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Form Approved. <br />PERMITTEE NAME/ADDRESSQnrMfr i.rWryNr/L.or.,,°.I/D~i.,m,J NATIONAL POLLUTANT DISCNMOE Ei1MINATION SYSTEIrt /NPDESI OM9 Na 2040-0004 <br />NAME .:. h I' l.:l n i, Z. G h J; h ~ Y • j i<i (. . <br />ADDRESS - SIp~ NG'tI n V JL•JTN t"ill:Jr.i <br />• Ei is X l 4 .; U <br />' ;iALc C~ t~15[ti <br />FACILITY ~IUF. ::UH"t :-I E. SO<JTtt ;1i'Ibr <br />LOCATION <br />I/I<a,ISALr. Cu r;l~lo <br />-.r~rr r _ wTnl Ff. v_ a_ <br />DISCHARGE MONITORINQ REPORT (D R) <br />PERMIT NUMBER ascNMaE NLIMeEn <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />!;I NG:t <br />(mil;: fi <br />F - }' i <br />!'Ot:u 1 <br />- ~k.. <br />NOTE: R~~d k»truetiofr» b~ttx~ ctinlpl~tlnp th{~ }wm. <br /> <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX fgEOUENCr <br />of SAMPLE ~ <br /> <br />TYPE <br /> ANAtrsls <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br />• MEASUREMENT t <br />_ <br />- PERMIT :: -- ti t r" fs n T Y . - .. - .. - <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REOUIREMENT <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 /> SAMPLE <br /> MEASUREMENT <br />PER MiT <br />REQUIREMENT <br />NAMERiTLE PRINCIPAL EXECUTIVE OfFlCER ' Ce""~ " ' pt""~ ° '" ma u,h document .nd .n .uscnrnenb were TELEPHONE DATE <br />pnrpsred under mt dlrecuon or wper.llow In .ttordsnrt wllb . fTslem deslLned <br />_ -- le tart tbst go.tltled personnel PtwPt~7 L.Iber snd etslustt the Inforerutlon <br />~ sobmltled. sate on m~ InqulrT of ure person or penom who rrunsLe IM c7sum, j~ <br />I a those pers°ro dl recth respordbk for pthert nL lbe Infornullon <br />Ibe Informsllon - ~ r ~ ~ '~~~- ~ f <br />I <br />, <br />.. wbMlltd b, to the beet of m7 knewled Le snd bttteL Irve, ocrursle, snd rompklt. i <br />_ ~ / <br />~,. ! <br />I sm swert tbel IAere ers s7 <br />NM1c.nt <br />msttl <br />bmlttl <br />iIONATURE Of MIINCIIAL EXECUTIVE <br />/ <br />he <br />I <br />fo <br />mstb <br /> L <br />p <br />e <br />or w <br />nL <br />x <br />n <br />r <br />n. <br />TYPED OR PRINTED InrtvdlnL the poralblllt~ of ens snd Imprisonment for ktrowlnL rtdsuorn OFFICER OR AUTHOR12E0 AGENT CODE NUMflER YEAR MO DAY <br />COMMENTS AND EXPLANATION Of ANY VIOLATIONS IR~f~itpnc~ ill •Itschmrnl~ h~r~/ <br />EPA Form 3320-7 (Rev. 3199) Previous editions may be used. ThIS IS d 4-pert fOrlll. PAGE OF <br />