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PERMITTEE NAME/ADDRESS(/wci~f. i,eUrry Xw,'(.oc,rto.. r/D~i.rnr/
<br />NAME '
<br />ADDRESS
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<br />fApLITY ~1vi-rR CAN'T•:f~{ h~IrJE
<br />LocATiorl ':'iA I.0
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<br />NATION Al POLLUTANT OiSCNAROE ELIMINATION S"/STEM //NPDESI
<br />DISCHARGE MONITORINQ REPORT /OMRI
<br />PERMIT NUMBER asc,+AnaE NUMeEx
<br />MONITORING PERIOD
<br />Y AR MO DA YEA MO D Y
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<br />Form Approved
<br />OpAB No 2040-0004
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<br />~;:F-IRONIC WET TESTiiUC; E
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<br />NOTE: R~~d k»trucdar» D~for~ compl~tFnp this form.
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS 1R~10/MC• all ~tt~chm~nta h~nl ;-AIL Tr rte' t E'Tr-SAL I TY DFk I4'~ T I fJNS AS " % EFFECT" , '
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<br />EPA Form 3320-1 lRev 3/991 Prevrovs ed+c~ons r•,a~ be used. This is a 4-Dart form. PAGE OF
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