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PERMITTEE NAME/ADDRESS pweir6F.rWeyNw/Leearo" IJn(Qlrnny
<br />NAME T~~~F'~R i'~i~i~ll€~5~, ItiIC.
<br />ADDRESS TRA~'l'~13 I"II~1~
<br />P. D. IiCJ~ 387'
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<br />A T Ti~l:s~,'~~~I~D6~11? G. DU SOTS, PF~~Sr {~M
<br />NATIONAL POLLUTANT aSCHAROE ELIMINATION SYSTEM NPDESI
<br />DISCHARGE MONITORING REPORT /D R)
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<br />PERMIT NUMBER ascNAaoE NuMeEa
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM C)? 1 O (? 1 TO !' $ r ~ g
<br />Form Approved.
<br />OMB No. 2040-0004
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<br />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER ' tt14itr ° er pe"^ tr o ^~ m^t this document ^nd ^u ^tt.chmenu were
<br />prep^red under m~ direetlon or aupervhlon In ^ceord^nee with ^ system deslened TELEPHON E DATE
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<br />submitted h, to the hnt of m~ knowkd~e ^nd bedef, tne, .arnle, and rnmplete.
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<br />EIONATURE OF PRINCIPAL EXECUTIVE 9~~
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<br />TYPED OR PRINTED neludi"[ the pomlDlliq of line ^nd Imprlsonmenl for knowln~ vid^tloln OFFICER OR AUTHORIZED AOENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXr'LAnw 1 wn yr r.n r vrvt.n t tuna I/fmienc~ sn ~aicnmtrnrs ntri~~
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<br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. ~Q~rBy~~~ • i~~g~~ Q'Qnp, PAGE ,OF
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