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f•ERMITTEE NAME/AODRESS (7wei,tY frtbryNrtJL«afoa I/DfQGt•uJ <br />NAME <br />-r - <br />ADORE 5 S <br />. ~ ., - .. _ .. r. ~ ~1 .. 1 ., i. ... <br />L~KJF. Cc, rti~ 16 <br />FACILITY ,-j1JL +~U:tTt; 6 ~i:Ui'`~ N,Itr)r:, <br />l0(.A TTON <br />E'AL1~ADt CO bi~Lb <br />- . n N ~ r ~ t r tt <br />corm Approved <br />wATipN AL POLLVTMIT aSCHMOf EIIMIwATtON SYSTEM ((NPDESI OMB No 2040-0004 <br />DISCHARGE MONITORING REPORT IOMRI r <br />~tlft uN) <br />PERMIT NUMBER ascwrwaE wuMeEn <br />MONITORING PERIOD I ~ ~ •1 <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />unTT• o__w t.y..,.,,.i,..._ ti_t,.._ ..___~_.r.... e-.t. r....r. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION P10. UFw~v <br />FREC SAMPLE <br /> D <br /> <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS EX u+Aa.vsts TYPE <br /> SAMPLE <br />MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~ - '. _ ,: n ~ ~ . ~ ~ . . <br /> <br /> <br />' SAMPLE <br /> MEASUREMENT - <br /> PERMIT ~ <br /> <br />REQUIREMENT <br />-' J L ~ <br />" - <br /> V <br />. . <br />SAMPLE <br /> MEASUREMENT <br /> PERMIT - <br /> <br />_ <br />REQUIREMENT .: L i. 1 <br />' ' ;ti i` . / <br />~ M ti <br /> SAMPLE <br />M <br />ASUR <br />M <br />T <br /> <br />1 ~' . E <br />E <br />EN - <br /> <br />. 1 PERMIT <br />.. <br />~ <br />i <br /> REQUIREMENT .. ~ ;, ~ u ;. <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> P <br />I <br /> ERM <br />T <br />REQUIREMENT _ <br />.. <br />- ~ <br />- <br /> <br /> <br />~ ~ ~ SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />,.~ 1 J .. . <br />REQUIREMENT <br />~ „cbGhi -~:.Y <br />. : c._ 7;: <br />I~ N ~' ~ <br />... r. i... ~ t :..i::. SAMPLE <br /> MEASUREMENT <br />.. <br /> PERMIT <br /> <br />~ c. .. <br />~ , ~ . ~ . <br /> REQUIREMENT - <br />.._,:. <br /> <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER ' """' " et p•"•'7 ° bw tn•t th <br />prrpered under m! dlrrrtlon or >upr h dorvmr"' end •u •nscnm <br />rrhton In nccord•n <br />e rilb . rnu were <br />t TELEPHONE DATE <br /> r <br />r]r <br />em defl[ned <br />t° <br />un 1hN <br />Nfl <br />l <br />~ <br />_ _ m <br />qu. <br />ed personne <br />propery [•t Mr and er•ht.te 1M Inrnrrtutlon <br />sobmltt <br />d <br />B <br />ed <br />n m <br />I <br />t <br />r - <br /> e <br />. <br />r <br />o <br />! <br />rpu <br />r~ o <br />tM person or persons .bo truntr[e tM srttem, <br />w tb0•e <br />erwt <br />dl <br />U <br />res <br />ordbl <br />f i <br /> p <br />s <br />rer <br />! <br />p <br />e <br />or plherltr[ the Inrorrrutlon, Ine Inforrrrllon <br />wbmitted b <br />t <br />th <br />b <br />s <br />t or m <br />kn <br />kd ; `,,, , t :. _, <br />- ~ <br />• <br /> ! <br />. <br />o <br />e <br />en <br />o <br />. <br />[e .nd betlef, true. ttrcvnle, •nd rotnpkte. <br />1 •m.w•re u.t tbere.re ft[nlflunt pm•1[In for <br />bmlttln <br />r•b <br />I <br />f <br /> <br />sIONA <br />• <br /> <br />- ( <br />r z, -. <br />/ ~. <br />~/ <br />G <br /> <br />TYPED OR PRINTED <br />..... ...r•,Tr •.,n coot eueTlnu nF euV Vlnl w <br />[ <br />e <br />n <br />onrut{on, <br />InAueln[ tM pntdD7Nt! or floe •nd ImpMonrnent for krto.ln[ .iM•t{otn <br />eTln-tr rn _.______ _u _..__. ____.. . TURE OF rRINC[f <br />Al EXECUTIVE <br />OFFICER OR AUTHORIZED AGENT <br />p' A NUMEIER <br />CODE ~ <br />YEAR L <br />MO <br />OAY <br />e e t. <br />EPA Form 3320-1 (Rev 3991 Previous editions may be used PAGE OF <br />This is a d-pan form. <br />