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PERMITTEE NAME/ADDRESSt7n&l&)r.0tyMn.?Loerla.(/D(dWvw) <br />NAME <br />ADDRESS `O <br />BOX i , V <br />ss? I r? ?jG?? g <br />FACILITY R NO. 3 ?v ?oo?• <br />LOCATION ;ERSET L1 20050 <br />N T'FI F Rr- <br />NATIONAL POLLUTANT OISCHARGE ELIMINATION sysTEM //NPDESI <br />DISCHARGE MONITORING REPORT tDMRI <br />PERMIT NUMBER D49CHAAGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Approved. <br />? t s ('--O 33 Form <br />OMB No o 2040- 2040-0004 <br />C <br />MINOR <br />( 8VI3r: '.. <br />F - FINAL GuNj <br />NE DRAINAGE TO N FK GUNN I SON <br />NOTE: Read Instructions before completlnp this form. <br />PARAMETER Pat QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREOU'NCY SAMPLE <br /> EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT D <br /> REQUIREMENT i ;A x I nun <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT :.r#f :" s i tr #3i i. <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT _ i iA rel.- DAILY <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT r#s;, i5#sr### ###s> r•t i. .:tF# 20 - 'o A <br /> REQUIREMENT TItiST "i;" - : iT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT 7 FWEPOR i #### # ###aFillF ??. L t <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />1 cerute under penalty o (law that thH docomenl and oil ¦Itaehments were <br />TELEPHONE <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />DATE <br />pmpared under my direction or supervision In accordance with ¦ syslerm designed <br />to asawrs that qualm" personnel property gather and eealvate the Informallom <br />' <br />submitted. Bard on my Inquiry of the person or perseom who manage the system, .. : <br />. <br />, <br />• <br />or (hoot penes directly msponsibie for gathering the InforanaUow, the Information ? <br />? :I <br />} <br />- submitted Is, to the best of my knowledge and belief. true, w umle. and complatr. <br />i am aware shot th <br />e ar <br />sl <br />nifkanl <br />ltl <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />en <br />f <br />b <br />iltin <br />f <br />e inf <br />tl <br />l <br />TYPED OR PRINTED g <br />er <br />e <br />p <br />a <br />es <br />or ou <br />m <br />g <br />a <br />s <br />orma <br />on, <br />Including the possibility or Rita and Imprisonment for knowing vtolallots . OFFICER OR AUTHORIZED AGENT CODS NUMIIER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS fRefersnce, a// attachments hers! <br />FA,7: Tr s-1T(-,HFc;7 1-'7NTt- v A'VFRA?-,E D11JR T c4C- P-Vr ti1!' RFP1_js-.TFr, <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. This is a 4-part form. PAGE OF