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PERMITTEE NAME/ADDRESS p~lrFaWryNw/Loearon I/D{QGnnr) <br />NAME OXBC]4J MIP~IIl~G, LL.C <br />ADDRESS SAN33DRN CRK pf ELFC ~Rlfi MLl~tF;'8 <br />P. D. 3~C]X X35 <br />SDMERSE'[' CD 81~~4 <br />FACILITY SAi~~o~ra CRK p,, ELF CR#~i MIMES <br />LOCATIONGiCIi'•{ERSI_T C>r) 5143~i• <br />.1 T'i'A!• IA. hd X:C y" rnt-iw1G'c? X11=r'~ It ~s <br />NATIONAL POLLUTANT DISCHMIOE ELIMINATION SYSTEM //NPDESI <br />DISCHARGE MONITORING REPORT /OMRI <br />G DO()~)O ]. ~2 O 1 ~ 4J <br />PERMIT NUMBER DISCHARGE NtIMeER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM '-~ TO ~ J ,•- •J ~ <br />Form Approved. <br />OMB No.2040-0004' <br />M I I~iC1R r <br />t SU33R [~1H 3 <br />~' _ Fi[uHL_ OUP~IS j <br />FfrG UTE t~lET i EST I [~aG F"DR i°) ~. 5A <br />NOTE: R~~d imtructlora br,lor~ compbtir,y thb form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION Np, FREQUENCY <br />of SAMPLE <br /> EX TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS <br />LCSU STATRE 96HR AC SAMPLE ##'~•#•## 3F##### ####~•# #~•#### ( c3? <br />t Er <br />P IM1*PH~ MEASUREMENT <br />, <br />a <br />TA(~t6C ]. Q © 'PERMIT ~:f~•### ~#ar~~# ### lOD. OOOf ###'t## ##-a### B:R-- TRLY FLAB <br />E~"F°L..UEIaIT C:~Rt)SS U'ALU REQt11REMEN7 #### r'il~d VALUE OE[~IT <br /> SAMPLE <br /> MEASUREMENT <br /> rr:;:;:PERMl1' <br /> REQUIREMENT <br />, `' <br /> . <br />SAMPLE <br /> MEASUREMENT <br /> 'iPERN1IT <br /> /tEgUIREMEN7 <br /> SAMPLE <br /> MEASUREMENT <br /> T'ERMIT <br />' <br /> fiEGUIREMEN7 r K` =: <br />Y <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ' ;tea ~ ~ <br /> <br />~"'~ <br />~ r i. ~'_ ~"~ ~ <br /> <br />~ <br />4 s~ <br />~' <br />; `~ ~~ ` t. <br />'; <br />~ ~ y ~ <br />2' ~ <br />` "'r ~- <br />r-~'I <br />,'L ~. } <br />w~' <br />~ <br />Yi <br /> EtEQUIFtEMENT ~ <br />~,~ <br />- ~ . +~ <br />- <br />7 ~ ` r ~ :~ ,.~, - <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT :' _ . _ _., ~ ,,- <br /> REQUIItEM~N7 <br /> SAMPLE <br /> MEASUREMENT <br /> f+ERMt7 <br /> AEl1UIREMENT _ <br />AME/TITLE PRINCIPAL EXECUTIVE OFFICER ' moor u v pens ry o I~w thN ihN doeumenl t,nd HI Ntschmence were <br />t <br />ith <br />d <br />l <br />d <br />l <br />l <br />I <br />d TELEPHON E DATE <br />N `ne <br />ana w <br />a sys <br />em <br />es <br />r <br />on <br />n ~ecor <br />prepsrtd under m~ direction or mpere <br />J G 1'4-rS T. to wore that qusNikd personnel P~H7 6slher sod eeduste the Informsllon <br />Snead on my Inquiry of the person or penoru who msnsee the arstem, <br />submitted <br />/~ <br />, „ I <br />' . <br />or those persoru dlreHt~ resporolbk for ptherlrK the Infonrolion, the Infortrtstbn ,,,~ <br />(/°'~Y! ~Q ~ <br />~ ~ (j <br />r/~ O~ ~ O ^ _ <br />` w1 /t <br />I ~ r f c) I ~p ~"~ <br />~xP~ submltled b, to the best of m~ knowkd~e and EeHef, toe, secvnte, and complete. <br />INCIPAL EXECUTIVE D _ <br />7 J T CJ G <br />~ <br />YY 1 1 rrm aware tku there ~n si~ntfleant pendtle for aubmittln~ hbe Infonndlon, SIGNATURE OF PR A A <br />TYPED OR PRINTED Indudin` the posdblutr of Ilse trod Imprisonment for knowln~ eldstlo~ OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION vF Any vwl.n I TUNS I/runrtrnce sn errecnmenra nere~ <br />SEE T. A. 4. A, Pf' S-b ~'DR DETAILS DF TSST PR~3CEI?URE. REPORT LCSt) - 5TATIS"CICAL f~TIVT b1S""fIMATE WNTCt-i IS <br />LETHr~I_ TO ~{)~ DF' TEST DROAhaISMS: AiVU ATTA~CM ACUTE TDKYCI~["Y, TEST REPORT ~DRM TL L~MR. <br />lJ05~~' 6f ~}~[I6~~4~4'p~tgr-r-. PAGE ~OF <br />EPA Form 3320-1 (Rev. 3/99) Previous editions maybe used. <br />