Laserfiche WebLink
PERMI7TEE NAM E/ADDRESS , Include Facility A'amdlotadun if lhJfnent i <br />NAME <br />ADDRESS ,,....~_ <br />!~d%. _sc~ ,. <br />i_1~1 l.~ ~1'~c'X <br />FACILITY HIZR I i-:l~ P1 ~. N>r <br />LOCATION ._ ~ t.. (] ~i y ~ ~4 <br />nRtf ~ t.ldill= . M 7 F!'~ MIaIULtGFR <br />NATIONAL POLLUTANT O13CHARGE ELIMINATION SYSTEM ((NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />oMB No. 2oao-oooa <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREQUENCY <br />OF SAMPLE <br /> <br />EX <br />Y <br />S TYPE <br /> SI <br />ANAL <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE ~ <br /> MEASUREMENT' <br /> PERMIT . n r ti. s :r-.., YFP~]RT <br /> <br />e t?t?f_iR"f '(~~)= <br /> <br />. '. <br />~h.~~ <br /> REQUIREMENT _ ~ ,.~ r^~,.'i= r, ~. T. L.'/ f l : ~f,l, <br />r, <br /> SAMPLE <br /> MEASUREMENTI <br /> PERMIT ,-, : _k •:i :~ ~_yt7(2-t 1,, -- <br /> REQUIREMENT , -.GliA H` ' ~' <br /> SAMPLE <br /> MEASUREMENT <br /> PEAMIT ~ ~ ~ ' ~' :. 7 t•_. " , . <br /> REQUIREMENT =, ~••~ ~~' urn' :.' ~• - <br /> SAMPLE ` <br />;.~ ; <br />, MEASUREMENT <br />• <br />'-? PERMIT ~c .Z # - . ~; ,~ ;csi. _ fr <br /> REQUIREMENT `-'"• I <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE ~ <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PEAMIT <br />REQUIREMENT <br />NAMEffITLE PRINCIPAL EXECUTIVE OFFICER I train undrr penalty of law that this duavmcnt and all auachmcnu were TELEPHONE DATE <br />prepared under mr dimYion ur supenisiwt in rnordanee with a s~ctem desigmW -~- - - <br />he aswrr tlsnt qualified perwnnei prnperfy gathrr and eraluute thr information i <br />. - -"~ __ _ submitted. Baxd on m~ imluin ed ttte perwn or persems who manage Ibr system. ~ _ _ <br />~ or there prnems directly rrpnuitrk for gatbrring thr information. lM• informntlem - : + - -j „ - -~ i - <br />~ submitted i+. to We tart of my knowlydgc and bclieL true. urtiurrtr, and compkle. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />J <br /> I atn uwrrc that thrrc arc signifkmt penalties for wbmiuing fuhr information. AREA <br /> owin <br />siofatiom <br />ibil <br />m <br />t fo <br />k <br />l <br />o <br />t <br />f f <br />d i <br />b OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY <br />TYPED OR PRINTED g <br />. <br />y o <br />ine mr <br />mpr <br />mrn <br />r <br />n <br />irk <br />uding f <br />r pass <br />i <br />. O <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference ell attachments here) <br />EPA Form 3320-1 (Rev. 399) Prev~cus edis~or.e I':i~ ., ;r; I;:I <br />