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PERMITTEE NAME/ADDRESS (Include Facility Name/Location ifD~erent) <br />NAME <br />y, f•FL <br />ADDRESS (_~~~,~`~: ~.~ i.;] f rih.~~i'!,it; '!'_I~;+_~ <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (IVPDE$) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />E~F "~~~~ ry ~~ FIrs~C r ``~ ~ ~ MONITORING PERIOD <br />FACILITY ~ i~ ~Yra ~ ,": t;,{,.r ,. .i ~-r,,FA= YEAR MO DAY YEAR MO DAY <br />LOCATIONf~Ir~;Tfi~t ~ I t'„ ~. ~ . - <br />-~ FRO .. ..I O -_ <br />M ~ T ~~ ~ r <br />.._. <br />r•x? li"--;. __ i .., fil ;- 1 -•1 ;.~ il':- F' .. •}~-ti c.y, Y-~.. <br />Form Approved. <br />OMB No. 2040-0004 <br />~fl r. ~(c:)la <br />... t1__f; ..1~".. <br />NOTE: Read Instructions hafnrP r_mm~latina this fnrm_ <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS <br />(.3~'.. :=s:.:1J ~~i~:.l:':~1;-.'_ SAMPLE .-.:?~'~.#=r. ; ~'<so •#%•-~.•ii''-E~F=3f- .:~u-•Y~33-?:•n zi..#r.i..t':•~•s <br />V I::a~JrhtL MEASUREMENT <br />`i3~ 1,~,' '. E~ PERMIT d~#;~i-?~t•# R~I~C:~h~"~ i~~r~=T ~#-##~## #•;~###•iE• ~}F#-i#•#3~# ~i.:.~ # di.;:.i~._ 1 .1;t.1=;;. <br />IWFi=I_','~~J'r r:'F(:1~5 ~,'~~i<.;..tE' REQUIREMENT II't!`:iT !"IAX i;fC_t-- .~_ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE 1 C <br /> MEASUREMENT ~J <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 /> PERMIT <br /> REQUIREMENT <br />N E/TIT PRINCIPAL EXECUTIVE OF I ER I certify under penalty of law that this document and all attachments were T ELEPHON E DA TE <br />,,/ ~ ~y ~ <br />~jp•tN ~ G/y e <br />' prepared under my direction or supervision in accordance with a system designed <br />to assure that qualified personnel properly gather and evaluate the information /~~ <br />f <br />`// <br />~ <br />~ <br />~ submitted. Based on my inquiry of the person or persons who manage the system, <br />or those persons directly,responsible for gathering the information, the information ~ <br />G/ <br />~~ <br />~~~ <br />submitted is, to the best 6f my knowledge and belief, true, accurate, and complete. <br />I <br />th <br />t th <br />i <br />if <br />l <br />i <br />f <br />b <br />i <br />i <br />f <br />l <br />i <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />' pp / <br />n~O ~ ~ <br />~ <br />/ <br /> <br />TYPED OR PRINTED am aware <br />a <br />ere aze s <br />gn <br />icant pena <br />t <br />es <br />or su <br />m <br />tt <br />ng <br />a <br />se <br />nformation, <br />including the possibility of fine and imprisonment for knowing violations. OFFICER OR AUTHORIZED AGENT AREA <br />NUMBER <br />YEAR <br />MO <br />DAY <br /> CODE <br />V v~ruY1G~~ ~a evw ~.i.r vu.r...v~. v. ru.. .wu~~ wow trie~e~enwe an ~{{ONIIIICIIW IICI C~ <br />.. <br />.. ..~ ~ Si`;,;~r );~t..4 ~ --.i?'~.. ~ ._ ;~~. _i.. i3~ {„)~1.4~~ _ ~~T~t>_~. ,_~ ~I:`•L_1C~~a L: il~f:a ,. 45Y.d..E.f? e"I~if. _- I.i'r.,; <br />''((mo~t ~'(~ '} (~.( h/ (~ 7( ~'1 1 .. ., <br />.C. ~V Tw~~~ I f t ~~-i: ~r~l~l4 M1.~t r~~ 71._~f li._,~. ~.~ .y L31... J. .J ..i .. i ~ L i._l i'..~f~J. A._a. ~ }a. .. _' -. .. ~ FTF ~._ F~~~C~{~ i ilt_.., i. 1~ L_.. ..t'~r _.. ~1t <br /> ..'.l .... ... a, ~I'T (.eLWyY1 .: )'i f~1 _i <br />T _- r t <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. {~ r-, ~i ~y => j;-: ~~i3;t9 ~ -4~aCt?f~iril. PAGE f; OF <br />