Laserfiche WebLink
PERMITTEE NAMEIADDRESS(?Ao"F@rWryNaaa?Lxaran(/D(fG q <br />NAME <br />ADDRESS <br />.. LI O X 14 j tJ <br />I5ADi- <br />FACILITY . 051 DE '+ U t1 T d c Li Li Q I I CS J <br />LOCATION A h V A L I S A u Z C <br />. I { f -l hl ! I- 1 I. w L. 1; . <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDESI <br />DISCHARGE MONITORING REPORT ID R/ <br />PERMIT NUMBER ascHAROE NlrrteER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No 2040-0004 <br />(?uin CsE) <br />t - FIJ<A.L <br />F:.IyG J8 IC CLLCrALC <br />NOTE: Road Irvetructlone before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FFIEOUENCY SAMPLE <br /> OF <br /> EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT 'j <br /> REQUIREMENT <br /> k r It ? <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />`Cil1: <br /> SAMPLE <br /> MEASUREMENT <br />i? PERMIT kLrh'1 ?? _/ rnL <br />J L REQUIREMENT A 1. L h? r <br /> SAMPLE <br /> <br />l' ? r MEASUREMENT <br />_ PERMIT .. _, . . J 7 t; ?I u <br /> REQUIREMENT <br />U r Y <br />`Ai i. Y 1 <br />Mc i• <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT n c t C r, . : 1 P• ' i, r, <br /> REQUIREMENT T <br /> <br />r SAMPLE <br /> MEASUREMENT <br /> PERMIT [tt?l.r i :i Evh ?LY 1 `? , r. <br /> REQUIREMENT j Q L ;'A A V. .i A L Y ,5 x <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT _ <br />REQUIREMENT <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER "'a" ""lly ° I" the' thb docu menl and all attachments were <br />TELEPHONE <br />H <br />i <br />DATE <br />prapartd under my direct <br />on or wPer <br />elon In accords, with ! System designed <br />to a25an [11111 qualified personnel properly [ltMr and ee Nutt! the Information <br />Submitted. Bred on my inquiry or the pe- or persons who manage the ."term <br />or those persoee dlreclly r Porelbk for gathering the Information, the Information <br />submitted k. to the best fir my knowledge @rd bteef. imo, accurate. and eornpkle. <br />I am were that there are significant Penalties for mbmllting fabe information <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />TYPED OR PRINTED . <br />IKlnding the possibility or fine and Imprlsomnent for knowing vlolallons. OFFICER OR AUTHORIZED AGENT ACODEA NUMBER YEAR MO DAY <br />COMMENTS AND t)krL.ANA i ivri yr nrr r vtvt_n 1 Ivrva frrar hence, off •rracnmenra narey <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used This is a 4-Part form.