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PERMITTEE NAME/ADDRESS ([nciude Facility Name/Location if Different)
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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDES)
<br />~~~ DISCHARGE MONITORING REPORT (D R)
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />~ ~ ~~•4 MONITORING PERIOD
<br />YEAR MO DAY YEAR MO D Y
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<br />~~13
<br />Form Approved.
<br />OMB No. 2040-0004
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER t certify under penalty of law that this document and an attachments were
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<br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. P,t~? ~, ;i, ~ /t.3fXY~g~S'~a`t'4-paift ~"•~•Ip• PAGE
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