|
PERMITTEE NAME/ADDRESS pneYJeF~efhryNw/L«rarron t/D~Qhrrnr)
<br />NAME ~Cli~~~ ~'~~s"JL1F',G'.::..~, ~..ya.9-?-~X
<br />ADDRESSjj(."~i;rS Y ~ ~~. c I f ~ f~l;.
<br />FACILITY ~ C7~~ - "f„ i' ~Ci, ~ )v7 I ~~~
<br />LocATloy,,c~Gli~-S~ C~ ~~~c~
<br />e s~v .~- ssnxe-.
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM //NPOES/
<br />DISCHARGE MONITORING REPORT (DMRI
<br />f" ..fl,l1 " _., ~ . ~. tn.
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM ~1~ ~, ~ Cr:~ TO Ctt ?.U ~'a
<br />Form Approved.
<br />OMB No. 2040-0004
<br />( ~;13L3','~ I ~,'
<br />NOTE: R~~d Inetfucdofa b~iw~ compl~tlfly this itxrn.
<br />r••r r r rro. wsw„r... r.r -
<br />PARAMETER v~xe. ~
<br />QUANTITY OR LOADING
<br />QUALITY OR CONCENTRATION
<br />NO.
<br />EX
<br />FRE°°F~CV
<br />SAMPLE
<br />TYPE
<br /> ANALYSIS
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br />'~#.._ ~tl~l7J G~3~s~~~ SAMPLE ~r~•-~x~:•~' t ~.;~~•?
<br />~ ~ri•._:~.•s~:z•.1~• ~'••;~•T'••~:•;••~ •it.;-,.::.gi-~.•~c
<br />i ~U~
<br />L MEASUREMENT ~.~-- 7
<br />,
<br />~i•~~,r; I C7 C•
<br />,. .~ a PERMIT
<br />
<br />~
<br />... :.
<br />;:.. ,.., j fd ~•'= $
<br />-.:
<br />. ~ , a~ . f. . ~ s ., . _, . ~- ~ ~~ . i -. ~, ,
<br />~~'~-[~~~h3'I- ~I~~~:S ~„ REMENI'
<br />i#EQUI ~i~~r:T ;•f ~, ,~{Ja=~ .: t..;•:
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIY
<br /> REQUIREMENT
<br />_.
<br /> SAMPLE
<br /> MEASUREMENT
<br /> `'PERMMIT
<br /> REQUIREMENT.
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIT
<br /> REOUIREMEN7
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIT ';
<br /> AEtSUIREMENt
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIT
<br /> AEQUIREM@N'C
<br /> SAMPLE
<br /> MEASUREMENT
<br /> 'PERMIT'
<br /> REQUIREMENT
<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER t eertrty u er pens ~~ o law mat m
<br />directbn or au
<br />ed under m
<br />a h document sad dl ettsa:nmenu were
<br />errhlon In ~ceordonre wllh a system desi
<br />tred TELEPHON E DATE
<br /> `
<br />p
<br />7
<br />prep
<br />r
<br />to mYR that qu~NBed personnel P~H7 purer sad erelude the Infernulbn
<br />- submitted. Btned on my Irululry of the person or penortt who rruna`e the system,
<br />~
<br /> or those person directly rtlpomibk for plhertrq me Infortnstlon, the Informstlen ~
<br />/
<br />/~
<br />~i
<br />~
<br />'
<br />'
<br />~
<br />~1 submitted b, to the bat of my knowkd~e sad beNef, true, sttvnte, sad complete. -
<br />IONAT'URE OF PRINCIPAL EXECUTIVE ~ ~. (;~,.~ . ~- ~-•~ G C[
<br />/
<br />ry /.
<br />l
<br />~~
<br />~~1 I nm 1w1R msf IhtR eR s1~nIBuM pendtltl for wbmlltln~ hhe Infornutlon, s -
<br />TYPED OR PRINTED includin` the poalblilty of ene sad ImpAsonment for knowlnS rlolsUons OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION or ArvT VIVLA I tvlva //rte/~itrnctr mi ~tt~cnm~nta n~r~r
<br />~~~t' i i..~l`-'Z3i._.:~ ~;a';.:iL..T ~'S L.~is`;`r i f~:Pt~'!_i ~~~ C.'i~'1..." t I" ,: G'~`a'F;, , .t~ril~ ~-'t~d=C F"r=' ?' ~. a...l'.', a :-: ~;i..~~'i'd~1=~~. ~~ {"~ '~<':ts ~;r;~1,i1~,~~cr~
<br /> ~iY' Irl~?C:;::~:
<br />T ~ E*.) ~I~ ,I 'l..~'~:. '~'~. s. -~ ice:.. .,r::~*,.,aE ~.. _,~{ ;..,--.,_ a:. ~. 3r .~1; ~.:I~i F' t I~l~GF'
<br />T ^~ ": Js~L7„? I~. ~ f~iY'~"~ P;J L... ~~• ~ ,^.~; ~ ~~ -s~F~*~y~ ,, ~~~- ~~ tP 1 c•;i-• ,= r ~~-; ~-; ~: •~; : t ' t ~- ~ s
<br />t-~,N -t' F-•:4 ~J! >s. '.= IL_i~'.,".'i.: ~.. L•:. ._.. .. 's', t;W;c i ,..:.._ , ....=.i', F_ ~., •~ ..,»:I . 1'.`.'.,~ ..R.a:+:~r - ~ OF
<br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. Tt1~S~ 1~ 8~~4 par ~fOrtil. P4GE
<br />
|