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P£RMITTEE NAME/ADDRESS(Gdr~rFaeWryNwa/Loeanonl/D(~Grenr) <br />NAME T}~if-'1~~~~ I`~J.I~~~IG-', '~11~It;. <br />ADDRESS TRAPf'~~ ~C.A~~ <br />P. D. ~iDlt ~~7 <br />CRAM CD 8$b~~s <br />FACILITY T13!~,I"'P~~F; i~ ~ ~Iw <br />LocATIONCRAZtr CD D%be ~ <br />1~71'N' RR~~lC~iCil\I%] !q ~'S!) F3(1T~, Ff21/~f(tiftii <br />NATIONAL POLLUTANT aSCNAROE ELIMINATION SYSTEM NPDESI <br />DISCHARGE MONITORING REPORT fD R) <br />PERMIT NUMBER ascNAROE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM U 5. p 1 TO ~. 3 <br />Form Approved. <br />OMB No. 2040-0004 <br />Iv) ~ 441D~ <br />t SUI3R ti.lG <br />,r <br />F -- iF' I #~r'~I... i~Dr r~7 <br />~~~i~:f'):~R,~•~~ T~ !•;fI`ST I-;Df~~~ ~UL.CH <br />NOTE: Read Irntrut:tiom baitxa complatiny this form. <br />PARAMETER QUANTITY.OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX FRECUENCr <br />OF SAMPLE <br /> <br />TYPE <br /> ANALrs1S <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />P'M SAMPLE #:~##~••>r• •~• ~ ##•Ir•~r •~ ##•it•tE•••!& t 3. ~ } <br /> MEASUREMENT <br />~}pe~,0{y ~ (~ (} PERMrT <br />E~1` L.U~iolT ~~3D5S V~Iii..U REQUIREMENT •~•#~•# i''f ~ hJ s'. i"It_il~1 i"3A ~ 3 M13h9 S3J <br />~DL. ~ I?~, TD"~'AL SAMPLE #~•#•sr•tE•t<. ~t••~••I#••p•-I#••IS• •s#•3f•#•~•#•sa• ~~ t ~. 9 3 <br />CUSP ~i~1D~ID MEASUREMENT ""----- <br />00~3(? :~ q 4 PERMIT 3'r•~•?:##~ #~••€~•~•~-t~" 3 •3f•#•a~ ic•~z•###~iz ~.~a ifJ )N~,_'~/ .~f7AL•3 <br />~I''~'LUEiVT CsRDSS Vr~f~U REQUIREMENT ,=- <br />/ ~;.~•~•.;: ~~~~ A~~ I~AIi..Y hitti/#_ 3`'Iit~iT <br />`~Cll_~~~, ~~'i'71..~1-~~~.~ SAMPLE ~~r r-:F•Z;-~- ~•? ;: ;~;fa• <br />~ !f •`r:£•:E#•'- ~ ! ~~7 <br /> MEASUREMENT ~ ~ ~ <br />Oa5•~•5 ~. C) C3 PERMIT ##~~~~ •?t-~-• ~- ~ •~#~• #~i•#t~•~••sr I ftEl'C'3R`T' tv~:;l=; ~P,r=,~ <br />~FF'L..U~N~I' G€~DS~ i~a>~U :REQUIREMENT <br />::... :;~.•#•~ t ~ ~'~A A1~'G ll~~:f LY f•9X Nit_/1... !"iCJ}~ITF <br />~ f~DRI, TDTAL. SAMPLE ;'- _ a: ~ ~ t <br />~ .pt ~~ .r r ; ~: ~.~•b ' -!i # ~~ { %T~ ~ <br />{ ~~ ~-~ s MEASUREMENT ~'~ <br />~"}~ 04~~ :% L? GD » <~tF1:Ml``:<<;;' ##. ~ ~ #zf# •t~~i--~•~•~a~ 3U~~ bC)OU tV~'E/ {~A~ <br />~F'r LUEtd~" {~~D,~"sS VP4LU ;F1EaUIREMEN7, <br />~• _ _ ,^s.•#•~•# :3UDA AVt; D I_.1r MX U~/f+.. MCJrV <br />DIL r~ll~llD ~P~r~~x SAMPLE ~.:#~~••:.=~••>v r: ,: .;-- ... ,. -; ~ ( 9.~i ) <br /> MEASUREMENT l ~ <br />Q~S~~ 1 ~ ~5 :::::::::;:PERMIT::;'':;::;: #ic•~r•srt~~ ##•>F•tt~l•~ ->~•-tg~ #~sF~t-rF•~ ~ .#ft-is- i~ ~f~l~IT7 ~~iA$ <br />I~I"'1=~U~1`lT CRD.~~S 'OJ;~I~.U :REClIlIREMEN'}` ~;•#•c:ate. I~tST M~tx 1v9c~flr G~<~i'~ <br />k~ IrDW, ~ iV CCll~t~?U~T Csh SAMPLE _~~---~" {~Q } •rs•r<•It#•:~~• #~~••~••~••1t•# •!?••l: #•rt•#~• <br />l-i1,U TRLA,TI°ilEl*IT ~'L,~:ti3 MEASUREMENT ~ <br />aC7(J5C3 1 t•) {~ PER..MIT F~~i~DRT R~POkT ~~•~if#•sr #i~~#~~r #tt•~-~-b•# •~•#•>;• E~KL` IPJ.:aTA, <br />~'~'1=L.UEi'~T ~13D~5 {a~1L.i.1_ ~EOUfREIVIEN'f` <br />........... . <br />...:..:. 3GI~A A4~~ DA1L`~ h1X f'~ty0 ~"~:~••~ <br />1 , TQ iAi... SAMPLE ^ •y~•.~••tt•3~•k ~•~•~r5•~•'.f•~• #i•i~••ir•~ ~~~• { .~ ci' <br />j ~ ~ r,~°[~~ ~~~~ MEASUREMENT <br />~iJ~ `Y5 ~ {~ C) `PEftMfT #•r<•->; #•~~• it~k-~ ~ -~ •~••><••~• ~~> •~•~ ~ _ _ ~~._. ,I•„~ ~ <br />~F~'I_U~h4T ~P.G~Ei ~r~m...U AECIUIREMENT •1`•t#3~• ;a~)r>A A4't:~ I~~•tIL_Y' "1X #'~~/3w <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER ' "~"y u er pena q o Isw that thN doavment and dl attachments were <br />prepared under my dlrectlon or super.blon In accordann with ~ system dtsl`ned TELEPHONE DATE <br /> <br />,'~ (J' /~ f~1 ~// S to assure that quaNRed perwnnel properly `ether and evaluate the Information <br />submitted <br />ul <br />Bred on m <br />Ir <br />of Ute <br />erson or <br />ersoro who mana <br />e fire s <br />stem <br />(~ <br />f p <br />ry <br />. <br />y <br />p <br />p <br />` <br />y <br />, <br />or thine persoro directly respomlbk for ptherin6 the Information, the InformsUon <br />//j'~ <br />~ n ~,/ ~~ ~~ <br />~~ <br />a. c„° C./ ' wbmltted h; to the bnt of my knowkd~e and DeHef, true, accurate, and compkle. ~ <br />lB <br />1 <br />h <br />J <br />ltl <br />l <br />b10NATVRE OF F'RINGYPAI EXECUTIVE ~ZO / ~//~ <br />~~ % '~J~/ J ~ ~~ <br />y ~n <br />am aware tAN t <br />ere are s <br />anl pena <br />es for aubm <br />ttln6 hbe Information, <br />TYPED OR PRINTED Ineludln~ the possibility of Rne and Imprisonment for knowln~ vldaUom. OFFICER OR AUTHORIZED AOENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANAT lvN yr nn T vwt.n i wns liraarmca sn afracnmanrs nara~ <br />TES f?t TDTA~: T R (~:~! ~' Ni I'T~ ;Py 7 LG. B= WA ~ tlE~3, u ~~7TL.EljI3~.~ yOL.I TAD ~ ~: id; ~ T Ai'f'~.I E;O F'DI~ <~•= i ~SV~a, ~•s!!•1-IR 4'~~d» ~ P ~V~NT- <br />~~IW IiURDFt~ DF ~RDD~' RE{~UZR~}'~IEI~ITS UiVD~P~ :t. A. ~. TDS ~'tD6~I"t'DP,Ii~JO - I. ~3. ~_ <br />EPA Form 3320-1 (Rev. 3/99) Previous editions maybe used. C3~•TB9 /Q'ytJ'Ct~}~4'R~~~~• PAGE AF <br />