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PERMITTEE NAME/ADDRESSpweYbFavOyNm.?L«alew(fD(06N) <br />NAME <br />ADDRESS <br />t oa 214 JU <br />?n?t CL <br />!:t. <br />FACILITY rl 1 I1 t; L N L. <br />LOCATX)N <br />?AL ZSAL- CG c. <br />Form Approved. <br />NATIONAL POLLUTANT OISCHAROE ELIMINATION SYSTEM NPDES) OMB No. 2040-0004 <br />DISCHARGE MONITORING REPORT W MR) <br />PERMIT NUMBER E SCHAROE NUMeEA <br />- AL <br />MONITORING PERIOD C L O F ALL i I V i fl <br />YEAR MO DAY-1 I YEAR MO DAY <br />FROM TO <br />/JATC- C-A I..?•.....•I....? 1./?._ __._? t_.t?? •s.l. 1... ?. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. NCY <br />FREO <br />U SAMPLE <br /> O <br />F <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALYSIS TYPE <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />REQUIREMENT <br />' <br />? - <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />} <br />/ <br />c / <br />!+ <br /> REQUIREMENT L r ?. ;. <br /> 1 ti <br /> <br />r SAMPLE <br /> MEASUREMENT <br /> PERMIT . ! <br />L : <br />/ n <br /> <br />' REQUIREMENT .. . <br /> r <br /> SAMPLE <br />ASURE <br />M <br /> E <br />MENT <br /> PERMIT <br /> REQUIREMENT <br /> y 4 n <br /> SAMPLE <br />MEASUR <br />M <br />NT <br /> E <br />E <br /> PERMIT <br /> REQUIREMENT = <br /> N <br /> <br />,e SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT FG M <br /> REQUIREMENT - - <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> I <br /> PERM <br />T r <br />tFL rGriI "i <br /> <br />REQUIREMENT . L Y C r. -- <br /> <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER ' """' " " p`""> ° ''"'n"'h' s d°"""e"' arse •° ¦ttachm mu "ere <br /> <br />prepared under me direrllon or supe <br />reNlon In arcordsieWf with a <br />s <br />stem d <br />i <br />d TELEPHONE DATE <br /> y <br />es <br />gne <br />t <br />h <br /> o assure t <br />at q.."ed personnel properly gather and evaluate IM Infnematon <br /> submitted. 6aaed on my I"ulry of the person or persons who manage the system, <br /> or those pe m directly responsible for gathering the Informatlon, the Information <br />submitted Is <br />t <br />th <br />be <br />t <br />f m <br />kn <br />l <br />d <br />• <br /> , <br />o <br />e <br />s <br />o <br />y <br />ow <br />e <br />ge and belief, true. accurate. and complete <br />1 am aware that there are sigNgcant penalties for <br />ubmitti <br />r <br />is <br />I <br />f <br />IGN <br />TU <br />P <br />- ? <br />' <br /> s <br />ng <br />a <br />e <br />n <br />ormation, S <br />A <br />RE OF <br />AINCWAL EXECUTIVE ?-- <br />TYPED OR PRINTED inswing lne possibility of fine and Impr4sonrnent for knowing Oolstlorsa OFFICER OR AUTHORIZED AGENT p A NUMBER YEAR MO DAY <br />?....?..? . ..... r • rrr..1 nc A MV vInt --- - . .. .. . _ . CODE <br />EPA Form 3320-1 (Rev 399) Previous editions may be used <br />This IS a 4-part form. PAGE OF