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PERMITTEE NAME/ADDRESS(1--"F«wryN...?Lec.ti wLfD(fi t) <br />NAME <br />ADDRESS ' <br />. DOX 14Jli <br />?AGt Li <br />FACILITY <br />LOCATION Pit Li S A L:, CL <br />Form Approved. <br />NATIONAL POLLUTANT DISCHAROE ELIMINATION SYSTEM //NPDESI OMB No. 2040-0004 <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER - y h L F". i <br />MONITORING PERIOD i r t : K <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />NATF• R.¦A {n.tnw-tlrus. I,.Iev.'nnn.nl.flnn this fnrm <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO FFICOUENCV SAMPLE <br /> OF <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX I <br />ANAL1'SlS - TYPE <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ,, <br /> REQUIREMENT <br /> 1/1 ii i1? :la1 <br /> <br />t SAMPLE _ <br /> MEASUREMENT <br /> PERMIT _ 7 J A / <br /> REQUIREMENT <br />t SAMPLE <br /> MEASUREMENT <br /> PERMIT 4CF/ :r.Ac <br /> REQUIREMENT i: `" C L 1'f <br />- SAMPLE <br />( ) MEASUREMENT <br /> PERMIT <br /> <br />t_ REQUIREMENT <br />...rt v? <br />..f,I I t N <br />1 <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />; c E C i i <br />?'i i p <br />/ F t <br /> REQUIREMENT <br />n , SAMPLE <br />1 MEASUREMENT <br /> PERMIT E T IW4a ,•.i=-o :. t1LY 'A3:F.' <br /> REQUIREMENT n I L Y t. X <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT _t <br /> REQUIREMENT <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER t ?^'re under o law that this ddoment and all mmU were <br />re <br />d <br />i TELEPHONE DAT <br /> <br />under my my direct <br />on or supre prre6lor on in In ac[order..e with ¦ system designed <br />pare <br />P E <br /> to assure that quallfled personnel property gather and evaluate the Infonnetion <br />submitted. Band on me In <br />of the <br />uir <br />erson or <br />wh <br />r <br /> q <br />y <br />p <br />pe <br />sons <br />o manage the system, <br />or those <br />ersons directl <br />- <br />ndble f <br />th <br />- <br /> p <br />y <br />po <br />or ga <br />ering the lnfoematlon, the Inrornutbn <br />b <br />f <br /> su <br />mitted Is, to the bet o <br />my knowledge and belef, true, sevrate. and complete. % <br /> I am awan that there are slgnlfkant penalties for submitting false Inforemtlon, SIGNATURE OF PRINCIPAL EXECUTIVE <br />TYPED OR PRINTED Including the possibility or fine and Imprisonment for knowing violations OFFICER OR AUTHORIZED AGENT CAREA ODE NUMBER YEAR MO DAY <br />V Vrerre.4rerJ r7r?V L/•r ??.?r•.•v.. ?. ..... ..??....v,•? ... w. w.wrr..w s.. w..w.r.nrrwrr.J rrwrwt <br />4;;h Pi.LCiP. EVEN'i CC LUHSll3.lf.CI IC EGhLES Cl rhCCF <br />EPA Form 3320-1 (Rev. 3,99) Previous editions may be used This 1S a 4-Pan fOn-n,