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PERMITTEE NAME/ADDRESS I/neludr FarJur :Yaendl.uratiun if IhJJnrnt) <br />NAME I'I 7 N 1 Pd{ <br />ADDRESS <br />:RP-i': .:. '--~TE Zt~: <br />FacluTY ~ P; i PIF_ <br />LOCATION ;~~~?~k+ i_, B~Esi <br />.=r- I t=;,f'H2. 'ri . ~Isit:iFIFFF2-. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM ((NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER c <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <br />C (,~ ~i ^i <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ, FREQUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> <br />SAMPLE <br />~ 1 ~, <br />~ I Q <br />`~ 1 <br />C <br />1~ <br /> MEASUREMENT (~ , <br /> PERMIT 'r=: ~ ~. - - i~EF~ - _. _- ~ <br /> REQUIREMENT 'ODA -~V':T ` T L 'r i". :~NJdUA <br /> SAMPLE <br />~ ~ ~ <br />~ <br />~ <br />~ I <br />/ <br />~' ~' <br />~- ~ . <br /> MEASUREMENT • ,. <br />~ <br /> PERMIT ~ I'~ `~ ' <br /> REQUIREMENT ~}.=, . i_.Y ~ X <br /> SAMPLE <br />~ <br />a <br />~ Q <br />Z ~ I <br />^ <br />/ ~~ , <br />I <br /> MEASUREMENT ` L <br />--= - <br />- <br />" ' I , <br /> PERMIT - L <br /> REQUIREMENT <;i jN~_`r'~ . <br /> a ~ <br />~ { 1 ~`) ~ I/ --, C~ <br />~ ' <br /> MEASUREMENT , i ~'--~ , <br /> PERMIT ~ . ;f - ~.a..y.,~ ~-: , ,._ , <br /> REQUIREMENT ~ ''I~'I~'t'-%F' <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 />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER l «•rtir, umler ix•n:dt) of law that this d.xnmcnt and au uuarhment.+wrre - -'" - + ~ <br />i <br />d ~ 'L <br />~~ <br />i <br />i <br />d <br />~ <br />i <br />h <br />d <br />i TELEPHONE DATE <br /> <br />r <br />l un <br />r w <br />a satem <br />gne <br />ti-~ <br />; <br />prepared under my Airauon ..r >uirrrr <br />. <br />n acrnr <br />am <br />t <br />es <br />ualifxd prnonnrl pruperl~ yalher aril esaluatr the information - ~~ <br />to a <br />+sure that <br />~ <br />~, ~~' J s t~ ,.S ~G+- L]-`~- ~~~ ~- ~ . <br />q <br />_ <br />whmittad. Ituxd on me inquiry of the Ix•r+am ..r penrm+ whn manaKe the ++strm. _~ <br />' or tMrsr prr`^ns dirMl~ mlxm+ible for ttathcrin¢ Ihr intwrmauon, thr informatnn <br />h <br />th <br />f <br />wl <br />d M•li <br />• <br />r <br />te <br />nd rr <br />lel <br />i <br />l r <br />• <br />A <br />d <br />f <br />I ; .'~ L _ f : ~-' J L- ~ ~.., O ~ , <br />~ <br />~ <br />J <br />~~' <br />• ~• ~" ~~- d of nrv <br />no <br />ge an <br />. <br />rw <br />, ac. o <br />a <br />, a <br />rmp <br />e. <br />w <br />m <br />ttor <br />. to <br />e <br />x <br />e <br />e <br />>i4nificant prndtie+for+uhmitun~ false ioGrrmaticm. SIGNATURE OF PRINCIPAL EXECUTIVE <br />I am aware that tM•rr rtn ~ _ <br />. <br />_ <br /> <br />TYPED OR PRINTED . <br />inrhdin the thilit f rme and im n nment twr Anowin idation+. OFFICER OR AUTHORIZED AGENT <br />K r~°+ rr` p +^ ~` AREDE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIVLaIIUNS (He-erenCB afl anacnmenrs Here) <br />This i~ a 4- art fttrn]. PAGE OF <br />EPA Form 3320-1 IRev. 3/991 Previous editions maY ~ used. P <br />