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PERMITTEE NAME/ADDRESS f7ntilir fwrlbyNw/Larwro» I/D(Qi.w.q NATIONAL POLLUTANT aSCHAAOE ELIMINATION SYSTEM //NPDESI <br />NAME DISCHARGE MONITORING REPORT IOMRI <br />ADDRESS ~ <br />• f3vi( i y .i V PERMIT NUMBER ascHAnoE NUMeE» <br />S A U )r ~ ~- MONITORING PERIOD <br />FACILITY <br />LocATtoN ~ j Li ~ ~ :•.: 1: c. J 1,, u'L H P1. YEAR MO DAY YEAR MO DAY <br />c~ALIShL c Cf. FROM TO <br />• ~ ~[ \~ 1 1- ~ L 17 f <br />Form Arplo:ed <br />OMB ~+c _'•CSG-UGC: <br />'r~LUnNZt, rt+: <br />\1I1TC. R__J 1__r._.l_-- l_.__1 .~~.~. .--'.. .l 1. ^--- <br /> <br /> <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION Np, ufNCY <br />EREO SAMPLE <br /> ~ <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALrsls TYPE <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT - ~~. N.:, - •. t:1',LY 'F:;~~' <br /> ., <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT ! . ' <br />~ <br /> <br />REQUIREMENT , . ~ r r. C <br /> •r <br />_ SAMPLE <br />ASUR <br /> ME <br />EMENT - <br /> PERMIT <br />E <br />I ... - v L ~, .~ ;. - :, c t C ~ r ~. c. E / :.:, <br /> R <br />QU <br />REMENT <br />.f <br /> SAMPLE <br />MEASUR <br />M <br />NT <br />,~ <br />E <br />E <br />_ PERMIT <br />.. <br />.. <br />. ` v ~ <br />:. U u <br />/ <br /> REQUIREMENT <br /> <br /> SAMPLE <br />MEASUREM <br />NT <br /> E <br /> PERMIT <br />REQUIREMENT .. ,~.~ ~ 1•. i' L, !. i' . ~ L <br />•• <br /> <br /> <br />r ~~ SAMPLE <br />1 <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br />- <br />~ . <br />_ <br />. . <br /> <br /> <br />- SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT , -_ ~ r ; c ~ L : 1_; :. <br /> <br />NAME/T1TLE PRINCIPAL EXECUTIVE OFFICER ' nnln ~ er pens q o u» lha ml. dorumrnl .nd \n ut.rnme,lu »ere <br />prep\ntd under m~ dlretlbn or wpenyon In Arrord.ntt »IIh . s~rlrm ddLned TELEPHONE DATE <br />_ <br />_ le more Ih\I qu.MneA personnel propM~ Luher .nd er\lutlr the Infnrnytbn <br />tubmitltd. seta on m~ Irpulry of the prrson or penoro »ho mAn\Le the rplrm, <br />tx Iho.r <br />rrsors dlre <br />tl <br />res <br />nl bk f <br />I • <br /> p <br />c <br />~ <br />po <br />or L. <br />hrri nL the InformAllon• the Inform\Ilon <br />wbrNllyd f <br />t <br />th <br />b <br />k <br />t <br />f <br />- - <br />- <br />• _ - s, <br />o <br />e <br />es <br />o <br />m7 <br />nowWLe .rd beset, Irue, \crvnle. \nd mmpkte. <br />1 •m \.\n m\I mere •rr dLnltksnl pendHes ror submlldn <br />hbt I <br />f <br />rm <br />tb <br />EIONATURE OF - <br />I <br />Ir <br />- <br />~ --~ <br />~% <br />TYPED OR PRINTED <br />w w..••r••~Tw ••.e~ rvM A\IATII'1\I AG A\IV \/IAI L <br />n <br />o <br />A <br />n. <br />IndudlnL Ihr pofn1b1111~ of llne \nd Imprbonmenl for kno»InL rldatlolu. <br />ATlr,.lw rn_i. R <br />NC <br />AI EXECUTIVE <br />OFFICER OR AllTHORIZEO AOENT A A NUM[fER <br />CODE YEAR MO DAY <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. <br />EaJECT •iC FLE;;t <br />This Is a 4-part form <br />Of <br />