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PERMITTEE NAME/ADDRESS Unrladr Fxitity :\'amdlocati.m if !tiJ]rrcntl <br />NAME - L.L <br />ADDRESS - - <br />f3 c~ <br />a ~? <br />FACILITY ; IE.ii~C .i ZGIC i^ T ~: <br />LOCATION ;~~ U <br />. wwtrr ..t r.r•.c u7r.tt: t+i9AidfuL~f7 <br />NATIONAL POLLUTANT DISCHAgGE 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. 20x0-0004 <br />R&f"i F f~iE DR WG TR I ii ~ ~~-~-t <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION ND, <br /> <br />EX FREQUENCY <br />of <br />ANALYSIS SAMPLE <br />TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />. SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT <br />~ <br />• <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I errtit) nndrr prmau) ormw that wi+d«vmrm and ~n attsehmrnL+wrrc <br />prrpured under my dirreti.xt nr wpen~ision in ucn.rdance Kith a +}+trm tSesipoed <br />__ - TELEPHONE DATE <br /> <br />.. ----- - _ t~r a.nvc that qualified per...nori pr~~rrrf~ patlK•r and r+ahtrlc the infnrmaUon <br />wbmitted. Kuied un m~ inyuin i~f the penun ur prrvm+ wlro manaKc thr sy+trm, <br />an.ible for KathcrinY the information. the informalion <br />dlrertl <br />rr~ <br />n <br />h <br />,/ r~ i' <br />--- <br /> <br /> <br />. <br />• ~ '~ ~ - <br />i ~ <br />p <br />ou prr+ <br />ne <br />nr t <br />mbmiurd h, lu thr best of m~ krwwledRc and bdkf, tnu, accuntr, and cumpktc. <br />SIGNATURE OF PRINCIPAL EXECUTIVE ~ '~ y <br />J`~ <br />• <br />` I am swore that them are sipnific+mt prnnltics fur.vhmlttina fake Mformatem. OFFICEfl OR AUTHORIZED AGENT AREA <br />NUMBER <br />YEAR <br />MQ <br />OAY <br />TYPED OR PRINTED including; the p.nabilitr of rim• and impriwnmem for knowing vidaliotu. <br />COMMENTS AND EXPLANA71vn ~r ArvY VWLAI IIJIYJ Intaeteucc m, arrow,,,,c.no ..~.~i <br />5 LIMIT AF'F <br />EPA Form 3320-1 (Rev, 3!991 Previous editions may be used. <br />003: This i5 a ~-~arCfi~t-m. <br />~ - - <br />