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PERMIITTEE NAMEJAODRESS 1•n1i1f1 f,rlMy Mrf/1.erwraw I/o~iwenf)
<br />NAME
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<br />NATIONAL POLLUTANT DISCHMOE ELIMINATION S/4TEM //NPDES/
<br />DISCHARGE MONITORING REPORT (aMR/
<br />PERMIT NUMBER DISCHMOE NUMDER
<br />MONITORING PERI00
<br />YEAR MO DAY YEAR MO DAY
<br />FROM TO
<br />Form Approved
<br />OM8 No. 2040.0004
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<br />EPA Form 3320-1 (Rev. 3199) Previous edt~ons may be used UC1r..J8~ ~` ~7iS,~~~S3-~3F{'~OT1T1 PAGE OF
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