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PERMITTEE NAME/ADDRESS tlnch dr Facility \'ame/location if iNJjerenri <br />NAME 7i LLC <br />ADDRESS <br />FACILITY ij? ZUI, t1I i'•i <br />LOCATION C13 E 1424 <br />.;4CE IJADEi Mlf•JF MAPIAC?FR <br />N?T.ONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDES) <br />DISCHARGE MONITORING REPORT (D R) <br />MI <br />PERMIT NUMBER DISCHARGE NUMBER : Nf <br />MONITORING PERIOD <br />FROM YEAR MO DAY TO YEAR MO DAY- <br />h1nTC• D....el <br />Form Approved. <br />OMB No 2040-0004 <br /> <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> OF <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALYSIS TYPE <br /> SAMPLE VO / 2 $ <br /> MEASUREMENT Z <br /> PERMIT = r : rr <br />^{ . REQUIREMENT <br />?i. <br /> SAMPLE <br /> MEASUREMENT -? <br /> PERMIT a` ??.. es <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT _- <br /> PERMIT .: , r u .. '7--r',.7 <br /> REQUIREMENT T t ?A <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 />NAMErMLE PRINCIPAL EXECUTIVE OFFICER I seriif-I under pcnutq of taw that flits document and all attachment%werr TELEPHONE DATE <br /> preparrd under its direction or suWnishm in accordance with as-lens de+ignttl <br /> to assure that qualified personnel properly gather and evaluate the information ?' - <br /> submitted. Based on my inituin of the perms or peruats who manage the system, <br /> or those penuns dlrrc1h responsible for gathering the informathat, the inrormation <br /> submktM is. to the best of my knowledge and hells(, true, accurate, and complete. <br />1 ,m aware that there <br />t <br />si <br />ifi <br />t <br />b <br />ltl <br />f <br />i <br />i <br />f <br />l SIGNATURE OF PRINCIPAL EXECUTIVE 7A, w - - T <br />TYPED OR PRINT D a <br />e <br />gn <br />can <br />pena <br />es <br />or su <br />m <br />tt <br />a <br />se information. <br />ng <br />including the possibility of fine and Imprisonment for knowing shAations. OFFICER OR AUTHORIZED AGENT AREA NUMBER <br />DE YEAR MO DAY <br />lsnUUWMTC AAIn CYDI AhtATinwl nr Anty s/cnt ATtnotc io..s.......,.....rr ....__?___._ s- <br />- <br />----------- -- ----- ----'----- .--------- --- _... <br />"I'S 9-- & FE t_IMITt.-3, 4)1L tJAV.-T---7? LIMIT APPLIED FOR 10YR/24HR PRECIP EVENT - SEE I. A. <br />EPA Form 3320-1 Rev 3199 Previous ed6ons may be used. ; r•.a r- • . PAGE OF <br />( 1 Y - ?I?Ilt3?f3 'T 4pdt't`TOMI.