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PERMITTEE NAME/ADDRESS,huludr' Farililr Namr4..ruti„nIf Aij/in•rfry <br />NAME <br />ADDRESS ; t ? N r c <br />FACILITY <br />LOCATION <br />!,,I I A <br />?, rf rti.?,la <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPOES) <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 />M I NOR <br />c SUBR. MH <br />F - i- f Taal <br />D' t_ T F <br />NOTE: Read Instructions before completinq this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREOUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE ,... ; -. _ . <br /> MEASUREMENT <br /> PERMIT ?s <; u is x u - # _ s t '_? w i F= % =R Fa t3 <br /> REQUIREMENT ; T I <br />T I`l <br />ll"; ' ^liJ??7t i <br /> t1 <br />l ±; <br />;, i ? <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT r, ': ire f .. ####kL =, wiO ?(Zc. , <br />.. REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT J'cz <br /> PERMIT : #c ; 4:.: w.hi• i; t?t:# it rrn#s i f?E;'pRT <br /> REQUIREMENT <br /> SAMPLE ?: r <br /> MEASUREMENT <br /> PERMIT : 't- it tf # s s If iz ?: ? 4'. F <br /> REQUIREMENT I- <br /> SAMPLE ozi I > t s' r z F <br />ice; c r? i P4 1 iD _AI N, <br />i PERMIT =f'C71'T R`.=' F'' xr. i•: _ ;,??- a _ <br /> REQUIREMENT A ,'; 71 <br /> SAMPLE xr= y4i <br /> MEASUREMENT <br /> PERMIT t: i. >,. ; fi_' cJ r i ?: = _ y r'. i; ,>; <- ti E '•'#-, <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMErrITLE PRINCIPAL EXECUTIVE OFFICER 1 arrlil. Ilndrr I-Al., ..nan Ih?l Ihi, d-.,,t lrnl a.d Al.+ll.ph..... .rrr <br />d <br />V 7 <br />? TELEPHONE DATE <br /> <br />- prrp.rtr <br />unrhr m. d <br />rrc7i"n •.r alp.'n Lum in xaurduuc.' .. ith a .I Nrm dc.i¢nad <br />In aa.ll l' <br />' That I <br />.l <br />ri .l <br />.- <br />o <br />-i, <br />nhrr <br />nd <br />W <br />Il <br />w' <br />I <br />f / <br />z <br />1 .. <br />T . <br />w <br />i <br />1 <br />mn <br />Ii <br />L: <br />a <br />r. <br />' <br />l, Itl <br />om <br />..n <br />. <br /> <br />•nhnlll lt•d. 11:14.11 ..n n,, 111111111 '1 id tllr Ilet?..ll r In'r•I.11• Nh.. n1Y11.+L't' (hr ...n' I.• <br />/ <br />z <br /> ..1 Hll l.l' {1r Y•nlla dlfa t'fIl rt'?Ill.nalhlr Iur Lalln'nnL' Ills' Illllninal+nn. Ihr Inrnr nat11.11 r J <br />-1 <br />•- -I ittrd i,• to Itlr Iml "f.- Lnuu lydy-r and t lirf. Irur. :u auruty. and t ?•ngdrlc. <br />1 um uw:+rr Ihar Ih,n an• "t <br />nifn-ani <br />n•n <br />dura <br />fur •uhmilun. <br />lal. <br />• udul nl <br />d l?n 1 <br />SIGNATURE OF PRINCIPAL EXECUTIVE -" ? - - " ? ? <br /> <br />?•? ' ?- .r / / <br /> . <br />, <br />. <br />; <br />1 <br />. <br />_ OFFICER OR AUTHORIZED AGENT AREA 1 <br />TYPED OR PRINTED inllu+lin IhrI-Ihilih nlfin, -1-pr....n...... .r Ln.,.an_.rdati• n,. NUMBER <br />CO YEAR MO DAY <br /> DE <br />t..UrvffYltlV 1 J ANU It APL ANA I IUN Ul- ANY vIULA I IUrvo (rrererence an arracnmenrs nere) <br />I. r:11 i P ! FJ,? T ?I 10. 1r : - 1 DURDENI OF PR1 !Cu F;;7(' L 1 1 c rzc:'± <br />Fri, <br />"1V 49 <br />EPA Form 33201 (Rev 3199) Previous editions may be used. •F4kti). ; 4-pLUI-fOrm. PAGE OF