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''ERMITTEE NAME/ADDRESS pwavr F.evhry N~./Lnr.r,e. (/D(D.r.w,)
<br />NAME
<br />ADDRESS
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<br />FACIItTY ~-~~~~~1 M 1 NF
<br />LOCATION 1'~.Ef' e, 0 ~ ~'4
<br />~Ll' b. SAND~.F~S, ~~P Of' OPS
<br />NATIONAL POIIUTANT DISCHA110E EIIMINATiON SYSTEM //NPDES)
<br />DISCHARGE MONITORING REPORT IDMRI
<br />PERMIT NUMBER aSCHMOE NUMDEft
<br />MONITORING PERIOD
<br />YE R DAY YEJ1R. MO DA
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<br />NAMERiTLE PRINCIPAL EXECUTIVE OFFICER 1 Krlrlf Y . pen.Ir ^ Lw Iha u,h dorurnem .nd ^11 .n.rn~u were ~
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<br />TYPED OR PRINTED IncludlM IM pod~lut~ of nne ^nd Imprtaonmrnl for knowing .Id^uotn OFFICER OA AUTHORIZED AGENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Refer~n,4ed/eftechmMfsheiel --,4'!~R PRECIP ]=N~NT IS E;L.AIM~D. IF GLAiI"I A~'F'RGVED ;?~1"' ri!YrL~,
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<br />EPA Form 3320-1 (Rev 3199) Prevwus editlons maybe used l ' ~.'r ~ 1 ,:, i ..~y~:~~~='Ip~n PAGE Df
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