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PER611TTEE NAMEJADDRESS (lnrludr Fariliq Namellaxarinn if f)ifJrrarll NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM ((NPDES) <br />NAME r DISCHARGE MONITORING REPORT (D R) <br />7A I Form Approved. <br />_,\?.. l =L? 1=?r`_'-?IJ? r-:• ^'f <br />ADDRESS I•JHI;, ..: 1:,ID PR0,1 : <br />?i?'= ; :C3AD 9t; PERMIT NUMBER DISCHARGE NUMBER <br />NUCL.r"1 i MONITORING PERIOD <br />FACILITY u1H I r?' 6: T. I', J FP.OJa YEAR MO DAY YEAR MO DAY <br />LOCATION, _rLWl'i r., -- FROM TO <br />OMB No. 2040-0004 <br />M1Nop <br />(5UBR DW ) <br />F - FINAL <br />POST TRMNT DISC.H TO <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ• <br /> <br />EX FREQUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE , •rt?t _ <br /> MEASUREMENT <br /> PERMIT #-:r?: ? {? :, it### ii sr #< 9E )f## ,y r? _ fol. ,-',- <br />-F I f- _ REQUIREMENT <br />I-' SAMPLE r rjr? <br /> MEASUREMENT 1 I <br /> PERMIT # st it#?t# # ' -F a _:, "0R <br />' 1% " G-, - A REQUIREMENT C} :(' l5." i ;i . ? : ?:• <br />'.7 SAMPLE <br />-7 F <br />MEASUREMENT <br /> PERMIT # U *It** <br />_- {.C_iJctti i' :=RnS`i VA;_ REQUIREMENT v ?.1 <br />- 1t- SAMPLE „ . <br />l I <br />l <br /> MEASUREMENT ; <br /> <br /> PERMIT 1##iftt IF•;; a# f r tF? ?;r?r- ; ?!? <br />JE(`i - VALUE REQUIREMENT A\;'•) x <br />;t)I T OR SAMPLE <br />t ?' t (j: la - 4' ';1 3t <br />` <br />T <br />N <br />- <br />' MEASUREMENT ?} f ! f <br />PLA <br />; <br />HRU TfZFA i <br />:Lr\ <br />,?; ;', ca r) C1 PERMIT 03 RtP!, 7 #-r}#tl.:q. ?,? .:. ;}-,r ?x.+ _ .- y •,t, •?_••r, <br />r l55 ti'F,' ! • REQUIREMENT : DDA AVG DA T UY NX IGD <br /> <br />i_ SAMPLE st### k t F r ra ,` = r <br /> MEASUREMENT ?} I f „ <br />r PERMIT ,..,;..?. #' IZ t r=z 3s f c 1## REPOR-' <br />I <br />-T. REQUIREMENT "0DA W,*; <br /> SAMPLE r##t*st' #..K 3t f tr _ <br /> MEASUREMENT <br /> PERMIT ###it#z" ##### it :x ###+:#r 100 ?:. 1,' i?Mr' r <br /> REQUIREMENT <br />NAME[TITLE PRINCIPAL EXECUTIVE OFFICER I eertib mtder ltcn.dlt of law that ihi.d+runtcnl and tdl athithmrnl` -tr <br />preparral under nit dinnlinu --r •npeni.on in actnrdamv aitlt a -fem det u"n d TELEPHONE DATE <br /> <br />? In ac.nre Ilan y .Airird Iw•rnni+I prnprrlt gallk r and etaluulr III, inf.rnwti.wt ,1 <br />, fl y. ' <br />' . f-t . J I t wbnni fed. Ii-axd stn mt inquu t "( thr lk-on or p.-- who manaeo the -i,m. <br />' ur fh.r p•nnm dnfv fit n•ywm+ihlr for enlhtmis: flit- informalvai. flit udnrtmtbon <br />, <br />- f <br />l ` .ultntllled i.. I•t tht• Imd or nn Annttkdee and In lief. Inn•, aentralr. ?nA tumplrtr. <br />1 not a.an• that lhrre urt• tigmria.mt <br />+rnalna far -bntitting ILIv <br />inba maliuu <br /> <br />SIGNATURE OF PRINCIPAL EXECUTIVE _ - - <br />ED OR PRINTED I <br />• <br />inrludim; the Ptn.Ibilit ttf finr and imp' nmem for Amat;u i tluli,n. <br />n `tt c t t OFFICER OR AUTHORIZED AGENT AREA <br />NUMBER YEAR MO DAY <br />TYP . CODE <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />Ott), tl?r. iriv ` rNa'. ;'y - I C. 9, E <br />3E SEE. I C.15 <br />EPA Form 3320.1 (Rev. 3 -1'+ Previous editions may be used 000 E3 / Tth 15 a l-pssrt Firm.