Laserfiche WebLink
PERMfTTEE NAME?ADDRESS rlradurk FucllilS Nante2ocalina rf'Dl(/rrrnil <br />NAME <br />ADDRESS ' <br />FACILITY <br />LOCATION . <br />+..rJ ! r_. ~r <br />NATIONAL POLLUTANT DISCHARGE ELIMINAT70N SYSTEM (NPDESJ <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Forrrt Approved. <br />OMB No. 2040-0004 <br />NnTF~ Raar1 Inctrttrtinnc hafnra rmm~latinn thic fnrm <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION Np. FREDUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS <br />' SAMPLE <br /> ~ ~ /~ ~ <br />t (, "~i'_ <br />- <br />= MEASUREMENT <~ <br />~ ~ C ~ <br />CG' ( = <br />~ <br />' ~ <br />. <br />. . . <br />_ ..,: <br />! <br />. <br />' PERMIT r t ~ .. n F, ; ~~~.: , <br />t: ~~ - _ REQUIREMENT <br />' SAMPLE ' <br />- `J ° , ~ ~. _ " " MEASUREMENT ~.~ ~ ; , C ~ ? ~ -~~ ~~'` ' . <br />r- <br /> PERMIT >~r p.~<. N.FPCtK~ h~~- <br />- -'i< <br />F''" ' '' ^' ' REQUIREMENT ~;; OA ~~,~0 <br /> SAMPLE <br />. ~ MEASUREMENT ~, G / G~ - . G ~ ~_, ~ ~: /":! .~'' <br />. .: PERMIT P;":'? l' ? I=.=-' _ ~ T _ <br />'JL ~+ ! 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 />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER ~ :;mt> under pcrafty of lain thnr thu Jswumrnt and all at[arhmcots were <br />) <br />d TELEPHONE DATE <br /> un <br />prepare <br />er my Jtrecnon or supenLSron m accardanee wrth a system dzsrgtn•J <br />_ "- ~ <br />--~' ~ u7F~ l ~_-.-' "~ , ~ "% ' to assure thnt yualiticJ pcrstmnd properlp gather anJ zvaluatr the infnttn~bnn <br />suhmuted Beset un my myuin o(thc person or perwm who manage the system. _ <br />- - ---- -- <br />- _ <br /> or those persons Jirecth responsible (trr gathering the information. the mfonnau,m ' <br /> submrtted is. to the fist of my knowizdgz and belief, true, aecuratr. and complete <br />th <br />i <br />I <br />th <br />t <br />l <br />( <br />b <br />t <br />l <br />f <br />f SIGNATURE OF PRINCIPAL EXECUTIVE ~ _ -_ <br />J ~-' <br />OR PRINTED <br />TYPED wn aware <br />ere are signrt <br />cnn <br />prne <br />at <br />hes <br />or su <br />mr <br />nng <br />a <br />se m <br />ormauon. <br />includme the possibility of hnz and irnprisnnmrnt f rr knowing s~nlntioas. OFFICER OR AUTHORIZED AGENT AREA <br />NUMBER YEAR MO D <br />~ CODE <br />ICI C~ <br />__- <br />~~,: ~. ~~,, _,.>: .. __ F .. a', :.r. I{t~~ !~ [i ~~-h~.rt-t I~~;ill PAGE OF <br />