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PERMITTEE NAME/AODRESS (Include Facilin Nume/Locurion i(Diflereno <br />NAME <br />ADDRESS HAYDEN GU'i-CH L't.-! r:t_E <br />TFAMBOAT SPRING'z' <br />FACILITY <br />LOCATION A ,,r F MW <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM ? TO <br />f- <br />Form <br />Approved. <br />OMB No. 2040-0004 <br />yMTf 01rT <br />r FINAL <br />NATF- Rand Inatrurtinna hafnra ilnlafinn thia f- <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> <br />? OF <br />? <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS ANALYSIS TYPE <br /> SAMPLE <br /> MEASUREMENT <br />_ PERMIT #P### # =3i k; 3 #ii d. ii## ?r g. CJ iEE.KL`r INSITI <br />?- •ti -j\I r °aR S ` ALt REQUIREMENT :t c c ; T I hI S MUM <br />aX I 1j <br /> SAMPLE x # z r- ., ^s ,: 9: j 4r <br />:- ' 'SP E.NDE, MEASUREMENT <br /> PERMIT #??#### # a ± ?i i> # # # # 4#ji r # S 70 RAS <br />FFF LUEN-T 'ROSS VALUT REQUIREMENT -:rte -ClU! A A'JU :D 5Ii_' ri i r-if MONTH <br />'• _ ._ + i.. r. s Ii 1 t7 <br />SAMPLE <br /> MEASUREMENT <br /> PERMIT z ?i### #x=i iF?rsi ii## #i? ki£ki> REPORT 0. 5 'NCE/ DRAB <br />F.F LUENT 9POSS VALUE REQUIREMENT -"FDA AVG P;Ai!_Mx MONTH <br />`..R T T .-..!_ SAMPLE -"i` ?-i:-# ? a<.::_.z. ?c ,?s: ## •^ ( j 9 i <br />r Nq? F'E) MEASUREMENT <br /> PERMIT ##### #1z# ## t> it 3E 3t##### 3. 5 7,0 'yNCEi ;RAE <br />EFFLUENT GROSS VALi,, REQUIREMENT -3 iClA Atrr_ DAI'L_Y MONTH <br />e!`•t'. ,...:,. L . :__ SAMPLE If , -?i r' # #-i; <br />c PIN) MEASUREMENT <br /> PERMIT I`##Itti# #1£##iF3F ft## ####a# 3. 5 7. 7NtyE? <br />CE GRAB <br />LFf-LUEN'T t'-RCISS VALID REQUIREMENT t= z:r 30DA AVG DAILY MX r-!GM / <br />S <br />? t_. p'..!'.; _; .,l,:c x:. ?,.• SAMPLE + tt-# S?AF45- <br />t 1 . <br /> MEASUREMENT <br />El PERMIT 10 CONTIN GRAS <br />EFFLUENT GR0RS VALUE REQUIREMENT i7X GENli' <br />. tt:._Il.'•i: <br /> <br />f_7 <br />F -1 <br /> <br />SAMPLE <br /> <br />3) <br /> <br />irr#x <br /> <br /># x• <br /> <br />.?. # <br />T HR:i TREATMENT FL_At\I I MEASUREMENT <br /> PERMIT REPORT R PCIR'T #### c ri r t? li v si# EEI:LY IEsiSTAf' <br />I? F OSS ? + I,A1 <br />EFFL _N'i CSR L 3" REQUIREMENT r :, <br />?t%.)A AY'G <br />RAIL' rlk <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all attachments were <br />TELEPHONE <br />DATE <br />IJU111 no %" Wo <br />` I <br />l prepared under my direction or supervision in accordance with a system designed <br />to assure that qualified personnel properly gather and evaluate the information <br />submitted. Based on my inquiry of the person or persons who manage the system, <br />0\ 276-5209 or those persons directly responsible for gathering the information, the information <br /> <br />?7 // <br />(7 <br />-- <br />submitted is. to the best of my knowledge and belief, true, accurate, and complete. <br />th <br />th <br />i <br />if <br />l <br />i <br />f <br /> <br />SIG <br />TORE <br />OF PRINCIPAL <br />EXECUTIVE <br /> <br />Ob <br /> <br />Qq O <br /> <br />77 <br /> <br />TYPED OR PRINTED <br />t :.3m aware <br />at <br />ere are s <br />gn <br />icant pena <br />t <br />es <br />or submitting false information, <br />nchiding the possibility of fine and imprisonment for knowing violations. O FICER <br />OR <br />AUTHORIZED AGENT AREA <br />NUMBER <br />YEAR <br />MO <br />D Y <br />.a...uru?c . ., runt wwuirrnu nr wuv vtrat wranuc. in_.______ CODE <br />r ,?_IF 24-HR' PRE CIF E%-5ENT c CLAIMED. EXEMPTIONS F? <br />LTMITATTONC- - :SEE I. R_ ? M_' <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. PAGE <br />i. ;' F c";?hi: ;?S d ?-ptir't?f?+rm.