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NERMITTEE NAME/ADDRESS nwcAM Fw•IMry Nor/Lxwlaw t/D(~ww/) <br />NAME <br />ADDRESS <br />_ =?Iii~i_ ;iltiYlrifs~ ._ <br />~ti F'~ ~ ~ _, 816 <br />FACILITY ' ~`ti` '' <br />LOCATION ~:~ ` . ~ ~ a ~ b~ <br />~i~~ :~Na~~:~~ ~-~ •~~ GPs <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDE~I <br />DISCHARGE MONITORING REPORT ID R) <br />PERMIT NUMBER aseNAROE NuMeea <br />MONITORING PERIOD <br />YEAR MO DAY YE R DAY" <br />FROM TO <br />Form Approved <br />M I NGR oMa No 2oao•oooa <br />{ SUBF{ ~ ~ > <br />~' - F I DIAL C <br />sT~)r~CR i.C1AL c.on-voU~riwl~.~~o:~ GR <br />.. L/AV - - <br />NOTE: Rud Irntrucdoru b~for~ compbtirtp thb 1wm. <br />PARAMETER QUANTITY OR LOADING pUALITY OR CONCENTRATION NQ, <br /> <br />EX EµEOUENCY <br />of SAMPLE <br /> <br />TYPE <br /> ANUrsts <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE ~ ,.~ /'1 _ - `~ ~ <br /> MEASUREMENT - . <br />j ~' <br /> ,: <br />L_l.' PERMIT <br />REQUIREMENT -r , • .•n I: _ . ;•it~~ ; <br /> <br />., - <br />' SAMPLE ~ <br />- <br />c <br />~; <br />- <br />` <br />),E'. I ; <br />' P;<;<':` <br />. MEASUREMENT 7 ~ <br /> <br /> PERMIT <br />REQUIREMENT <br />:~`•' -- <br />~?~ - , ~r <br />Df~1 ' i_ r !': <br />i <br />'1i~P.t <br /> SAMPLE 7 <br />. 1 ~. L~- j ~. , <br /> MEASUREMENT , <br />. <br />- <br />~ •~ <br />~~ <br />- <br />-~ <br /> <br />( i? Q:_ - ~ PERMIT <br />~ " ' <br />3UU!~ ~=,'J~• <br />';P. T L '. ~"X <br />...:: ( . <br /> REQUIREMENT <br /> <br />Vr <br />I SAMPLE ~ // //~ <br />J.+i'•c[~ ^ <br />1.).L.'~~ <br />~ _~_ <br />~f <br />_ -. _. _; <br />.J MEASUREMENT . .~ <br />•,~ <br />' ~ -- '-• <br />~O 3 PERMIT ri <br />~ UFNT ~ REOUIREMENT <br />- - :3i)LiA ~,,•:~• <br />- , Y <br />DA__.~ ~1., ' <br /> SAMPLE ,v A <br />Ci- ! <br />~ -- <br />f ~ <br /> MEASUREMENT j <br />; ' <br />;.. <br />O <br />-' PERMIT <br />' ~UEPdT CROSS `/r, <br />-- <br />~` REQUIREMENT <br />- - ~ rl~ ~ r ~•:A • <br />-- -x. ~ - , <br />_ <br />A;'! <br />i-F7L <br />ATMI-~R? ~~ <br />- <br />, <br />= ~ I _ +r ! <br />_ <br />, <br />• <br />U <br />. MEASUREMENT <br />` ~ ; :r ~ , <br />. <br />~50 1 ~ <br />1 L ' <br />T GRC; ~''.: PERMIT _ <br />.'i.F, ~.;..;_,~ ar.rdTF <br />:_ REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <br />NAMEfT1TLE PRINCIPAL EXECUTTVE OFFICER 1 (<rln) r rr pan• 1~ o law IMI lAb doramaM and aN rtlachmrnU ware <br />prepared coder rnf dlrxlbn or trprrrfflon In •eeortlrnrr witE • fTitem dr~~ned <br />Ih <br />lMd ! ~ 1 <br />~ ~ %, % . <br />~ ~ ~ / ~f <br />TELEPHONE <br />DATE <br />_ <br />~- ~ / i ~ <br />L F In as~vn <br />N tuM <br />prrwnrM Pragrrt~ ~•IAer and rr.lw•It tAt Infarm.llon <br />tubMltrd. bawd en wry InqulrT a<drr ~rfon a prraont wAp n+anate IM rr7trm / <br />~1 / '~ <br />r <br />1~ <br />~~L ~ <br />'~ ;, ~ <br />? <br />, <br />~ , <br />a Ifforr ptr•etM dl ra[tlr re~pertd bk for ~NEtA~ the InformNlan, tAr Infornrllon ~ <br />~ <br />. <br />'~! <br />`l•y ~' ~/ .. / ~ <br />~ <br />~ <br />~~ <br />~ ~ i <br />~_ <br />' <br />' <br />.%! :~ . • . ~r t_- F/t~ <br />~ <br />-t' /V F ~- ii L - wern+nre Is. w the Eat of mT lro.kdEe end EeMrf, Trot, •rcuratr, and tompklr. <br />I .w. aw.ra uw IErra are sidnr,nt pen.itla for wEnrlnn <br />hba Inrorrmtl ttIONATVRE OF NItNCt-Al EXECUTIVE J <br />t ~ 1 <br />~ <br />~ / <br />~ : <br />i~ - / <br /> s <br />on, <br />TYPED ~ PRWTED Ins,ebtlEt~.demly.rnn..,,elmvn,.n~rnlrorrnow+n~.lot•uott~ OFFICER OR AllTt~toRIZED AoENT ~~E NVMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (R~Jrr~nce sl/elf~chminrah~rtl '4HR F'RFC iP EVEN'-' IS CLAiA1ED. IF GLF~Ii•1 APFRQVEG BY w~ L~• <br />_ FOR "': = EN _ <br />- -- ~-•- - ~ - - -'itr"i. ii~iv ~-~_ r?i1C~T tr7 ~~c ~ ~ •t ~.. -' <br />;jL.~IJ; ;w _i-1 ;1~ ~- - - - - ~. <br />.. ~ r... <br />EPA Form 3320.1 (Rev 3;99) Previous editions may t+e used L ~'• c - • ' ' ~~t}y~•'{S-a ~=EfOr~-fEifm PAGE OF <br />