Laserfiche WebLink
rERMITTEE NAMElADORESS pwrbl^fr/MeyM~/Lee.rre^ (/L>(~wwrl NATIONAL POLLUTANT DISCHMOE ELIMINATI7N SY9TEM IIVPQf•Sl <br />NAME ~ ,. DISCHARGE MONITORING REPORT /O R1 <br />ADDRESS -. ~,-r~ _ ~_:_:-. :~1,:, •:I'. _.:; .. . <br />~ n X S;3 := PERMIT NUMBER aSCNMOE NUMtlEn <br />FACILITY i~C~F?N Ct~h ~ El..i4 Crl~, MlIdE~ MONITORING PERIOD <br />LOCATION .~FS~T ~~! YEAR MO DA YE R MO DAY <br />'' ~ ` ~' `~ fROM TO <br />',MFS T. ~OOPERr EXEC V. <br />Form Approved <br />'FMB rvo 2^4C-OGC3 <br />c susR <br />F - F I I~. q <br />SUFtF~CL ;,~urv~r ~ ! ~~ },t:i:Uf*r:L' ~:;-r <br />NOTE: R~^d 1[Ntructla» b~fw~ eompbth+p thb 1wm. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX f71E0UENCY <br />of SAMPLE <br /> <br />TYPE <br /> ANKr~fs <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE - _. - s - . <br /> MEASUREMENT <br /> PERMIT ~:~#3t-r•x~ ~'-s~-~-,- J, I ~. ,.._._ <br />~!:_;" ; : ,. U`:;~ v! REQUIREMENT - - MAXIM'.: r MOP'.?'!-i <br />~.. ' . ~ . ~:. SAMPLE ,:. .. F. s. ,• „>;j, <br />- i. " "~ ~ MEASUREMENT <br />:. .' PERMIT ~ ,- ,. aoev.. -. - .~ r :~ ~ ....._. ...~ <br />. _;..~~.. ., ',.J~J ~L':-I!_l: REQUIREMENT ;iOI'.!'~ --. - ~_.,,.. .. <br />- l~iL7NT~~~ <br />_ ._, . .._ . SAMPLE 't ,: ~ <br /> MEASUREMENT <br />'-: PERMIT :~ ~ ~- -.. .. ~ ri - .__~- . >... .,- <br />'I_t~~t ,,. `.'r~.:.._ REQUIREMENT ':;~:?:'A r- - r~.Cl_Y <br /> SAMPLE ~ ..: .. ... ., <br />AS MEASUREMENT <br />S 1 ~ - PERMIT ,.. - .. - ., ~ ._ . . , <br />_L~~r~T GROSS t"`r-.!_~ ' REOUIREMENT :'t~G;; 1 :_ , ''1'•.~•'~'; ' <br />v ' ;7 SAMPLE 's .. , .. _. <br /> MEASUREMENT <br />- - <br />2.~ C'~ V PERMIT - <br />'.-!_tJ; _'SS `~'~1L_'..11` REQUIREMENT -- ~.r::~~~ ^1AX (~Et1rT <br />_. ; ~ . ., . SAMPLE .> > ,.. <br />.~~'ir :_.r '. ~.~ ;JT PLh,t~l MEASUREMENT <br />' ..? ~ PERMIT .. ~ - -, - ,~ „ . _ . <br />_„ _I,~ ''3S ~rif._' 1} REOUIREMEN7 ?(.1n14 r" `_ 1_Y t`i ` ' ~ ~fOi~j, <br />. . ~ - - SAMPLE ; <br />r , <br />Aj~ MEAS'_1REMENT <br />, '~ <br />,f' PERMIT ~ " ' ~ - .. <br />~ ... . . <br />„ <br />{ ': REQUIREMENT ' .r i.:.', "IUIV i i <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFlCER f """ t ° ` w""~ ° ''"'n.t tLI^ tlontrneat .nd ^u .n^rntrrenlf .ere <br />TELEPHONE <br />DATE <br />yrep.r.e under m~ eir.rn°n w ayenMlon In rKCOrd.nr<.un . fttfern eefl[ned , <br />-. ~ Cif t^ rn~ure tA^t qu^Mfled pen°nnN yroy.A7 ptber •nd ndu^te IM Infenrt^tlon ~ , <br />1 ~ _i~ • --_ <br />~ ~ <br />abmll/ed. Sold on m 1 I d 1M n°n a <br />f nq^ ~ fx ve..,o..no m.n.[e tb. ^r,at". t : ~, ~ ~;.' <br />~~~%~ ' ~ <br />' <br />' <br />~ <br />, j ~ , . i ~. <br />t ^.lbo^e penors alr.eo~ raypordbk ror [aAenn[ u. Inrornuuew. tM tnronn.u°n <br />' /_ ' <br />~ <br />t of m <br />kno~Md <br />~ <br />~ <br />~ ' <br />~ ` ! ~ <br />nd b <br />l <br />~ <br />b <br />l <br />lM b <br />l <br />l <br />r _ ~ <br />~: ;. <br />l ~~ r <br />: <br />~ <br />a <br />a <br />~ <br />[e • <br />i <br />~ <br />tni <br />ted b. a <br />e <br />hf, true. ^mrn <br />e, •nd comp <br />ete. <br />l- ~. <br />re y <br />Nllunt <br />en <br />•~ fIONATVRE Of PRINCNAI EXECIlTTVE <br />I <br />m <br />u <br />A <br />ftf <br />r <br />b <br />I <br />tb <br />l <br />b <br />r <br /> e <br />^.^rr <br />ere ^ <br />/ <br />^ <br />er wr <br />n <br />orm^ <br />n. <br />. <br />r.t t <br />a <br />m <br />tnn[ r. <br />^ <br />TYPED ~ PRM~TED InHudin[ tM yodDllltt of floe •nd ltrprF^pnrnent fa krro.ln[ .ld^tborn OFFFCER OR AUTHORIZED AOEPfT CODE NVMEIER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rtd~r~nc• d! •tt~chm~nta h~r~l <br />1.~:.ii.' ?ir ~ '.FACILE grll.'PS C_MT ~F'P1 jF'!'I F[1R '._?t~?.'~HR PR~~"IP Ft1~NT: <br />EPA Form 3320-t (Rev 3199) Previous edthons maybe used TllIS lS 7 3-pari' COtTn. PAGE Of I L <br />