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PERMITTEE NAME/ADDRESS (include Facility,VamelLocadon if ix fereml <br />NAME <br />VET <br />CO <br /> R f- <br />ADDRESS <br /> O 20 <br /> J <br />FACILITY eclamabO"' <br />VIStUt101 gafetl <br />LOCATION ?I <br />Mini"9 a"d <br /> <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 />Form Approved. <br />OMB No. 2040-0004 <br />( SUi3R 11H) <br />F - FINAL <br />f?f I NE DRAINAGE TO GUNN I <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX FREOUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT :.;. ; <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I c" if omlrr penaltn or law that thi, d-mrm am] all atWchmrnis were <br />ed <br />nder m% dir <br />ction or su <br />rsisioo in a <br />with a system d <br />cordan: <br />si <br />n <br />d TELEPHONE DATE <br /> prepar <br />u <br />e <br />pr <br />c <br />r <br />e <br />g <br />e <br /> In us ure Mat gmdiried personnel proprrl> Rather and evaluate the information - <br /> suhmitled. Based on my inquiry or the pe"m or persons who manage the s7.tem. <br /> or those persons directly mponsible for gathering the information, the information <br /> submitted is. u, the exert of m? 6nowlcdge and belief. true, accurate. and complete. <br />w <br />e th <br />t there arc si <br />niric <br />n <br />lties fm uhmittin <br />information <br />I <br />m <br />fal SIGNATURE OF PRINCIPAL EXECUTIVE - <br /> <br />TYPED OR PRINTED y, <br />. <br />am a <br />ar <br />a <br />g <br />a <br />pe <br />a <br />x <br />inedudinu lhr I-ibilitY nr rive and imprisonment for linnwing sL>rations. OFFICER OR AUTHORIZED AGENT AREA <br />D NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />EPA Form 3320.1 (Rev. 3/89) Previous editions may be used. This is a 4-part fon-n.