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PERMITTEE NAME/ADDRESS l/nclude Fuilin %arne:L, anj it UilJrrrntr <br />NAME <br />ADDRESS <br />FACILITY <br />LOCATION <br />I:O 504 <br />Na T NEFR <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 />F" - FINAL Ri]i <br />t:F1RONIC WET T•ESTINO FOR 007A <br />NOTE: Read Instructions before' comPletin9 this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br />'{ <br /> MEASUREMENT <br /> PERMIT .. ?-.; ...._ ._ ,.?_ . z?. - <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 />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER . wader penau+ gnaw that ml+d.auna•m and all auachment+ <br />ere <br />P <br />i <br />d <br />i <br />d TELEPHONE DATE <br /> e. <br />.r <br />preparrd under m? dir"m or +upemsion in wetwt rote w <br />th a y+irm <br />r, <br />Rne <br /> t.. -we that qualirted per.annel properl% Ruttier and e+aluale the information <br />o <br />erwns who mana <br />ltem <br />h <br />itl <br />R <br />s <br />r i <br />ire rdth <br />e the <br />d <br />d <br />- <br /> g <br />i <br />. <br />+u <br />. <br />e <br />on m <br />nqu <br />e pervm <br />r p <br />m <br />e <br />a <br />or lho,r prrvms directlY re+gmsit4e for gathering the information, the ink,rmadon - - - / , <br />i - submitted i+. to the best or m+ know"go and Wirt. trur. accurate. and complete- <br />SIGNATURE <br />OF PRINCIPAL <br />EXECUTIVE J <br /> <br />TYPED OR PRINTED I aware that tMrcc• urr+ig n peaalt+uhmltlt fake i n aUnn, <br />incl rludinR for qn+ibilih .d firer r and d i mpri+omurrunrttent for knnwi ng +iulatitinro a+ OFFICER OR <br />AUTHORIZED AGENT AREA <br />D NUMBER <br />YEAR <br />MO <br />DAY <br />auawrrntxnta nw cl <br />GUMMENT5 ANU tXVLA14M Ilvrv Vr- mivT YtVLAttVt7.7 Inrrrrrncr all <br />STAT DIFF <PT RESULTS ON THIS OUTFALL. -IF NOT, <br />,WEST % AT WHICH STATISTICALLY SIGNIF DIFx- BTWN TE:I'!- <br />'? J ;. :}PT i C -. `li. .. JL, r F -:'T ('PT)>~ "P". 1 WC=94%. <br />EPA Form 3320.1 (Rev. 3W) Previous editions may be used. -" Thiti IS• a 4-Qatt form.