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PERMITTEE NAME;ADDRESb <br />NAME <br />ADDRESS <br />FACILITY r< L _. L Jf+ i ! I'•lL <br />LOCATION 1 <br />NIA CO E31rpE <br />ANLEY MUHR, PRESIDENT <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Fotm Approved. <br />DISCHARGE MONITORING REPORT (DMR) OMB No. 2040-0004 <br />PERMIT NUMBER DISCHARGE NUMBER i NAB DELTA <br />MONITORING PERIOD -? CREEK <br />YEAR MO DAY YEAR MO DAY <br />FROM TO Xx <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREQUENCY <br />OF SAMPLE <br /> TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT + -,t at # #zit ii if St ?j• st .. ?j. W . <br /> REQUIREMENT M I N "'ii ?M MAXIMUM <br />+..' <br />i1 lPd i H <br /> SAMPLE ( _. <br /> MEASUREMENT <br /> PERMIT # '+it:'+ #####'o #tr^ ?u #tri2 PEPO`-T 0 c :r.J F <br />\"AL tJr REQUIREMENT :, C,ft : ; . Y' ^1 Pif?f,f 1 N <br /> SAMPLE t' <br /> MEASUREMENT <br /> PERMIT s x + #'f it # ; of > a: tr . _< # iii •ti ? # r - ' '•. O ! iv I <br />•. REQUIREMENT DA 11 l.- Y t i X GEN T <br /> SAMPLE <br />P _ Ar.i i MEASUREMENT <br /> PERMIT REPORT R1.:.P(3F,r ###3? 3 3( R•tt it # r# tt ## # z _ 1 <br /> REQUIREMENT 301)~1 A.VC RAIL.',' 1`1 X ' <br /> SAMPLE r <br /> MEASUREMENT <br /> PERMIT u' ##1! ?t## # REPOT?T <br />" it P4 3L 11: REQUIREMENT 30DA AV0 <br /> SAMPLE _:..t <br /> MEASUREMENT <br /> PERMIT REPORT _5=- i ###3r3 ### :; # # s a, . '5 <br /> REQUIREMENT ' f'JFi T MAX f l f"IONTH <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certtf} under pcnalt, tit law that this &,,:un,crn and all attachments were TELEPHONE DATE <br />rr prepared under m} direction or aupereiswn tit accordance with a system designed <br />d <br />l <br />i <br />d <br />l <br />h <br />l <br />h <br />i <br />"V I c J y? <br />J int qua <br />proper <br />nfor nattan <br />to as-,ure <br />if <br />ed Ixr.imn <br />} gat <br />er and c%a <br />uate t <br />e L <br />? <br />• 1(? submntd Ita,,ed •+n my mquirv of the perum or persons who ntanage the system, <br />y <br /> or tho,c person. dire d% responsible far gathering the infamtatian, the informnuon <br />- submtned is <br />to the bast ,d im A,w, led,c and hc'icf <br />true <br />acetate <br />and o,r late <br />l <br />? <br />o ?d <br /> . <br />. <br />. <br />, <br />n h ti <br />am aware th <br />t ,h ar GNATURE OF PRINCIPAL EXECUTIVE <br />9 U <br /> <br />TYPED OR PRINTED i.- <br />a <br />n <br />h OFFICER OR AUTHORIZED AGENT AEA <br />NUMBER <br />YEAR <br />MO <br />DAY <br /> Including t <br />e p .,, n t t r n CODE <br />COMMENTS ANLI EXPLANAI IUN UI- ANY VIUL.AI IUNb (Hererence all arracnmenrs nere) <br />-RECI,": EVENT SUBJECT TO BURDEN OF PROOF RErjU1RF',111- 1T9 TN <br />PAGE OF <br />EPA Form 3320-1 (Rev. 3,+99) Previous editions may be used. D0024," ,-' lb53 a 4-perform.