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PERMITTEE NAME/ADDRESS,Include Failur A'amr/L~Katiun iJ(h%J4renfl <br />NAME _ -..~~~, LLG <br />ADDRESS ~ ~ ~ •; ~. <br />L~QX .728 <br />FACILITY I..IQR I ~ f.7N P°4I iVE <br />LOCATION 4~ ~ Q ~ ~ 4 c~ <br />r nnfr^c t.t .'+rlr wtTKtC I+iApJAl3FR7 <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM ((NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHAAGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <br />8rt?-:^'iSNE DRt~O TRI3 TO TV <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ, FREQUENCY <br />OF SAMPLE <br /> EX Y <br />I TYPE <br /> ANAL <br />S <br />S <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE - <br />_ <br />; MEASUREMENT <br />- PERMIT # ~ REt~OR-i :i GF <br /> REQUIREMENT ' v s'f X Mt"~- <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~~ ~r REPORT ;?F~~)R- ?tv' '_ - >-; <br /> REQUIREMENT ~ :.iUD~•~ AVi~ O~ ' • f.~: , <br />- SAMPLE ~ - <br /> MEASUREMENT <br /> PERMIT ;~ : -~ '` `` :; <br />T REPCRT rtEPC`3 ~ <br />• <br />~ • <br /> REQUIREMEN ,;i;l.1!ri A~:: IsAll. ' <br /> SAMPLE <br />_;~~,, MEASUREMENT <br />" PERMIT (--< L. ~' ~:'r ti 't i - -.. <br /> REQUIREMENT 300F~ ~ ~=; ; _ "!(!' <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT ~ <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I <ertir, under pemlt+ of law mm mt+d,xument aod,m mtnchment+ were _ _ TELEPHONE DATE <br /> prepared wrier m+ dirn•tion or +upcr+i+iun in an~urdam•e with tl s+-+u~m de+i~nrd _ _ •_ <br />.._-- <br />- <br />- to a+wre that yuulifnd prrwnnel pnprrh Kathrr and e+aluale the infarmatiou -' <br />~ <br />~ <br />~ <br />- -~ - <br />_ <br />_ _ - +ubmittnl. Itu.+rd un m+ inyuin of the perwn ur perwns who manu~v Ihr +yetrm. ~ <br />- <br />j , <br />~ r <br /> or thou' prr+orts dirtrU~ ,-e+pm+ihir fur i;tltherir/~ Ihr informatkm. the informatlan --~" <br />- - <br />~ ~ <br />~ - <br />~ t <br />let <br />d <br />b <br />li <br />f <br />d ~ <br />~~ ~ <br />~ ~ <br /> <br />. true. accura <br />e. an <br />annp <br />e. <br />e <br />e <br />+uhmillcd i+. d, IM lwrt of m) knowle <br />>:e and <br />SIGNATURE OF PRINCIPAL EXECUTIVE - <br />~ I um aware that there mx +ignifn~ant penaltie+ for wbmittinK fal+e Information. ARE <br />A <br /> t+iolations <br />d im <br />ri+nnmrnt for Mnowin <br />th <br />ibillN <br />f fi <br />i <br />l <br />di OFFICER OR AUTHORI2ED AGENT NUMBER YEAR MO DAY <br />• TYPED O PRINTED l <br />. <br />nk <br />e pn+ <br />o <br />ne an <br />p <br />nc <br />u D <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re-erence all attachments Here) <br />F~ti , _ ~ ;__- _~ ~.F~.c~_ ~~d.t~n~ <br />