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PERMITTEE NAMEIADDRESSOnoio reeayN..?L°r.ne„VD06rmv1 <br />NAME <br />ADDRESS <br />TSADV g <br />FACILITY I DE j i i T H r S'O(, [ NEE <br />LOCATION PAL I BADE i <br />NATIONAL POLLUTANT DISCMMOE ELIMINATION SYSTEM NPDESI <br />DISCHARGE MONITORING REPORT ID RI <br />PERMIT NUMBER INSCI4AAOE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved <br />OMB No 2040-0004 <br />NOTE: Read hietruetlsxse halm. r•nsnnl.tinn thle fortes <br />PARAMETER <br />1>< <br />QUANTITY OR LOADING <br /> <br /> <br />UALITY OR CONCENTRATION <br />T- <br /> <br /> <br />O, <br /> <br /> <br />REQUENCY <br />OF <br /> <br /> <br />AMPLE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALYSIS TYPE <br />SAMPLE <br />MEASUREMENT <br /> <br />PERMIT - <br />REQUIREMENT ;''' ' ' a X .I Mt II ; <br />SAMPLE <br />MEASUREMENT <br /> <br />PERMIT <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br /> <br />REQUIREMENT ' <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT r r. <br />SAMPLE <br />MEASUREMENT <br /> <br />PERMIT <br />REQUIREMENT ;.irdT! <br />SAMPLE <br />MEASUREMENT <br /> <br />PERMIT <br />REQUIREMENT GRTR AVG ORTR MAX <br />SAMPLE -- <br />MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAME/T1TLE PRINCIPAL EXECUTIVE OFFICER I nrttly " er pen' ty ° I.w that this document and 1R ¦tiachtnenN .ere <br />prepared anger my dlrec'lon or mpervh"n In accord.nre with a system designed TELEPHONE <br />to assure that qu.Rtled personnel <br />ro <br />ert <br />ather <br />d DATE <br /> p <br />p <br />y g <br />an <br />eealu.te the Information <br /> .1trtrtiM. Stead on my Inquiry *(the person ea persons who manage the system. _ <br /> <br />f or those persons directly resportdble for tathering the Infonnatlon, the information <br />submitted I; to the bnI of me knoaleel <br />and b <br />ll <br />( <br />i _ -- <br /> p <br />e <br />e <br />. <br />rtee, acr,,-te, and complete. <br />I .m ..)n that there an sl <br />Ntkam <br />tn <br />r <br />' <br />R PRIN g <br />pma <br />ea <br />oe wbmltting War Information. <br />I <br />d <br />i SIONATURE OF PRINCIPAL EXECUTIVE <br />TED <br />TYPED O n <br />ud <br />nt the podblilty of Rw and lmprff ment for knowing eidttloln OFFICER OR AUTHORIZED AGE <br /> NT CODE NUMBER <br />YEAR <br />MO <br />OAY <br />COMMENTS AND EXPLANATION OF ANY VIOL ATIONS (Reference &# attachments here) <br />I t s:- -v I r J. J 14LJ t C,- / r_ l La L.-= r UM C AM Mf- I I UIYS r MUM I U <br />FETTLEABLE SOL T DS LIMITATIONS - SEE I. A. ? <br />tnluEla COL I DS (TSS ), TOTAL IRON <br />.i PA Form ??20-t (Pe, 3:99) Previous edit;ons may be used <br />Ttiis-lsa'4-pan form. PAGE