Laserfiche WebLink
PERMITTEENAME/ADDRESS,1,vdna Fulifi&Name[..vta,n,jOi#e n,f <br />NAME <br />COMPANY, LLC <br />ADDRESS M NE <br />22 WEST ! 1 %-; E - - ! FET <br />-RIN!DAD -_ <br />FACILITY ;: F W F:1 u M F PI s- <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER] <br />MONITnRINI: PFt71nn <br />Form Approved- <br />OMB No- 2040.0004 <br />LoCATIONirJ YEAR MO D AY YEAR MO DAY <br />]'`.' C c. FROM - ? / TO <br />J <br /> <br />PARAMETER NOTE: Read Instru ctions bef ore co mpleting th is form. <br />QUANTITY OR LOADING <br />QUALITY OR CON <br />CENTRATION <br />NO. <br />FREQUENCY <br />SAMPLE <br /> <br /> <br />;a i 1 T F? A( <br />i <br />AVERAGE MAXIMUM UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS <br />EX OF <br />ANALYSIS <br />TYPE <br />, SAMPLE <br />R IODAPHN'. MEASUREMENT <br />ri L f. ?...? <br />PERMIT ; <br /> . IOC <br />3 C i tt?rsf?t#-f <br /> <br />'ENT GF REQUIREMENT . it?t tF•tt It c ..+ _ <br /> 'IN VALUE <br />SAMPLE <br /> <br />MEASUREMENT <br />y; <br />PERMIT. <br /> 1 G0 <br />QOO 1 ?# # <br />i <br />t ?' <br />; REQUIR . i st it st <br /># # . <br />_ <br />EMENT <br />' <br />t <br />+ _ - <br />f L <br />r, <br />LIE I <br />SAMPLE <br />MEASUREMENT , <br />PERMIT < f <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br /> <br />REQUIREMENT I <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br /> <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br /> <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br /> <br />REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I aerttf% under penalty of law that this &kument and all attachments were <br />:pared under my direction or supcrosion to accordance with a system designed ^ <br />TELEPHONE <br />` DATE <br />I <br />i assure that qualified personnel properly gather and ev <br />h <br />i <br />th <br />d <br /> <br />_ a <br />c <br />w <br />e u <br />brmanon <br />uhmittcd. Based un my inyuin ul'the person or pemom who manage the s <br />i <br /> yp <br />ern. <br />or those persons direcd% responsible for gathenng the information. the information <br />suhmingd ts. W the best of f m <br />mtwl <br />d <br />d b <br />i <br />h <br />r <br />d <br />-??-?j')" <br /> <br /> <br />TYPED OR y <br />ec an <br />c <br />c <br />tef. tau. accurate, and complctc. <br />I <br />aware that there are <br />sivnificant e <br />ve an for submittin <br />tal <br />t: <br />i <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />PRINTED g <br />e <br />n <br />:nnatinn. <br />including the po,jhdit? .n tine <br />md int <br />n <br />o <br />f <br />k OFFIC <br />COMMENTS AND EXPLANATION OF ANY VIOL . <br />p <br />-, <br />nmcm <br />or <br />niming ciolanons. <br />ATIONS <br />Ref ER OR AUTHORIZED AGENT AREA <br />NUMBER Y EA <br /> ( <br />erence all attachments here) CODE R MO DAY <br />'ttucrDURE. REPORT LC50 - STATISTICAL POINT ESTIMATE WHICH IS <br />TAC:H ACUTE TOXICITY TEST REPORT FFIPM TrI nt,ncj <br />`l -. ,d r,D. oc Used.