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PERMITTEE NAME/ADDRESS pweYlefaelbryNawa/Loeatat t/Ot~r-enr)
<br />NAME ~~`~~lfi rt`'~f 't {~~. )t{isr fr. L.v
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<br />FACILITY ~!~ti~fSE°,.,{t.f`! {.af`~it ~}: j`f...i~t ~ ~~Z f {.tf~la:.r:i
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<br />NATIONAL POLLUTANT OISCHAROE ELIMINATION SYSTEM //NPDESI
<br />DISCHARGE MONITORING REPORT /DMRI
<br />PERMIT NUMBER olscHAROE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM .. ;r ) ._ i.F .t TO i " +..:~. _,
<br />Form Approved.
<br />OMB No. 2040-0004
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<br />PARAMETER 4UANTITY OR LOADING 4UALITY OR CONCENTRATION NO. FREOVENCV
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<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
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<br /> MEASUREMENT
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER «ru~7 u er pen. tr o aw mat mla document and au attachmenu were
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<br />TypEp OR PRINTED IrtduainE the possibility or Ilne and ImpAaonment for knowlnE ridatlo~ OFFICER OR AUTHORIZED AGENT CODE NUMEIER YEAR MO DAY
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<br />EPA Form 3320-1 (Rev. 3/99) Previous editions maybe used. + { .. c.+ i + T)I~S.~1S a 4 aR'•fQrm. PAGE . OF
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