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PERMITTEE NAMEIADDRESS (Inelade PacillryNamelUcarion IfDrreno <br />NAME N c W ELK C m A-t-• _ Cam Pj9A/ .W..G <br />ADDRESS ' Z-Z Yd T FjgM, S . <br />?f'1N1D1?-D CD' le/08t- <br />FACILITY W BFL)t rn //VO' <br />LOCATION WSCM$,; CD S J G 8li ??/ <br />- - , D t? dLF•(, p eS rje ofy <br />Form Approved <br />NATIONAL POLWTANT DISCHARGE EUMiNATION SYSTEM (NPDES) OMB No. 2040-0004 <br />DISCHARGE MONITORING REPORT (DMR) MINOR <br />(SUER X714 ) <br />N MSER -- F I NAL LAP1Af <br />MONITORING PERIOD <br />YEA$1 MO DAY TO YEAR i DAY <br />FROM ### NO DISCHAIRQ£ f,( ### <br />NOTE: Road instructions before completing this forma <br />!( fvz ?I V <br />PARAMETER <br />QUANTITY OR WADING <br />QUALITY OR CONCENTRATION NO. <br /> <br />EX FREQUENCY <br /> <br />ANACLYSIS SAMPLE <br /> <br />TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />OIL AND GREASE SAMPLE ###### t 94) ###### ###### ###### <br />VISUAL MEASUREMENT <br />?I IRl <br />Y <br /> <br />' <br />' <br />SUA <br />I £? Q <br />84066 <br />PtH i'f.. <br />eRtniirt?r,"mdm+: <br />?x <br />f??xl;ld'?` <br />aamttt` , tW: .`. <br />r«31 <br />p if'ir f 1 <br />tl### <br />#3t#### <br />#fE?t <br />3h#tF <br />. <br /> <br />. <br /> <br />SAMPLE <br />MEASUREMENT <br />I-NAMF,MTLE PRINCIPAL EXECUTIVE <br />?resloPev?7? <br />TYPED OR PRINTED <br />>, Ts a OF <br />I o"fy under ponsity of law that this document and all adaohmmta ware <br />prepmd under my dkreotkon or supervbion in accordance with a symom designed <br />to enure that qualified personaal properly Bather and evaluate the IdanuStiaa <br />submitted. Sued oil Vmy Inquiry of the pmaon or PM M who maaa o dw syetom, <br />or those persons dungy relspoo dble ft gatherln the Information, die inibmadm <br />submined is, to the beat of my knowledge and bAef, true, aocurste, end complete. <br />I OM Were that ihero are S1 ffoant ties fbr submltting fbiso information, <br />including the possibility of line end mprlsonment fbr knowing violations. <br />e S e ranee aff atta nlent8 ere) <br /> <br />SIGNATUREOF PRINCIPAL E)MCUTP <br />OFFICER OR AUTHORIZED AGENT <br /> <br /> <br /> <br /> <br />'ELEPHON 6r <br />E <br />DATE <br />gyb'?9?.5 ?8 07 Z7 <br />NUMBER YEAR MO DAY <br />'rSSr IRON & MANGANESE LIMITS WILL BE WAIVED ,.Pit SETTLEABLE SOLIDS L.IMIT Al''I°L IZU rUrc ? =svrRr WtF"M r-nKv a EV1ENTl TSS, IRON 8e SETTLEABLE SOLIDS LIMITS. WAIVED FOR >10YRt 24HR <br /> PRECIP EVENT SUBJECT TO BURDEN OF PROOF <br />. MThft3as a 4 narL,ferm. PAGE -OF <br />7-77- -