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PERMITTEE NAMV DDRESS17!.**F..ho,Nw?Loe-l-tfD(f-1) <br />NAME <br />ADDRESS <br />?'^?wig <br />FACILITY P'UN ` K' C; A FW i:. N I°i I "" .1' <br />LOCATION L_4?1?3 t <br />'!.`I'N: O?D.'.. 71. fnF,L. <br />Form Approved. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM /%PDESI I OMB No. 2040-0004 <br />DISCHARGE MONITORING REPORT IDMRI M?.NOR <br />_ PERMIT NUMBER DISCHARGE NUMBER g /, _ 6 70 MONITORING PERIOD _ <br />YEAR O? D. Y Y DA ^. <br />FROM TO <br />NOR NOTE: Reed instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br />EX FREQUENCY <br />OF SAMPLE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />? ANALYSIS TYPE <br />°? ? SAMPLE ?. rr?;•:. .? ..., ._ M--xr ,. .:? . ...... <br /> MEASUREMENT <br /> <br />i30tr6?0 R O ?i <br />: 'I . wad C t ?a?tL.i.T . PERMIT <br />aEQU1REMENT ?? - v <br />N N I MIUM <br />{*` u <br />;a wl 03 I f SAMPLE ,::. n ..:.. <br />sus3 r"L=t?f? "c :X) MEASUREMENT <br /> <br /> <br />E?, c V L U IN " 0 '1 S5 fit PERMIT <br />REQUIREMENT <br />z I ? t <br />J'01),, AW3 <br />D'A A . _ <br />? <br />a <br />MON17?1 <br /> SAMPLE r ..,: _ .. ,... _. .: a: . ..._ _ ... ._ ,. _ .. . .. <br /> MEASUREMENT <br /> " <br />0C,b6=i5 '. `: <br />G 'LUr-ENT GROSS '+I!?I. UX" <br />Z' PERMIT <br />REQUIREMENT <br /> <br />f <br /> <br />VAIL-Y N 'K <br />wwA4?, "?=,._ SAMPLE <br />A4 i MEASUREMENT <br /> "RAB <br />01045 <br />}?.i' FL; E-INT C:;PG-SS a._'. E' <br />_. . PERMIT <br />REOUIREMEN'f:. <br />a .: <br />C. _)'AVG <br />Da I LY M X <br />.f' . <br />l???1hd"'°.? <br />s. +r SAMPLE w ... ; <br /> MEASUREMENT <br /> ' r:a: ?I -+ <br />CI C ?PERMIT rte <br />V `!.. x aEQUIREMENT <br />GENT <br />rv s a,.w s.? a i SAMPLE <br />•?'?'' 1.! "I-E??s?r o'jyta ;z)"I" $?-_?',n MEASUREMENT <br /> ` . ; to rr s r .?. <br /> PERMIT ,; <br />: t ? ! . ?;?r y.- Mai aEnuIREMENT' J-00 - AVG DAILY MX il(77T) :..r ?. ? <br /> SAMPLE , <br />1) T 61301-V EY MEASUREMENT <br /> <br /> PERMIT <br />AEQUIREMENT <br />;3C3Itf k.tr L7 <br />?}.. Z ..Y 1? <br />?' =i ?a <br />: , #.;.. <br /> <br />NAMEnME PRINCIPAL E)FECUTIVE OFFICER 1 mrhly under penalty 0 law that this document and all attachments were <br />prepared under my direction or supervision In accordance with a system designed <br />TELEPHON <br />E <br />DATE <br />www.???+ _ 'f? <br />e IIs r L <br />6 <br />r to assure that qualified personnel property gather and evaluate the Information <br />submitted. Based on my Inquiry of the person or persons who manage the system, <br />or those persons directly responsible for gathering the Information, the Information <br />--- <br />e?m°an?+ <br />2? e? <br />d n7- c <br />®e a <br />A <br />submitted Is, to the best of my knowledge and belief, true, accurate, and complete, ?? e? <br />all <br />4?? 1 am aware that there are slgnifiant penalties for submittin <br />false Information tit NATURE OF PRINCIPAL EXECUTIVE <br />TYpED OR PRINTED g <br />, <br />Including the pmWblllty of fine and Imprisonment for knowing vlolatiorm OFFICER OR AUTHORIZED AGENT CARE <br />ODE <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference e// attachments here/ <br />7S :':: TOTAL. ?F`r?E?? a??I_L BE 4aic+IEJiEz3i A'?'"?r z l"?'? F,'?1?1,?= .3C+_I? .. L,-1- <=1O`ti?j PREC10 F`V:-?Wi <br />E-"_";'r'_,?zAB LIE' SZA-TDFJ .J4`!' AA-y! OE WA?:V'+'Dr?yj'C.k ">1.°y 'R-1I?R .' yC?:t,? ?:?= w. A. 2y pi1._..4C?PP }?.r.ta.QR'€']1'. Y MV_ ?a7i0s?16,Q' G ... EE <br />h C p.O, 4- C 74 DA/ 7 AW; X'S .S i-? .R7HES Aq^ 1- Nr1°LY PVC ??, l C L'A j?l NG PA..! = 1 0D. mo 1 DS--181'-:t[y-?-•RPp 2 F /+UMUL?.I T { r wd-d AL r <br />C.S/,,: . I. C. <br />ACC <br />?i?4= "fp)Yp. PAGE AF <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. Y h&