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PERMITTEE NAME/ADDRESS (UaU&FarosyNat•?L«arronI/DIQGra.r) <br />NAME <br />ADDRESS <br />• 6W i4JL <br />tp„ <br />FACILITY SAW' Cv i <br />'ID :'?JI'.1F! h ::vU'1'H i11hE <br />LOCATION <br />PIkL15AL c CC b.1 <br />;nN t f r..I• Ir <br />Form Approved <br />NATIONAL POLLUTANT 04SCHAAGE ELIMINATION SYSTEM //NPDES) OMB No 2040.0004 <br />DISCHARGE MONITORING REPORT IDMR) <br />PERMIT NUMBER b=scGE NUMBER y ) <br />t raa+? "` n <br />MONITORING PERIOD <br />YEAR MO DAY YEAR M O DAY <br />FROM TO -•--- - .. - i ?' <br /> .....?. ....a. r.r.n?a.aaa,ve. v.raa r. com pt.urry u^. rvrm. <br />PARAMETER <br />1>< QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREOOVI NCY SAMPLE <br /> <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS EX ANALYSIS TYPE <br /> SAMPLE <br />MEASUREMENT <br /> PERMIT <br /> <br /> REQUIREMENT <br /> SAMPLE <br />MEASUREMENT <br />1 <br /> <br /> PERMIT <br /> R "CE <br /> EQUIREMENT <br />A v* / T. <br />a <br /> SAMPLE <br /> MEASUREMENT l <br /> PERMIT <br /> REQUIREMENT .. r C!! <br /> <br /> <br /> SAMPLE <br /> MEASUREMENT l <br /> PERMIT <br /> REQUIREMENT „ . <br /> El' A'l <br />t <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> <br />REQU <br />RE <br />E v r <br /> I <br />M <br />NT i <br /> <br /> SAMPLE <br /> MEASUREMENT <br />, PERMIT <br />y REQUIREMENT r L 21 Z' e; x ... + i r i? <br />r . <br /> <br />i <br />?r SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br /> it ` c C i <br />: C <br /> REQUIREMENT , <br /> 7 f* <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I "'lay " `I p`"•'? ° I•""•' thy <br />Prepared under m <br />dlrecllon or su <br />er davmem and aA machmrnu .ere <br />vi <br />i <br />n I J T <br />L <br />P <br /> y <br />p <br />s <br />o <br />n accordance .Ith • system designed <br />to assure that quaMfied Personnel <br />ro <br />erl <br />ath <br />l E <br />E <br />HONE DATE <br />_ p <br />p <br />y L <br />tr ¦nd eva <br />uate the Informallon <br />submitted. Based on m <br />In <br />uir <br />of th <br />ar <br /> q <br />y <br />y <br />e P <br />son or persons who manage the system, <br /> or those perm dir"Ov resporotbk for gathering the Information. The lnrormatlon <br /> submitted Is, to the best of my knowledge and b <br />B <br />f <br />I <br /> e <br />e <br />. <br />me. accurate. and complete. <br />i •m aware that there are si <br />nificant <br />lt{ <br /> <br />D OR PRINTED <br />TYP g <br />pena <br />n for submitting false lnformatlon, <br />imludin <br />Th <br />l SIGNATURE OF PRINCWAL EXECUTIVE - <br />E g <br />e posa <br />blilty of fine and Imprisonment for knowing vlolatlor,& OFFICER OR AUTHORIZED AGENT A A NUMBER <br />YEAR <br />MO <br />Y <br />COMMENTS AND EXPLANATION OF ANY VIOL ATIONS fRa/arartra aN arrarhrv f. A-I CODE DA <br />_ i• •?•t-.• f"`?k l:L t, ijt~; 1 TA1 Z• 11•`? w4 n I,; Al rkI c.i F. <br />P ? LC1t'• 1.C <br />EPA Form 3320-1 (Rev 3199) Previous editions may be used <br />This is