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PERMITTEE NAMErADDRESS 4neludeFacilin NamoT arionifDifferenU <br />NAME <br />ADDRESS `?ALA G V T <br />FACILITY <br />LOCATION <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. 4 <br />OMB No. 2040-0004 <br />T1 <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY <br />OF SAMPLE <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM I AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT if # =? b. 5 i_: N. f? . • . <br /> REQUIREMENT , M J. N' `111,1- <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT k ;: . sF r t 4 x #;i ?t rF# t J j k' <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT I3ti> r F#ti3! t ,. =. <br /> REQUIREMENT 3C+I;, lH1:_ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT x'>? a ;RA0 <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT : +. va ;0NTTN -.'F . <br /> REQUIREMENT t=c.t`IT <br /> SAMPLE x„ # -si i. <br /> MEASUREMENT <br /> PERMIT EPOR r RI-;'Ou.. # rTr14-;t *4F**-y,i :ORITIN CUPD <br /> <br />REQUIREMENT t <br />-- <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - r x -- i# REPORT REP:'- <br /> REQUIREMENT 3f?DA R {; t::. ' <br />NAMEJITLE PRINCIPAL EXECUTIVE OFFICER I cenny under pcnalt of laa that this document and all at7uchrncnts were TELEPHONE DATE <br /> pr.-parcd under m} dnectiVn or .upervi:rnn in acconLmce with a system designee <br />Dennis Jones u, assure tlmt gw1ifi d pem nncl properly gather and csalwnc the mf,rrnation <br />t <br />t submitted Hawd on me inquiry of the Person or person, who manage the .yst.•rn. . <br /> <br />Hydro?o <br />9? <br />or those Perim brectly rspnn:ihlc for gathering the inf,mtation. the rnfimrnath,n _ <br />276-52N suhmm d n, to the he,t or m•. 4.ro., kd.*c and behct, true. accurate, an,l.omplcfe <br />;n n <br />w <br />th <br />t ii <br />: <br />nir w o a- <br />r : <br />I SIGNATURE OF PRINCI AL EXECUTIVE J <br /> <br />PED OR PRINTED : <br />are <br />i <br />I <br />am a <br />a <br />, <br />including the Ix,. t .. .u, • .. n, . ?, ., OFFICER OR AUTH IZED AGENT AREA <br />cone NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANAnUN OF ANY VIULAItUN5 (Hererence an anacnmenrs nere) <br />IP EVE.;.; SUEJECT TO BURDEN QF PPOC:- RE(3UIREMENTS IN <br />_ THE T :'11SIUN WI r11IN 49 HOUR' <br />EPA Form 3320-3 (Rev. 3199) Previous editions may be used. 002C.. This is a 4-pwl tDrnl.