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PERMITTEE NAME/ADDRESS <br />(I.d.riadEtryNers?L?erfenUDldwaa) <br />NAME <br />r <br />ADDRESS <br />OUk 14 jU <br />iil?UC <br />FACILITY CL, I <br />LOCATION DSIbL ",0h'it, c, vCu'fh jaINJ <br />n rALI`i+t:c. cc <br />NATIONAL POLLUTANT OISCHMOE ELIMINATION SYSTEIN NPOESI <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 2040-0004 <br />F - t i:eAL <br />t . G NIL b IL- (:CAL Chfin <br />NOTE: Read Instructions before comoletinp this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREOUENCY SAMPLE <br /> OF <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALYSIS TYPE <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />' . V <br /> REQUIREMENT r <br /> <br />' SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br />7 <br /> <br />C <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br />l PERMIT , <br />r.: F 1. t <br />Z <br />t, C: <br /> REQUIREMENT . - <br /> LAllY r'). <br /> <br />' J L SAMPLE <br /> MEASUREMENT <br /> <br /> <br />- PERMIT <br />a <br />' z` ;: r. <br /> <br />U <br /> <br />i <br /> REQUIREMENT <br /> I: f ? y <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - <br />C ^+'i . " <br />r r <br /> REQUIREMENT <br /> <br /> SAMPLE t <br /> MEASUREMENT <br />- IttLbl?i?hl r.. <br /> <br />1 U PERMIT <br />+rif <br /> REQUIREMENT <br />` <br />I <br />1 } y SAMPLE <br /> MEASUREMENT <br />PERMIT Ir C r. CiF 7 <br />fit .z <br />REQUIREMENT <br />F v ., n A A <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER t nrtrly under penalty ° lye that u+h dxu mint and all! atlarhments wen <br /> <br />TELEPHONE <br />prepared ender my atr.suon or super.tslon in rcord.nn with . system designed <br /> <br />DATE <br /> to assure that qualified personnel property gather and evaluate The Inrnrmatton <br />submitted. Based on my inquiry of the peon or personsn who manage the s <br />strmr <br /> y <br />, <br />or Ihose <br />ersons directly m <br />ortObfr f <br />th <br />i <br />th <br />f <br /> p <br />p <br />or ga <br />er <br />ng <br />e In <br />ormation, the Info Ikon <br />r su bmltled h, To the bet of my knowledge and belief, true, amlrete, and complete. <br /> I am aware that then an ssgNneant penalties for sebmllting faire Information. 510NATURE OF PRINCWAL EXECUTIVE <br />TYPED OR PRINTED Inducting the possibility of Mm and Tmprisonmem for knowing vlotauoma OFFICER OR AUTHORIZED AGENT AREAJ NUMKR YEAR MO DAY <br />(.VMMCPa 1 J /?1`IV Gnr ?t,nn r rvrs v. ..... .... r.-...v..,, Inver wr wncw amr arnar?rrrnwnr? nwrq <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used This is a 4-Pall forth. PAGE OF