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PERMITTEE NAMFJADDRESS flerludr Faritity:\'wnr/locoNnn if IfiJJernul NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM ((NPDES) <br />NAME ~ DISCHARGE MONITORING REPORT (DMR) <br />ADDRESS <br />y?i,,_:: ry r.r,• ~ ;~~ ::r uT~ PERMIT NUMBER DISCHARGE NUMBER <br />~' CG `:~- <br />FACILITY ~ ; l is ~ MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />LOCATION ,~I~EEK CC ~ - FROM TO <br />~4r)= L.Er~;,N, SR £N~' EIVG I hi•F <br />Form Approved. <br />OMB No. 204D-0004 <br />•' r 1fYPfL <br />SUF2FACE Rllt~Oi= F TO TROD i CRi <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ, FREQUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> ~ <br />~ ~ <br />~ ~ ~ { r~ {~c.IT•,l <br /> MEASUREMENT ' . <br />- PERMIT ;x. . • ,.. sr :: -: ¢ tiv :: <br />• a . <br /> REQUIREMENT f•' . I'i . -.- ~ M{JM riG~i <br />~ F' <br /> SAMPLE c; ,S (o ~. <br /> <br />~_. <br />~ ~:.,~- <br />/ ~~ ~ <br /> MEASUREMENT <br /> PERMIT ;t~r~~-::i ;: ~-x >r x ~ .,, <br /> REQUIREMENT ; ._; L; , : .1 V (y ' ~' F, V . , ~ .. <br /> SAMPLE ~ <br />- l ~. 1 (~i ~ J3~ 1` 'LR <br /> MEASUREMENT <br /> PERMIT -' *` ~„ -: .... <br />~ := <br />'~~•:; <br />u r: A L . ..., ~. <br /> REQUIREMENT . <br />. <br /> SAMPLE <br />I I ~ <br />~ ~ ~~~ <br />~~~~ <br />~ r,~ <br />L. ~~ <br /> MEASUREMENT <br />,. PERMIT -- . ~ r u ,, :~~ <br /> REQUIREMENT , ' 1_ ;~ ;~}r;nlT, f. <br /> SAMPLE c <br />- ~ } ` ~_ <br />~ i <br />~ 2 ~ ~ <br />`"~~ <br />~_- ~~ <br /> MEASUREMENT <br /> PERMIT ,. .. st r - ._ ~ . _ .. _ ... <br /> REQUIREMENT <br /> SAMPLE ~ ~~ I.Y ~ ~ <br /> MEASUREMENT <br /> PERMIT - s ~ .. 1 , ~ ,-. ~> <br /> REQUIREMENT ~ '~`' ; r'' -- <br />` I <br /> = ~~ <br />U 2 ' ~ ~) ~ f <br />I lT I /J-~~T~F` <br /> MEASUREMENT + <br />PERMIT _ .~ : ~ _. , ~ .: ,~ .. ;. - .._ ~-,: <br />REQUIREMENT ~ - , ~ <, : .- , . , <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I eerur+ ender penatu> ..r mw alm Ihk dllcumenl alld all mtachmant+ wrn• <br />A - - , TELEPHONE DATE <br />,._~ <br />preparrd IIIIde! 1111 dlrPa'll. rll Il( Nlper+'l+/1111 In Yee.Irll YllCr Nim a +\sleln da. igPed ~y~ I <br />r <br />•+ <br />1 <br />II <br />r <br />11L111 <br />--' <br />• <br />I <br />' <br />I <br />II <br />' <br />1 <br />a <br />M Ill <br />af1 <br />N1 = <br />P+..11f1f <br />pfllpl <br />f <br />ICI <br />:1(N <br />t1 <br />Ui <br />! <br />~' 1 ~ ~ • \ ~ ~ ' V ~ 111 K\+UrC IIIYI tI11LI1rYtvl (M <br />~ I;H <br />v ` 4J - ~ G•- ~ 7 wbmiu+d. R•.c+ed on m~ inquire of thr prl'snn lu In•nun+ who maws IAa• cptrm. -- - <br />_ ur thu+r penon+diracll~ rc+p.n+ihla' fret gathcrillg the infnrrtwtHm. lbe inlormoNnn ;%. j ~: •//~ <br />+uhmiltad is. In the br_+t <d my knowledge wld Ildicr. true, racuralr, and compfetr. ~ '-"~ ! • ~,~ ~ V I ~ <br />~, L <' <br />'~ ~' ''-1"~-~ ~ SIGNATURE OF PRINCIPAL EXECUTIVE //~~ <br />V ~~ O~ I <br />~ <br />_ <br />• <br />TYPED OR PRINTED 1 am aware That Illcro are ~iKnifiavnl q•nullia~ for wbmiuing rake infurmalioa <br />including Inc po++ibl8n orfirte and Impriwlnmem R.r knowing liolaliom. <br />OFFICER OR AUTHORIZED AGENT AREA <br />ODE NUMBER <br />YEAR <br />MD <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />G <br />c`PA F- ,Rey 3 e~, P -•v„,~y ~ ,. .. .. ('A~c <br />arm 3320''. - - - l~hr~ i~..I -; (~I,ut f~ll~: <br />