Laserfiche WebLink
PERMITTEE NAME/ADDRESSpwe~~rF.rwryNw/L«wrenl/D~p..wv) <br />NAME <br />ADDRESS _ _ _~ .~ ~ .. _ .. ., _ .. , , . , t, ~ _, <br />t1UX 14 ~i} <br />:SAD CC diSZb <br />FACILITY jjD): ,tiOkTtr t Jvi'i'h Hilti~:; <br />A <br />LocATxxr aAL1:.nL:: LC o15tb <br />:..SUN i. K iLl7t.i+. Y. r . <br />NATIONAL f OLLUTANT aSCHMOE ELIMINATION SYSTEM NPOESI <br />DISCHARGE MONITORING REPORT lD RJ <br />PERMIT NUMBER ascNAnoE N~IrteEn <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OM9 No 2040-0004 <br />?iit-C4 <br />(~V=%i1 <br />F - F. <br />PnhD <br />NOTE: Reed Irntructiaw belo~~~`coinpletlny thfe form. <br /> <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. ~EOO`NCY SAMPLE <br /> <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANltirsls TYPE <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />.. <br />. ~; ;, <br />~. i : <br />! - - <br /> REQUIREMENT <br /> N t '~ :y <br /> <br />r ~ SAMPLE <br />' <br /> MEASUREMENT <br /> PERMIT <br />.• <br />!; ~ r C ' <br />. `~ <br />. ~ / <br />1 i <br /> REQUIREMENT - , <br /> v r <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />~ <br />~ - ~- <br /> REQUIREMENT _ ~ <br /> 1 . y ~ l r, <br />_ <br />~ SAMPLE <br /> MEASUREMENT <br />...._.... ..L1 , <br />~~ ` ,~ U PERMIT .... r :.: .. _ l (: F: .. ~ .,... , >;: +: o ~ , •.~ ~ ~ t v r i i; i. 'L r i< _ ' <br />F. <br /> REQUIREMENT _ <br /> <br /> SAMPLE <br /> MEASUREMENT <br />. <br /> PERMIT • ~~'• - !? :. E G h T ~ _ •.; c~ • n ~ Y Y 1 ;. ~ A <br /> REQUIREMENT <br />.< <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br />PERMIT <br />REQUIREMENT <br />NAMElTITLE PRINCIPAL EXECUTNE OFFICER ' fe^") " " pr"") ° 1•" Ihel thh donlm[nl •nd ul •nuchmenn .ere <br />TELEPHONE <br />DATE <br />r: .red rnerr to tnrectlon or w <br />p p ) perrlflon In eccordente "Ilh . f)flem Qtll~ned <br />_ <br />- to Aare IhN quefleM personnel proprri) [Nher end trehrele IAr Infnrmetlon <br />fubmltled <br />efexd on m <br />or the <br />In <br />ui <br />erson or <br />"M tn <br />n <br />th <br /> . <br />) <br />q <br />ry <br />p <br />penoru <br />e <br />a~t <br />e frflrm, <br /> or Ihott prnonf dlretll) rapor~bk for E.lherlrK lht Informetlon, Iht Informelbn ~ ~-~ - <br />` <br />- - fu bntllled bt to Ihr belt or m) -nowkd~e ^nd beeer, INe, ecavnlt. erd tompkle. ~. ~ i :.}. <br />~ <br />' 1 •m ."ere Uel Ihere •n rlErJflunl pmeltla for fvbtnlttln~ febe Inforrmlbn, 610MATVRE OF -RINClPAL EXECI,ITTVE r <br />TYPED OR PRINTED Includlnt the pofeiDlUl) or floe erld ImpMonmenl for too"Ind rtdeuorn. OFFICER OR AIITHORIIEO AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF AN1 v1UL~ I IONS (HN~r~nci s// •ft~cllm~nfa h~r~/ <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. This is a d-part form. PAGE OF <br />