Laserfiche WebLink
PERMITTEE NAME/ADDRESS 17mc&*s.ewdNar't«rson(/DW4mrr)_ <br />NAME ' <br />ADDRESS <br />FACILITY -: - A „>_ 11, .. -- r r r , r - <br />LOCATION PAl- ISA_',E CD <br />LSON L. -',',,DER, V. P. <br />NATIONAL POLLUTANT OISCHAAOE ELIMINATION SYSTEM //NPOESI <br />DISCHARGE MONITORING REPORT (DMRI <br />PERMIT NUMBER ?IC.AIGE NUMSM <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />M 11, OMB No. 2040.0004 <br />I ?l <br />ROADSIDE N1-' 34 TO CUB RIVE <br />NOTE: Read knetructkx» before completing thle form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br />EX FREQUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT ' <br /> <br />° <br />REQUIREMENT t'• _''; ; <br />AXIMUI'' <br />- SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT C'fr i. I`i <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER ' e`""y under p`""y ° " that this davment and .u attachrrmnts were <br />TELEPHONE <br />DATE <br />prepared under my direction or mpe-Won in aeeordanre with a system detlgned <br />I . <br />r Io enure that qualified personnel properly gather and eealuale the Inrormation <br />- ,' <br />.. submitted. Board on my Irputry, of the person fir persons mh° nusnste the system. ,'?,1t_•_ ?( i <br />or thoor person directly responibin for gathering the Information <br />the inrornutlon -- - <br />' <br />, <br />t of m <br />hn <br />ubmitted b <br />t <br />the be <br />.d <br />I <br />d <br />d b <br />li <br />f <br />y <br />` - s <br />, <br />o <br />s <br />e <br />ge an <br />o <br />e <br />e <br />. <br />me, otcvrste. and complete. <br />1 <br />m mare that there ar <br />si <br />nificant <br />SIGNATURE OF ?RINCWAL EXECUTIVE <br />f <br />bmitti <br />r <br />f <br />lti <br />t <br />TYPED OR PRINTED g <br />a <br />e <br />pena <br />ur su <br />ng <br />es <br />ain In <br />orma <br />ion, <br />Including the poadbtuty of fine and Imprisonment roe homing elol¦tiorm OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />CAREA ODE <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS 1Ra/arence ap arrachmenfs here! roraL SUSPENDED SOLIDS (TSS), TOTAL IRON AND/CIF <br />EPA Form 3320-1 (Rev 3/99) Previous editions may be used Q 0 09f .' _Thts'is t 4-part Term. PAGE OF