Laserfiche WebLink
PtCRM1TTEE NAME/ADDRESS 4nr ladr Fardip \amr.'h , nr .n : r l hl ti rent <br />NAME <br />ADDRESS <br />?4 l I t: II'. ?V <br />:SP EPUC; <br />FACILITY <br />LOCATION '- SP EP Urr <br />,AN REL;-1. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDES) <br />DISCHARGE MONITORING REPORT (D R) <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-o0i1•t <br />g <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 AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT r <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT r <br /> REQUIREMENT <br /> SAMPLE 1 <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT J <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER 1 r.mr. m.. (KUau. of tan Ihcn thi, d-umetn mtd aU auarhment...a•rr TELEPHONE DATE <br /> prepan•d undrr nn direction or .upa•rt i.ion in accurdunrr w tlh a -ta•nt dea¢nnl <br />- - - In a..nrr that ij i.fi d Penonno proprrf, rather :md e.: I-W 11rc infurmimon <br />t - <br />x• <br />. <br />. uhu m <br />Ih ...tem <br />I <br />l R <br />-, <br />f the <br />r <br />t <br />i <br />d <br />e <br />• • <br /> - <br />ou <br />• <br />ll.v <br />mp <br />o <br />jw <br />r l <br />r <br />.m <br />>; <br />- <br />m <br />A. <br />,-,, m. , <br />- _?_ <br /> ur lh.... 1 - din•a U. r.?p.mvLl. for vm 1. ring Ibr iuf..rnwlton th mfonuatiou <br />- <br /> wl <br />r and I <br />•Ikf <br />an <br />ncruratc uu1 omph9r <br />h <br />t <br />r <br />. kn <br />d <br />I <br />d <br />th - ? <br />r V <br /> . <br />. <br />c+ <br />n <br />u <br />y <br />u <br />x <br />r <br />, <br />.ubmiRa <br />t.. W <br />e <br />m SIGNATURE OF PRINCIPAL EXECUTIVE , <br /> I uni aearr th:d there a-witiftcanl penAfic, fnr.uhmitiinv f.d.a• mh.rmutlm. <br />k <br />i <br />4 OFFICER OR AUTHORIZED AGENT AREA NUMBER YEAR MO DAY <br />TYPED OR PRINTED mrx <br />ng; - <br />al om. <br />including; the I-ihdit, of fine and imprnonment for CODE <br />L,VMNILN15 ANU tAYLANAIIVN Vr- ANT VIVLAI IVIVJ (nctrtta+(,c an auaunrtcnw nct c/ <br />:-r IP <br />,tJP._If_Cl' TO 13URDEN OF PROOF REG <br />1 S I C-)N W I 1W I N 40 F!Ul1R _; <br />EPA Form 3320-1 (Rev 3199) Previous editions may be used. TFttc i? ii 4-r2itt tnrnl.