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PERMITTEE NAME/ADDRESS tinclude F"&y A'amdlveation if Different) <br />NAME _t <br />ADDRESS i <br />2E3 <br />FACILITY i jOR i T ; <br />LOCATION A <br />I Gi,14' LIAT) "AT?u= Ij4rJA:4'F! <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 />1 SUBN <br />FINAL -1R&MINF- DRNG To TUTTL CRAW <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREOUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT I '- JiA <br />V '-L <br /> REQUIREMENT ± i-. <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 />NAMErnTLE PRINCIPAL EXECUTIVE OFFICER I certify under penatq or law that this document and all attachments were TELEPHONE DATE <br /> prepared under m} dimctimt or wl-loon in accordance with u system designed <br /> to assure that qualified personnel property gather omd evaluate the inrormulitm T <br /> submitted. Bawd on my inquiry or the person or prrsons who manage the system. <br /> or those penony direelh responsible for gathering the information. the information <br />- knowledge and belief <br />true <br />uccurote <br />and complete <br />submitted is <br />to the hest of m / <br />i i <br />" . <br />, <br />g <br />. <br />. SIGNATURE OF PRINCIPAL EXECUTIVE - <br /> I am aware that there are signifwant penalties fur mbmitting ralx information. <br />I <br />THORIZED AGENT <br />R <br />R A AREA <br />TYPED OR PRINTED including the fu-ihility or fine amt imprisonment fur knowing eiolutiomi. OFF <br />CE <br />O <br />U DE NUMBER YEAR MO DAY <br />GOMMEN 15 AND EXPLANA I IUN Ul- ANY VIOLA I IUNZ) Irreverence an arracnmenrs nere) <br />LIMIT APPLIED FOR 10YR/24HR PRECIP EVENT - S£E I. A 2, <br />TIONS - I, C. 10r PG 20. 30 DAY AVG IS HIGHEST MGI IHLY <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. nis 1s a 4-lion form.