Laserfiche WebLink
PERMITTEE NAME/ADDRESS tlnrlude Fatiliry :1'amr!/~ralinn iflh;(/arnfl <br />NAME <br />ADDRESS .il'!. i_,. <br />~x X70 <br />ro 51639 <br />FACILITY Mj"dE OOMPI_E'X <br />LOCATION .-~~ cry ez63y <br />Ks:aF7fl. f7~r~l tsr+~nT'inw! h~:nnlenca <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM ((NPDES) <br />DISCHARGE MONITORING REPORT (OMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 240.0004 <br />t ,r f <br />_ .i c. <br />F - 1-:"~~~ ~v~. <br />nTSCHARGE TO TRIHiCiRY CRFE.K <br />---..__.._HAr2GE ~I... ... <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREDUENCY <br />OF SAMPLE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALYSIS TYPE <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 />, - <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT <br /> <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 />a <br />NAMElTITLE PRINCIPAL EXECUTIVE OFFICER l errtin ender penalty of mw That this dtxument :md all auarhmrnt+ were <br />prepared under my dirrctlnn nr wprnisinn In aa-cnrdunee with a sy+trm designed TELEPHONE DATE <br /> In wsxtrr that ytutliried pennnnrl proprrh gather and evaluate Ihr information <br />wbmittrd. Bascd un my inyuin of the prnun ur persons who manage Ihr system, <br />ur thuae persons dirrc0y respm+ibk for gathering the informatfon. the inlnrmmion <br />~ <br />/ ~~ ~ <br /> <br />-~ <br /> submitted Ls, to the hest of m) knowledge and belief. true, w~curatr. wnd compirle. <br />I <br />w <br />th <br />h <br />i <br />f SIGN URE OF PRINCIPAL EXEC <br />IVE `~ I ` <br /> am a <br />are <br />at t <br />ere are + <br />gni <br />kant penalties (or suhmitting false information, UT <br />TYPED OR PRINTED <br />~'.nMMFNTS eNn FYPI ANATIl1h1 AG AAIV VIlll including the p~nsibility nC fine and imprhonmem !nr knowing si~dationa, <br />ATI(lA1C /Onfn......+.+ .. rt ..se.... t........... ~___a O ICER OR AUTHORIZED AGENT AREA NUMBER <br />C YEAR MO DAY <br />~~ETTL.EA)?L.?~ 501_7I'j~ ! ]MIT' WAIV>`L) F(3F2 %!O'r' %E <br />ti. - ,,•. , <br />Thl` h .1 •~-(l£U~ f~rlli. PAGE OF <br />