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PERMITTEE NAME/ADDRESS pweY/rFieY,ryNw/Loe.Nar I/D(Q4rerrr)
<br />NAME TRo~F'~'Ei~a Mi~td~6~lU, :iiiiC.
<br />ADDRESS 7F: AaP"Ei3 ~i l ii~~
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<br />FACam T•~s~PP~;~ t~~iV~
<br />~ocATION G iz ~ T ~ ~ i"t ~€ 3. (, ~ ~
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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM //NPUES/
<br />DISCHARGE MONITORING REPORT /OMR)
<br />CQO03~ 1 R 5 41 i3 s~
<br />PERMIT NUMBER DISCNAROE NuMgER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM ©: ~. C7 U 1 TO ~ ~ 3..
<br />Form Approved.
<br />OMB No. 2040-0004
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<br />t~7St_.E3,~,i,t^>E TO t•~C;ti'~~~ dyUL.ii•I
<br />NOTE: R~~d instructlora b~tor~ complytiny this form.
<br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO• FREQUENCY SAMPLE
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<br /> EX ANALYSIS TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
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<br /> MEASUREMENT
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<br />cw,. U~~y ~iiiD~D MEASUREMENT
<br />070530 1 0 0 PERMIT •tl•3:-ir~•~-•~€• 3i- ~•~--tf•t~ • •?'~••t~# ##~t-•3~•~•~- 35 7{3 P~L.~~ ^f~t~B
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<br /> MEASUREMENT j
<br />CD05~•5 :i ~) O PERMIT -If•~if-'sr•ir•#~ •~• #•i~#~• iF•ii4 ?f•fi•#ir P•i" t3iil~L_ R~i/C?Ri' '1t~FI xi~AEi
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<br /> MEASUREMENT
<br />03'...e"i32 1 0 0 ...:...PERMIT„„,:; #~~#* ~~:~~at~ •~?t•-~• ##~a[-## ~ ~e~~# 10 QN1-T R~,B
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<br />7'i~Ji?U 7 ~~~,7l~iiw#i37 C'LARI EASUREMENT
<br />500}50 f 0 0 ';PERMIT Ri=FDR7 RF~'URT #-~•~-a•-tt--t~• ~••~#•tt-•tt-# . -~•~•tc•~r-r~# t••~•~••~• Iriri~,i,.. IiVS7A
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<br />NAME/TITLE PRINCIPAL EXECUTIVE
<br />OFFICER 1 arsny u er pen. ly o aw Ihat fhb doivmenl snd slt sttxhmenb weR
<br />prepared under my dtreetbn or lupervblon In necordura wuh . sptem ee~`ncd
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<br />S to rmuR Chet qu.Nged personnel property ether snd eraluete the Inforrrwtlon // Q'
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<br />J / //++ /~ or Ihose peraom dlreetly rrspondhk for ptherlrK the Inform.den, the Informslbn \
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<br />whmitled b, to the best of my knowkd~e.nd beget, Irve, xeavrale, end complete.
<br />I sT swlR thH IhIR .R slgnlgtlM pendUO for wbmlltln~ hbe InfOrnudon
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<br />SIGNATURE OF F'RINgPAL EXECUTIVE ~
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<br />Imprbonmenl ror knowing .IdaUoln. OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND' EXPLANA I wn vI- NR r v1vLn I wrvs -rr~r~i~nc~ sn •R~cnm~nrs n~r~1
<br />755 L< Tt37r~L.. IrrdQti{ LT.i"ix7S WILL ~i~ !nl!•~I!)EF~, u Si'=7"t'L.i~~-IZ3i,."I; SD~..Ii7~ LIi"i~7 ~F'!°'i_.~~I} F"Ji~ ~= 90°x, 2~t•i-3t~ PaFdilt:Ti^' ~41~i~11`_
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<br />EPA Form 3320.1 (Rev. 3/99) Previous editions may be used. 0)0469 P0"~~1~j~~ ~~fQrlTl. PAGE ~OF
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