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PERMITTEE NAME/ADDRESS (h d 1, twilin kuno'Lavrion iJ Uiff"rrrn, <br />NAME <br />ADDRESS t- <br />'?IH <br />FACILITY <br />LOCATION <br />-NIA _ <br />(DMR) <br />PERMIT NUMBER DISCHARGE NUMBE9 <br />81 MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY I <br />FROM TO <br />Form Approve,'' <br />OIV46 Nr,. 2045 <br />I)`L_ T A <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT r. <br /> SAMPLE r# i <br /> MEASUREMENT <br />- PERMIT -. :r .jF.:c ,? i-?-ii -? ?# rr •3f#•? n -1L) <br /> REQUIREMENT .CC/.; 4`J: iif; Ti• -,, <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT :t•..#-. ='?i,l it r <br /> REQUIREMENT 3i:iL)A P V <br /> SAMPLE : r. r. <br /> MEASUREMENT <br /> PERMIT + i t# #:i .o # a .< i # :- # r x? e t • .. i_ <br />r , REQUIREMENT <br />i i SAMPLE ? r .. <br />i t tj - P t MEASUREMENT <br />"r517 PERMIT ZEF'ORT F?-I,: < - : 'RC0RT)R <br />- t j_;.j REQUIREMENT 7A A?,%G <br />11 L; SAMPLE -.-+ #4s ( 9LF) k# ??, :#Y# <br /> MEASUREMENT <br /> PERMIT <br />F <br />- i REQUIREMENT <br />- <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMErfITLE PRINCIPAL EXECUTIVE OFFICER I.evnfn undrr Ia-nau..dl:n. thal Ilimd-onsenlunit allalf-lin-tt-r.' <br />^ <br />TELEPHONE <br />DATE <br /> urd un h,m. dirarliunur.n <br />n <br />x-".„n ina,'--dame wilha-h nd"rgm•d <br /> <br />.` // ?JI ? ri '? ? f' • ` i ? <br />.' - . <br />p <br />p <br />I <br />lu e-ni That , nliried nanud ro w•rl. <br />1u {n' P I i:athrr and e. aluutr Iha ndurnrauon <br />whnuued. lk-d on m> inquire of linr pr nun ..r Pe nun. oho uuuat3e the -t-i. <br /> <br />l <br />r, ur Ili- Ixr. - dirt,, 0 rrpon.ihlc for t:alhrring the udrmmiun. Ihr :.tumuli.." <br /> -Innaml,.- I,. the I-i of m, Ln.... h•du and 1.10. m...-uratc. and rnmLh•Ic. <br />I.nn a„ar, Ihat Ilivi", rr ignifinaw <br />n?n <br />duc, forulbnnnin <br />luk, inform awn SIGNATURE <br />OF PRINCIPAL E <br />EXECUTIVE - - / '• <br />? . c e <br /> I <br />. <br />¢ <br />. ? <br />OFFICER OR <br />AUTHORIZED AGENT AREA <br />TYPED OR PRINTED nrbuline it,,- p u.ihilm of rem .md nupr unnu•nl for Lu.u.inp.i.,lau.m.. CODE I NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLA I IONS (Hererence all attachments here) <br />°REC IP EVENT SIJB,.1=CT FO BURDEN' OF PROOF REQUIRE!';:=I.J f ? <br />D TO TH iIIVS 01\11 :.IITHIN 4E' ?." ..:? r. <br />EPA Form 3320-1 (Rev 3%99) Previous editions may be used Fbis,iS a 4-part fonii. PAGE ,OF <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT