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Form Approved. ~ <br />PERMITTEE NAME/ADDRESS pweYJrirfMryN.wlJLoeutw (/D(Qinnr) <br />NAME QX~-,C)W MINIhI~`r t_t_C <br />ADDRESS Sr"t~~3Ct~:.hf Cftl~ $: Et_4~\ CRS. l~flh~ES <br />SEJCpp~~i{~}R~pS(L{`t' 7~''`` ~~,,(( ~^+[~~[ } t;© t~, ~.4~Q~t <br />FACILITY ~ftl \t 771~}r[IY ~.afii`\ YJ, L. I_C4 f..e d\r\ l~.f.14C, i! <br />LOCATION~~)'°t~(:'~y~-.~T CQ ~r.(.~-.'..~r~- <br />ATThi' ~tAMES T. Gt7QP~:F=s EXEG V. ~. <br />NATIONAL POLIVTANT DISCHMOE ELIMINATION SYSTEM ((NPDES/ OMB No. 2040-0004 e <br />DISCHARGE MONITORING REPORT /DMRI I„) I hl~f~ <br />taCiU©t~Of.:~~ G1~ A tBE;~~ ~fL,.:, <br />PERMIT NUMBER ascNAROENUMeER ~" -• r ~ stij,•,;_ ~1.3i~1I;, <br />MONITORING PERIOD SECxI~~yi~a~t ~'Si\lI ' `'~ SAFdI<Ci~:i+l i~'("i~:~'~S, <br />YEAR MO DAY YEAR MO DAY <br />FROM '~ tt TO ! <i,1 •aE -~..~F=,;. j''.#? !)I•`_•°iU~?~#iG~ (~ 1 •~~# <br />NOTE: R~~d 11»trucdtxa b~itx~ complratiny thb itxm. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX FREQUENCY <br />OF SAMPLE <br /> ANarsls TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />C)IL Ai\l~ ~F?EAvE SAMPLE ~t•##### t g~t~ #•a###:~ #•r~iF-'st•#?F kn•~•##.I• <br />4' I SUAt_ MEASUREMENT <br />E'4Ctbb I G C7 PERMIT' ~#~#~-# RE URT ES~I. ~###~•# #~r~#~-~ ##~~#~ F#~•# ~' A <br />EF'FLI.J~!4'~" ~~F~r.~BS VI~LI! ~~nUIR~MENY INST {hAx NQ=Ci '~ a••~# i~tONTF <br /> SAMPLE <br /> MEASUREMENT <br /> >;>;:>PERMI7 <br /> ~tEQU1REMENT <br />.. ... ..... <br /> SAMPLE <br /> MEASUREMENT <br /> .PERMIT '. • <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> ..PERMIT <br /> REQUIREMENT <br />::::....:................ <br /> SAMPLE <br /> MEASUREMENT <br /> .';.PERMIT ;' <br /> <REQUIREMENT <br />::::............ . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ' <br /> AEQUIREM~NY' :. <br /> SAMPLE <br /> MEASUREMENT <br /> f'ERMI? ; <br /> <br />REQUIREMENT a <br />PRINCIPAL EXECUTIVE OFFlCER <br />T ' "^"y ° er pens ty o lsw thu my eoavment ow w utnehmenb wen TELEPHON E DATE <br />NAME/TI <br />LE preprared ender my direction or superr6lon In ueeordr,nre wllh ^ system desi`ned <br />n , 1, _ <br />G Va`r `~ T' <br />"`" `~ to mun that qu~NOed perwnnel properly ether and erduNe the Informdlon <br />~~ <br />o eubmlttM. Oned on mr Ilpulry of We person or penoro who mramee the system, ~ <br />~ /~~ ""~ - <br /> or those penoro directly respomlbk for ptherln` the Informstlon, the Informsllon QZl 1~/~ f% ~ ~ <br />~ <br />'' ~ <br />~ O ~ fi .9 <br />' / <br />f P~. y • r f 5 I ~ h~"^ <br />X <br />C wbmlltad b, to the bnt of my knowkd~e end Eetlef, lrve, raccvntq and eomplele. <br />1 ram swan th~l then ire sl <br />nlllunl <br />endtln f <br />bmlltln <br />h6 <br />I <br />f <br />fl <br />EIONATl1RE Of PRINCIP L EXECUTIVE / /` J <br />FNS _ <br />, (JD <br />~ ~ <br />p <br />or su <br />~ <br />e <br />n <br />onnu <br />on, <br />TypED OR PRINTED Includintl the plmlblllty of ene and Imprlsonmenl for knowln` rldsUotn OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION vF AnY v1ot.AnvNS /Rtrf~r~nci st/ m~cnmtrnta n~nl <br />~'SS °.v. T"QTAI. IftQN LIMITS WILt_ DE WAIttE~i, At~IU SETTt_EA~t_E SUtrIDS trMT AF'Pi...IEI3 F`Cf~t ~~-=1C3YR, 24N#~ PFtEGI~' EVEhdT: <br />SET7LEAL'LF_. SQLIL)S LIh'iIT MAY IiE WAI`~EI7 F#~R ~>IC}`fR, 24NR E'~E:I'+#T-SEE I. A. 1, P~ 4-S, Ai`dG I. A. ~, P. 5 FQR I~:Gtt'lt~TS. <br />f tl1 f ` G. ..f ~. J •• •1 <br />EPA Form 3320.1 (Rev. 3199) Previous editions maybe used. t~02c'7~ ~ OTIS~a,4-p~al-I. RiYp, F <br />•tvr3 •...r Y. +3~:t'-rte <br />