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PERMITTEE NAME/ADDRESS (tm bh&FedhfyNomdLoeoNom 1/DlOlwamr) <br />fi.' b" k r1.aP t,a <br />NAME ? 0n,,1r."??., a ?7 > <br />118aaI?>5 f t*iF`Eaj2fhd fti .a z <br />ADDRESS' <br />FACILITY `.="iUNOL'< ?'•l3`8+)'3a:Q <br />LOCATIONLQN'& H, r? y 1'~,'-b- <br />NATIONAL POLLUTANT OISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />Y AR MO DA YE R M DAY, <br />FROM -1 1 :, . - TO <br />Form Approved. <br />OMB No. 2040-0004 <br />W..ti d !: `' `'... lftt.:i j !..' "1, TF?ta:."i <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br />EX FREQUENCY SAMPLE <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />: <br />? <br />WA 1. Y.o ± e ? SAMPLE ? ,,,.,....,; ,_ ., ,Y.?.. M •.- ... .:• <br />: <br />f <br />r-PHFtL.:Si ti's .sIIq C' <br />MEASUREMENT <br /> <br />412.3 S ? <br />..r n <br />PERMIT <br />?. <br />. ,. t{t _ <br /> <br />1 <br />.. , :,.. <br />s 8; f i4 1 "s L,? n i"'s}rJ REQUIREMENT i Ii??F,s'3' <br /> SAMPLE <br /> MEASUREMENT <br /> „ PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT r <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT - ' <br /> 'PERMIT '< <br /> REQl11REMENt <br /> SAMPLE <br /> MEASUREMENT ` <br /> PERMIT <br /> REQUIREMENC' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIR...MENT <br />NAME/TITLE PAIN IPAL EXECUTIVE OFFICER t ceritty a er penalty o law that this document and all attachments were <br />stem desi <br />ervon In acco <br />dance with a s <br />ned <br />di <br />ti <br />su <br />d <br />d TELEPHONE D ATE <br /> y <br />g <br />rec <br />on or <br />p <br />r <br />prepare <br />un <br />er my <br />to assure that quaBned personnel properly gather and evaluate the information <br />Based on my Inquiry of the person or persons who manage the system <br />submitted <br /> <br />cod a ?'^+ ?w , <br />. 2415 <br />7 ? <br /> <br />or those persons directly respomlbk for gathering the Information, the Information v <br /> to the best of my knowledge and beNef <br />true <br />accurate <br />and complete <br />submitted is <br /> , <br />, <br />, <br />. <br />' <br />S ONATURE OF PRINCIPAL EXECUTIVE <br /> 1 am await that (here are s1?nlBunt penalties for aubmlltln? hbe Informatlon, <br /> <br />TYPED OR PRINTED <br />Induelnt the posslblllty of Bne and Imprisonment for knowlnL vlolallotn <br />OFFlCER OR AUTHORQED AGENT <br />CODE NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLA Runs fifsrsrsnce sit srrecnmsnfrs nsnf <br />'/_ <br />, <br />t .-. m.. f 1 ,(:; ti^ 3 . °' •"• { 8=.,.,.I c- t o E::,T t °_:.P { 1 'fitT 6pl L't H .. + ??'$'r '8!'-"N):7 D I ?" e <br />g?+???ry y? 32- <br />I rtl tom' 1 ° }Q '') ?,+ ? I,C I . Ii°a( }u)a., 5t 4• ^? I'G s 4?'i'. 6 ? ?; per. 5 I- <br />EPA E{ y y 4 /` <br />Form 3320-1 (Rev. 3/99) Previous editions may be used. = t l,_'i F-1?S-I$??4=15? t?fbfttl. PAGE OF <br /> <br />