Laserfiche WebLink
PERMITTEE NAMEIADDRESS(Ym"i«&ryN..WL ,wit l/D(fG t) <br />NAME <br />ADDRESS <br />• ?. uOX l4 jV <br />i >AUt (:L <br />FACILITY 511) L b y ii T h L: U V `: t: l I <br />LOCATION ? A L lb, h u c LC <br />.iUN V 7 111, F L .1 _ u _ <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDES) <br />DISCHARGE MONITORING REPORT (D R) <br />PERMIT NUMBER k-c."IE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved <br />OMB No 2040-0004 <br />rib AL <br />Nf1TF- R..A iti r...rrl r.... 1.. (.,.. ., ..... t-einn #kI. f...... <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. NCY <br />FREO <br />U SAMPLE <br /> D <br />F <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALYSIS TYPE <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT J <br /> REQUIREMENT . • <br /> I <br />p ; ?t :(: <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT y( n L Y h '? ` t, ; f <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT >c :• : ;t C 1< C h I h (: / <br /> REQUIREMENT ;; A L L Y ?X <br />' <br /> SAMPLE <br /> MEASUREMENT <br />_ PERMIT a . - y :..' UL `? C P is <br /> REQUIREMENT ti '11y <br /> SAMPLE <br /> MEASUREMENT <br />_ PERMIT i <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br />_ PERMIT 1 t 1 <br /> REQUIREMENT L y <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMI <br /> T j ;•, i i 'i' V n` <br /> REQUIREMENT <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER I r:nus • r Penalty o (low that thi <br />Prepared under my direction or sups s document and all attachmenti were <br />w_ In a-ordan- wllh ¦ s <br />stem d <br />i <br />n <br />d TELEPHONE DATE <br /> y <br />g <br />es <br />e <br /> to assure that q--fled Personnel property gather and esaluaie the Inrormatlon <br />subr ilted <br />In <br />uir <br />Dowd on m <br />of the <br />r <br />n - <br /> q <br />y <br />. <br />y <br />Pe <br />ro <br />Penom who manage the system, <br /> or those penors directly respomitbk for gathering the Information, the Information <br />itt <br />b <br />d ls <br />h <br />' 1 <br /> su <br />m <br />e <br />, to t <br />e beat or my knowledge and Wier, true, accurate, and compkt.. <br />I am aware that then are significant Penalties for svbmlltin <br />false Inf <br />ti SIGNATURE OF PRIN <br />I , ( I r' <br />TYPED OR PRINTED <br />vnr Aa,AT,nal nc Aaly \/Irll g <br />onna <br />oe, <br />Inc'eding the po.dblilly el fine ¦nd Imprisonment Ion knowing slolaol <br />ATlnarn C <br />PAL EXECUTIVE <br />OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />_ • :1 • 1 • ?? • i V .l fL 1 1 L li i{ ? F .. V 1 :' ? 1 :l ? .. ._ .. <br />Y t,c4!!A YF.iclk <br />EPA Form 3320-1 (Rev. 31") Previous editions may be used I IAiS IS a 4-parl form. PAGE