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F'ERMITTEE NAME/ADDRESS(-we~4frM'ry1~..rL«.tid.U~'fOG+~J <br />NAME <br />_.,t , <br />AGGRESS .., ,..f, ~. ; ., <br />LL'.'~~ti.Tt= F-illi~4jf~tif 13 <br />FACILITY ~~' E R - , ~ ~ . => 41 <br />LOCATION ?WY© ''I ? , : c <br />~:R ."'~ 816 1 <br />NATIdVAI pOILUTANT dSCHAROE ELIMINATION SYSTEM (JVPDESf <br />DISCHARGE MONITORING REPORT (D RI <br />i:'. <br />PERMIT NUMBER dSCHAROE NUMDEIt <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO 1 ; <br />Fnrm Approveo. <br />AMEt No 2040-0004 <br />~~.~.- - - <br />T r'~~ , <br />NOTE: Rt.~d Irntrualorn b~Iw~ eotnpbtklp thb form. <br />RAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FaEOUENCr <br />or SAMPLE <br />PA EX TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSts <br /> SAMPLE <br />_ <br />''~ MEASUREMENT <br /> <br /> PERMIT ,. ;s-I ~ R>rPC?R ~ !~2EP':,- t. <br /> REQUIREMENT ~ r• - <br />' SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT _ <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT __ <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENTC _ <br /> SAMPLE <br /> MEASUREMENT _ <br />PERMIT <br />REQUIREMENT <br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER t centt~ r er pen. t~ o .w lhM a+h dotromeM •nd dl •tt.chmrnb .ere ~ TELEPHONE <br /> <br />/ <br />prep.red under T~ dlreelbn or ruper.tyon In trcord.nn with . r)rlem dW[ned ~ <br />~ <br />~ <br />~ DATE <br />// <br />le tmunr IA.1 ge.tlfled perwnnel properl7 [.Iher .M er.hl.lr the Infnrrtytlon ~/ <br />~ <br />~ <br />entwu -ho tn.n.[e the ryftem <br />i x / <br />' • <br />~ ~ <br />ui <br />of tM <br />rnon a <br />ll <br />d on <br />In <br />t <br />• ~/G' ~ <br />r~ ' <br />' <br />, <br />.. _ <br />ry <br />p <br />p <br />lted. <br />~e <br />my <br />q <br />wtbm <br />~ <br />tln <br />~ <br />~ <br />? <br />k f <br />Ih <br />l <br />th <br />I <br />tl <br />n <br />Ih <br />I <br />l <br />rn <br />l <br />f I <br />' <br />n ; <br />~L, ,,~~. <, <br />. ~,;, <br />n[ <br />n <br />orms <br />o <br />, <br />r <br />n <br />o <br />w <br />~ repe~b <br />or [. <br />er <br />e <br />a Uoee penom dlrect <br />~ . <br />[,N, : II • <br />1 <br />mbmltted b. to the heel of m~ Ltwwlea[r end beMef, true, uatnte..M compkte. - <br />` <br />. •. ~ <br />- ~ <br />~ <br />-RINCtP <br />EXECtJTTVE -~ <br />~ <br />~ <br />- <br />, _ t .m .w.re Net Ihere.re rl[nlM1cant pendtla for Nbmlltln[ hbe Infonmaon, {IONATVRE Of <br />AI <br />T <br />t <br />ENT A A <br />NVMEiER <br />YEAR MO <br />DAY <br />~~~ Includln[ tM poeybllltT of flne.nd Inryrbottntrnt for knowin[ .Id.tlorri HOR <br />2ED AG <br />OFFICER OR AU CODE <br />TYPEb ~ <br />COMMENTS AND EXPLANATION OF ANY <br />(/fI/I/MCI M I7f/CRRtI/1f3 n~i s7 <br />-~ Form 3320-1 fRev 3K~9) Previous editions maybe useA <br />'+_ -`" ~ ~:~T' ~ '`-. Tfiis rs a'4-pert' ~Ofitl. PAfiE OF <br />O~.,G~ <br />