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PERMITTEE NAME/ADDRESS pwsY4lwAhryNws/Lerur•w 1/D(Qbwr) <br />NAME <br />ADDRESS <br />'~%f~,1~R C O 1 <br />FACILITY '~OWY, . i" I NE <br />. <,1` i_i_y D saNn~RS, v!= oF' o~ <br />NATIONK pOILUTANT OISCMMOE EUMINATON Sr9TE1N ///1~PDES~ <br />DISCHARGE MONITORINO REPORT IDMRJ <br />PERMIT NUMBER aSCHMdE NtAASEN <br />MONITORING PERIOD <br />YEAR MO DAY YEA MO DA <br />FROM TO <br />Form Approved. <br />M Z NG)R oMe N°. zoao-oooa <br />~ ~~;-•F' 1r , <br />WASti DAY '; ~ WORl4 r;`/ r r= ;'r_~'~D <br />• .: - _ -- <br />NOTE: R~~d In~tructloM b~fw~ eompbttrty thh twm. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX FREOUENGY <br />of SAMPLE <br /> <br />TYPE <br /> ANKrsls <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE ~ - •~ ~C1 <br />I ;' i ~-- <br />~ Iii - <br /> MEASUREMENT <br /> PERMIT - - <br />.- REQUIREMENT - Pi i'•: r ~`'A'x IMt.;t'I <br />- ~' SAMPLE ` ~ - _ <br />~' ^I' MEASUREMENT ~ <br />-_i _J ~_, , <br /> PERMIT _ ~ _ <br /> REQUIREMENT '.l•:;Jr~ =, `.. ~i.=~ _ _ V `; :' .:r <br />• SAMPLE ' ~:~ <br />~ ~ `l~ ~' ~) <br />~ `~ _ _ <br />~ z _ <br />~ ~' ' <br /> MEASUREMENT ~~ <br /> - . - ~ ; <br />~ <br />. PERMIT -. , - , , ~ <br />_ <br />-i.•' !L'' ! I' G REOUIREMENT i~7i1P. ~'+':~Ci :`rat i i_'i ~I X "!1'?h) i 1 <br />' SAMPLE -,I ~ ~ ~ I ` ,~ ~ , <br />- <br />:'1)Tr c?! , . MEASUREMENT 1,. - _ ~ <br />~ . <br />- <br />_, ~ <br />. ,-. PERMIT - <br />~_ ,~ REQUIREMENT ~7;.:~, i'~i;... t '.Lirr i <br />_.. - ,-,, ,: SAMPLE <br /> <br />•~~ <br /> <br />~ _ <br />~ 1 .. <br />~ <br />` <br /> MEASUREMENT ~ 7 <br /> _ <br />,..' PERMIT ...s = _ _ <br />:: I ~ - I? ~. _. '. REtiU1REMENT " 2N:i~1' MAX .. . . <br />- <br />~, . : ~, _. c.- ~ _ . , <br />i' I <br />~ <br />; ' <br />i I IEC <br />I SAMPLE <br />M ~~/ `~ ~/~•+- ~ - is <br />_. <br />r - <br />+ <br />~ EASUREMENT / - :(% <br />' - <br />•t3'3 <br />1 PERMIT •-. <br />' ` ;_l)1_ ~ <br />•- 3 VAL'-,i <br />^' REQUIREMENT j`1 MAk !"c` <br />_ <br />_. ~ <br />.-i'IFZE.1 `': _. ." _ ~ Pt ~'. SAMPLE <br />MEASUREMENT ( <br />C • ~,~ll. `t_ <br />`l ~ "I .i <br />,~ <br />.~I, <br />- <br />r ~ <br />^ , <br />^. <br />t', <br />, PERMIT ~ - <br />,.. REQUIREMENT , , ~ - ~ ,. <br />NAMElI1TLE PRINCIPAL EXECUTIVE OfFlCER ' "^"J " " pr"•'J •" Uwi Uh dotvmenl ^nd .u atwchlnenb.ere ~ TELEPHONE <br />l <br />d <br />i <br />I DATE <br />on or fuprrryon <br />prep•rtd uw <br />rr mJ d <br />recl <br />n •rcordwnrt with . sntem da4[ned / <br />' <br />/ <br />to lbwrt thN ~uwMMd prtxnnd ptoprrtJ p/hrr •nd r•wWIr IM Inrornutbw %~ : <br />~'' 1 <br />` __ <br />/ <br />[ <br />s <br />F / J `'~ f~tL y twbmltled. 6wwd on mJ Inquiry a! t!n perww a per•olu who mwngr IM r <br />~. ~/ / ! ;f <br />strm <br />"~ <br />~ <br />, j <br />J <br />. <br />\ <br />" f - ., <br />tho <br />dtrecn <br />r., <br />ow.bw r <br />on <br />.IhrA <br />I <br />r <br />tt <br />th <br />( <br />r <br />th <br />- - <br />- <br />p <br />le pm <br />a <br />, <br />a [ <br />~ <br />w <br />or,n. <br />ow. <br />ermwllon <br />r <br />r <br />n <br />~, <br />1 r ~~ <br />I }~ ~ ~ - ~ ~ <br />lt <br />-' I <br />wbwdll <br />to the btlt of m <br />kwe.fed <br />d If <br />r <br />d MYrf <br />Ir <br />r <br />l <br />d <br />l <br />t <br />~ <br />Y j ~ <br />; <br />,, : yr <br />:. ~~ <br />~ <br />` <br />J <br />[ <br />r % <br />l <br />, <br />.1 <br />. <br />1N. wcrO <br />e. .n <br />Comp <br />f <br />e <br />e. <br />~t: I~~• d_ ~ <br />/'1 -.~ C~ -~;4---- <br />1 em e.•rt Met thrn wrt fl <br />nlfkwwt <br />endtln for <br />bmlttln <br />iIONATVRE Of -gINCIrAI EXECUTIVE <br />fwh <br />1 <br />l <br />tb V <br />TYPED ~ PRINTED [ <br />p <br />a <br />[ <br />r <br />n <br />ornr <br />w, <br />twrludlw[IMpo:iewtJornw..nermpmowm.mra.bn..tlt~.tw.uo,.. OFFICER OR AuT-~oR12EO AoENT CODE NUMftER YEAR MO DAY <br />COMMENTS AND EXPLANATION Or IINr VIVLA 1 IONS IR~/~rlnc• M •rliCnm~nlJ Ir~r~) <br />• - _ '~HR PRECIP EVFiVT IS (:LAIM~D. IF CLAIM P.F'PROVED 13'f WC,t^D, <br />- .. - :EMENTS - SEE Y. A. ?. ,.. ' ,r: :-,.-r., .~r - <br />cw~ , L h , { ,~i ~ T~IFt t NC R r'!3D ONL'f I ~' ;v r', ;;> ~.•, , ; ti,.: <br />EPA Form 3320-1 IRev. 3/99) Prevrous editions maybe used nr t~:~t / :~t13. ~51:4~pa~t`SOfiTI. PAGE Of <br />