Laserfiche WebLink
1 PERMITTEE NAMEiADDRESS rLudadrFtwilln,1Yumt2 xadnn,fD*rrntl <br />NAME .,., ..... <br />ADDRESS ` ?rPF;LID MINI <br />'.1rV <br />-LY <br />FACILITY <br />-. h U <br />LOCATION .-I Y <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <br />NOTE: Read Instructions before comoletinq this form. <br />PARAMETER <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT r' is F i "! - ( r. ?iL• <br /> REQUIREMENT <br /> SAMPLE _ <br />r' MEASUREMENT <br /> PERMIT <br />r L - REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />r ,. <br />r L tJ ?_ f . ' REQUIREMENT <br />4 SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT _ y , .. >7[^Qa fit <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ` F:F'C?Rl REPORT : <br /> REQUIREMENT ' I_ Y I NI x <br />SAMPLE <br />MEASUREMENT <br />PERMIT > . -s r•,<,- <br />REQUIREMENT _: L: tom':.: T t <br />NAMErTITLE PRINCIPAL EXECUTIVE OFFICER I cendy under penalty of lain that this document and all attachnients wcrc TELEPHONE DATE <br />_ prepared under me direction or suprnlston in accord:mce with a syaem designed <br />? J? •. to assure that qualified penennel properh gather and esaluate the mtomanon <br /> suhmtned. Rased on m> Inywny of the person or pmionc who m:utage the.ystem, <br />' - - -- <br /> or those pcnons directly responsible for gathering the information. the inb <br />ortnati„n <br /> submitted is, to the bust of on' knowledge and belief, true, accurate, and complete <br />t th <br />1 <br />d <br />i <br />if <br />i <br />l <br />f <br />f <br />l <br />f SIGNATURE OF PRINCIPAL EXECUTIVE <br />'J ' <br /> am aware <br />ere are s <br />in <br />gn <br />icant pena <br />or submnfing <br />ormation, <br />ties <br />a <br />se <br />n OFF <br />C <br />O <br />I <br />TYPED O fl PRINTED Including the povihilm of fine and nnprsonment for knowing swlations' I <br />ER <br />R AUTHOR <br />ZED AGENT AREA <br />CODE NUMBER YEAR MO DAY <br />AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. ?ttjp3q. .. This is.a.4-part fOITn.