¢ the infurmntion, the intnrnwti.ro ~- <br />~ ~ C :'" ~ <br /> <br />r <br />-- <br />J t/ <br />.. - <br />i ~ submiu d is, to the hest or my knowledgo and hrlier. Inu•, ua•urah•, uttd complete. <br /> <br />wu <br />+ fo <br />for <br />tiuu <br />I <br />e Ihrt the <br />e <br />si <br />irxa <br />t <br />dti <br />b <br />iui <br />rulsr i <br />SIG ATUiiE OF PRINCIPAL EXECUTIVE •~ ;~,{ j'~ _ +l U <br />+` ~. .. <br /> <br />TYPED OR PRINTED , <br />am w <br />r <br />r <br />are <br />gn <br />n <br />prn <br />r- <br />r w <br />m <br />n{; <br />n <br />nw <br />inrludin>; the poscihilih rd fine and imprisonment fur knuwinR riolalions. OFFICER OR AUTHORIZED AGENT AREA <br />OD NUMBER <br />YEAR <br />MQ <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Aeterence an attachments Here) <br />+i E <br />S~JP~E~T TO BURDEN G'F PROOF REQUIF2EM1=NT8 IIV <br />PAGE OF <br />EPA Form 3320-1 (Rev. 3f99) Previous editions may be used. ri'hi~ is a ~-pan f~rrn. <br />