Laserfiche WebLink
PERMITTEE NAME/ADDRESS(1~.eVyFrlMyNrrrLer./rew(/b~ruw/). NATIONAL pOIWTANT DISCNMOE ELIMINATION SY4TErr1 /INPDESI <br />NAME - DISCHARGE MONITORING REPORT IOMR) <br />ADDRESS <br />L ~J'~` PERMIT NUMBER OtSCHMOE NUMEER <br />::iRDE ~ , <br />FACIIrTY `;~ I (~k: t1;- MONITORING PERIOD <br />LD~~ i~ PAL I SAI)E ~ = YEAR MO DAY YEAR MO DAY <br />;_SC1N L. f<. (j •', .. ~ .; FROM TO <br />Farm Approvrd <br />OMB No. 2040.0004 <br />~ ._ <br />NOTE: R•sd {nstruction• b•Iw• compl•tMp this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FRECUENCY SAMPLE <br /> of <br /> EX je'rl~Yps TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ,.,~ ; .~~ ;h1 - <br />'" SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT _. _ <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> <br />, PERMIT <br />REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br />" <br />_.L;._'`'' PERMIT <br />REQUIREMENT <br />_ <br />: >..:. <br />, <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER ~ nn~rr u r pen. t7 o s. tha wy e~,n.nr .nd w NtKhtnett~ ..~ TELEPHONE DATE <br />pRpered Ynder T~ eIRf1I011 «wtper+ilon In tucordOntt •IIA . s]sltrn eest~ntd ~ \ <br />O r .~ ~ ^-ir:a ~ . r~ le tenure IhN qu.NMd personnN properly ether ^tu! e.Juslr the InroeenNbn % ', <br />sobrNlled. tired on mr Inqulr~ a( the person « persom .ho m.nste /he fntrtn, r <br />int.. - .~ `~-.... ~~,~ <br />, <br />.,~~ - <br />' <br />_ _ <br />.. <br />« moee perswr elr.enJ rapntdhk r« i.rh.rint the Inrrtrnuuew, the inrorm.uon , • <br />' i':' f ~ ~.. <br />~ -' r , <br />~ <br />~ <br />< <br />`~ wlmllted Is, b the !test of rnT knew4dte srtd DeMef. true, .rrunte. end twnpkle. <br />-- .. ._ <br />~ ~ <br />I .tn.~.re th.t thrre sre etnlnc.n~ penNnes ror ..ht„tinnj r.ex ~rtror,nNbn. 610NATURE OF -RINCIPAL EXECUTIVE <br />TYPED OR PRINTED tnclud~^R ~~ po~bllltr ornne snd impAsonmenr for tno.lnt .id.u~m OFFICER OR AUTHORIZED AGENT COD£ NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANr vIVLA I IONS (Rdsrmc• •H •tt•cAm•nrs n.r•I ~{~1 <br />Q3 ThiS IS 1 4-part fOfiT1. PAGE OF <br />