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PERK E NAMEIADDRESS(?•e6&F OyHa.?L«atimyD, CENED <br /> <br />ADDRESS <br />SEP 2 ? 20Q8 <br />N I H W-Owne <br />t <br />FACILITY ,IR N.i . <br />LOCATION pivis?on a <br />e Sd* <br />; E,9 S, <br />NIEI_ <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM /INPOESI <br />DISCHARGE MONITORING REPORT IDMR1 <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />CACN?-C?3 <br />F - l' l j,4 -- L <br />LINCIFf TO N FK C:'UNNI <br />Form Approved <br />OMB No 2040-0004 <br />ilN i S <br />NOTE: Read Inetructlorw before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX FREQUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ,- . :.. ! <br /> REQUIREMENT ti's <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT flit CIF tr -r f•. <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT it ;s_L 1 ._ Y •. ; ;; - <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER I cerbly er pens ty o fl.- that Ihh cl tumenl and all ¦llachmenu wee: TELEPHONE DATE <br />prepared under my dlrt tlon w supervision In accordann with a System deigned <br />to mart that qualified personnel properly gather and rvaluele the Inronnatlon <br />s.bmltted. Based on my Inquiry of the person or persons who manage the system, <br />or those Persons directly repardb4 for gathering the Information, the information <br />submitted q, to the bet of my knowledge and better, true, accurale. and complete. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br /> I am swam that there am significant penaltw for oubmltnng War Infa nsdon, AREA <br />TYPED OR PRINTED Incwdlnt the possibility of nne and imprisonment rw knowing .lolauonm OFFICER OR AUTHORIZED AGENT ODE NUMBER <br />C YEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference, aN affachmonta here/ <br />- i l" 1-i T - L:! F 7 e re, l l e- c r) I T l i c 1 T *IT F c .i A' l! f 177 , .! C) %f , <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. TFUS IS a 4-Part form PAGE OF <br />--------------