Laserfiche WebLink
PERMITTEE NAME/ADDRESS(7mAfrArWrylr--?L«ati w /Dtf--$) <br />NAME <br />ADDRESS <br />FACILITY <br />LOCATION <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM WPOES/ <br />DISCHARGE MONITORING REPORT /DMRI <br />PERMIT NUMBER DISCHAA01 NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No 2040-0004 <br />y! r3/C FhN r? 7 L ..7? >'? r? <br />+l/?/L 5 T T1 <br />NOTE: Read Irmtructione before compist" this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br /> <br />EX FREOUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> AMAtvsls <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <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 /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAMEfnnE PRINCIPAL EXECUTIVE OFFICER I nrt"y ¦ Pen' y o I.w that this document and all attachment, wen TELEPHONE DATE <br />pnp-d ruder my dlr'cllon or mperHfon In accordance wllh ¦ system dultned <br />to assure Ih.t q-111I d personnel properly (.thee and ...Ium. the tnrormatlon <br />.nbmltled. Beard on my Inquiry of the pawn or persons who manse the syttem. <br />or tho.r penorat dlr tty mpordbk for ptherlnt the Inforrnatloo, the Inform.llon <br />submitted b, to the best of my knowiedle and bebef, true, amtntr..nd complete <br />{IONATURE OF PRINCIPAL EXECUTIVE <br />- <br /> i .m aware th.t then .n sitnlnunl penallly for srrbrnlttint hew Inforwwtlon. 4 A <br />TYPED OR PRINTED InAudlnt the poodblllly of fine rod Imprbortmenl for knowing Aol.tlotn OFFICER OR AUTHORIZED AGENT NUMBER <br />CODE YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS fRelerence aN attachments here! <br />EPA Form 3320-1 (Rev 3/99) Previous editions may be used This is a 4-part (Doti.