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PERMITTFE NAME/ADDRESS(h.r,V4frWryN~/L«~rlon(/D(QG..v). <br />NAME - <br />AOORE33 <br />~1 ~~Att_ riiGhiWAt A;.: <br />.. ~ ~KER CC <br />FAalm `': C1WYL7 MSNE <br />Loa-TaN =KcR LC <br />'~ ' ...LL_Y' u. SP.NDGRS, '.'~ OF <br />NATIONAL POLLUTANT dSCNMOE ELIMINATION SYBTEM- fNPDES/ <br />DISCHARGE MONITORING REPORT (D RJ <br />PERMIT NUMBER dscNAnoE NuMeEn <br />>/ , r -. <br />MONITORING PERIOD <br />1 YEAR MO. D Y YEAR MO DA31' <br />`" FROM TO <br />7P'': <br />Form Approved. <br />M I fJO~`: OMB No. zo4o-o0oa <br />(SUDR .lam i <br />F - fiINAL. <br />GUL.CI-! A ~ELIT_ PUNLt/G047U `iPGS t.P <br />~~~ <br />NOTE: R~~d irntruetloe>» t»tor~ compl~IkW thb }am. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX FAEOUENCY <br />of SAMPLE <br /> <br />TYPE <br /> ANAtysls <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br />~. MEASUREMENT <br />- :1 PERMIT .. <br />' _ ~'. '~ i •~_' ` REQUIREMENT , <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REOUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REOUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT • <br /> REQUIREMENT <br />_ <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REOUIREMENT <br />NAME/TiTLE PRINCIPAL EXECUTIVE OFFICER t een~ y ^ r pros 1~ o b. th^1 Ihb dt+tvlnenl ^nd ^tl ^nfKAmrnl~ were ~ <br />TELEPHONE <br />prep^rrd unAer inr di recllon or fuperNS•on In ftcord^nR wllh ^ srrlrfn desf~ned ~ <br />~ <br />DATE <br />le nacre Ih^t qu^MMd prrwnnN proprA7 plMr ^nd e.fdu^Ir IM Infnnn^Ibn ~~ ~ .; / <br />~ <br />~ /// <br />j ~~ <' ~ ,~~ ~ j~~ ~` / tnbmlllel. lfwd on m7 Inquln or tM prnoll a plnoro who m^n^~e the ryetrm, - ~'~ 'i <br />' ~' '/ ~' <br />// %(~ <br />• <br />~ <br />~ <br />~ <br />~ <br />~ <br />- . _ or Thou perx~r Mrxll~ repomlAk (er ~^tMAn~ lM Inform^tlna, IM Infornl^Ibn ~ ~ _ <br />~ <br />'_ / <br />f -';~f _ /yJ(y. <br />' <br />~ ~ ~ <br />~ /~ ///yam! !+1(~J/ <br />, <br />f :" ': - / ~=-- wbrnllled b, b the bet or r^7 lnewYd~r ^nd Mtle(, Iroe, ^rc^r^Ie. ^nd complete. ~ <br />~J ~ <br />/~J <br />"~ <br />F <br />~ ~ V / I <br />~~ <br />(_ r• t : V <br />C. ~ ' <br />- 1 <br />f1 <br />Nfk>.nl <br />! <br />iIONATLME Of /AINCMAI EXECIlT1VE <br />th <br />t Ih <br />•r <br />dtl <br />lltl <br />f <br />b <br />i <br />tl <br />A <br />f <br /> E <br />fcm ^.^If <br />^ <br />m <br />e <br />pm <br />n <br />pt m <br />m <br />w~ <br />^ <br />e <br />n <br />ornr <br />en, <br />TYPED OR PRWTED Mrhedi^! IM p^^fdAllll~ o! Awe ^nd Impr1^^nment for tnowin~ HN^tloen OFFICER OA AIfTHORIZEO AOEMT COOS NVMBER YEAR MO OAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rd~r~nci d/ •K~chm~nl~ h~r~/ <br />~-i4 PRFCIP ~V)=I~T IS CLAZI'"~D <br />F1 F[va; - RF,~iFNl"5 <br />EPA Form 3320-1 (Rev. 3/99) Previous edidorss maybe used <br />IF CL_AIIM APPHO'~ED ~!Y WGCD: <br />'I'bis vs a 4~part'fdtrn. PAGE bF <br />