Laserfiche WebLink
PERMITTEE NAME/ADDRESSQno6*F.,o,N-a/ror,N,_t/D(p w) <br />NAME <br />ADDRESS <br />• tIUX 34,iu <br />SADt: CC <br />LOCATION C-LDL hUhTH C SCUTH :11 <br />YALiSAL'E CC <br />rl U I IF it r r. . r V r <br />Form Approved. <br />NATIONAL POLLUTANT DISCHARGE EUMINATION SYSTEM NPDES) OMB No. 2040-0004 <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER _ F I N A L P t SA <br />MONITORING PERIOD b 1C CC LC h A C C 1111E A <br />YEAR MO DAY YEAR MO DAY _ <br />Lb ` FROM TO ?I <br />NOTE: R..d kwtructlom b.fo..,ene 1stina this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREQUENCY SAMPLE <br /> <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALYSIS TYPE <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT , <br />, • t7 <br />n L : <br />- ` - - <br /> REQUIREMENT , <br /> r <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />1 V <br />/ <br /> REQUIREMENT ° <br /> <br /> SAMPLE <br />` <br /> MEASUREMENT <br />J 1 U PERMIT <br /> REQUIREMENT <br />'' L t. T h I.) _ <br />y U I }. <br /> SAMPLE <br />r, • <br />MEASUREMENT <br /> PERMIT sp <br />. ta t r <br />v <br />i. l / <br />F r: <br /> REQUIREMENT <br /> , <br /> SAMPLE <br /> MEASUREMENT <br /> <br />,. PERMIT <br />r. i, <br />Z I <br />r r <br />j " REQUIREMENT y - 1 r.AX <br />- <br />l _ SAMPLE ;; <br /> MEASUREMENT <br /> PERMIT -hLY iA <br /> REQUIREMENT y i X <br /> <br />r SAMPLE <br /> MEASUREMENT <br /> <br />PERMIT C a'1 h E PC n 7 <br />REQUIREMENT d V v: <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER t cen,ty under pen. ty o ta. that this document and OH.tlnchmentswere <br />R ared under m dtrertton or TELEPHONE <br />ervl <br />n In <br />t <br />D <br />DATE <br />> <br />o <br />s,ccord.nce with .system designed <br />P 7 P <br />_ to savure that qualified persemnet properly gather and evaluate the Information <br />- - wtbmltted. Bred on my Inquiry 0 (the person or Persons who manage the system <br />, <br />th <br />tl <br />di <br />b <br />or <br />ose persone <br />rec <br />y responsi <br />le for gathering the informs0cuL the Information <br />submitted Is. to the best o (my knowledge and begat, true, accurate. and complete- <br />I ...ware that there are dgnincant penalUa For submitting rain Information, SIGNATURE OF IP INCIPAL EXECUTIVE <br />TYPED OR PRINTED Including the possibility wane and Imprisonment for knowing violations. OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />?. e?mmu.e.a nnv ..nr v+...-....... _. ...-. .._?....?.. . w. w. w....w w.. ?..?w....w....a nw•.r <br />rC! 71 n! nC_? rp rFCCF <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. This is j 4-paFt foray. PAGE OF