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PERMITTEE NAMEiADDRESS tlncludeFacflkr.Vawrc•ZacariunifDiArm) <br />NAME -,I, COMPANY, LLC <br />ADDRESS = -+'- r'i.( NS <br />WEST FIRST STREET <br />;vIDAD ?C) <br />FACILITY ELK M.1 NE <br />LOCATION !ESTON C G <br />,.t,%vrdt=• rnlaf=t?nai F <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />sic MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />M I NOR OMB No. 2040-0004 <br />( SURF. (_ ?. <br />F -- FINAL Lt3lt IAS <br />DOMESTIC SEWAGE. TO POND <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY <br />OF SAMPLE <br /> EX TYPE <br /> >< ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />..................... <br />. <br /> <br />AY <br />SAMPLE 1 <br />= <br />DE MEASUREMENT <br /> <br />-J PERMIT - a st a fi? ? T <br />r'rF1 U'`•f'47 ?S Vt;i.U REQUIREMENT MONTH! <br /> SAMPLE 4-41 <br />- <br /> MEASUREMENT <br /> PERMIT <br />f (_ -)~lJ s GROSS VALLIr REQUIREMENT Nl It I-IA X I'' ' <br />LID, T SAMPLE ?F <br />`;VSPENDE_ D MEASUREMENT <br /> PERMIT t if :b # i ! 7. t r F <br />-F r i..Ul (-41 GFOSS VALI.`, REQUIREMENT <br />I riNl_: ` `- SAMPLE it r ,• / <br /> <br /> MEASUREMENT V <br />Ce? i ? PERMIT t***** <br />#'. • is # tf a <br />e -r.? <br />t <br />?##### <br />} ! <br />, <br />LUEN•1 ;FOSS VA1. ' 'i REQUIREMENT <br />IOW IN C C)r DIJ I T SAMPLE <br />QU TREATMENT PLAN I, MEASUREMENT <br /> PERMIT REPORT F?_P r.p 3Esi s. Ayt dt 4# k'x:e ; <br />E"F L.UF, i ALUM REQUIREMENT -- FDA AVG <br /> SAMPLE i a;?•.- <br />;GivERAL MEASUREMENT <br /> PERMIT E PORT P _.. OR T <br />1::,;_,S VAi.t", REQUIREMENT AVGEO <br /> <br />SAMPLE ? xtx#k <br />;! I l . 7,I MEASUREMENT <br /> <br /> <br />PERMIT f4i='t <br />_lir <br /> <br /> <br />ms'} <br /> <br /> <br />##tt <br /> <br /> <br />#x## <br /> <br /> <br />:,• .. .. <br /> <br />_ <br /> REQUIREMENT : lST A,X <br />NAME/TITLE PRINCIPAL EXECUTIV OFFICER I certify under penalty of Lm that this dixument and all attachment were TELEPHONE DATE <br /> prcpural under my due.uon or supcntsion in accordance with a s}stem designed <br />to assure that qualilicil perxmnel prvperh gather and evaluate the information <br /> ersons who mana <br />e the s <br />stem <br />b <br />itt <br />d <br />n m <br />n <br />ir <br />of the <br />er <br />on <br />r <br />d <br />B <br /> y <br />, <br />su <br />o <br />y i <br />y <br />p <br />s <br />o <br />p <br />g <br />m <br />e <br />. <br />ase <br />qu <br />•spon.ible for gathering the informawm, the information <br />or those persons direcdv rr _ yt <br />rr <br />L . <br />submitted is, to the hest of my knowledge and belief. true, accurate. and comploc <br />1 SIGNATURE OF PRINCIPAL E CUTIVE <br /> <br />TYPED OR PRINTED - mfor na ;on <br />1 am aware that there arc stpvticant penalties for submttnng t: <br />including the Ixtssthilita of fine and imprisonment for kn.ncmc .: ,lanom OFFICER OR AUTHORIZED AGENT AREA <br />CODE NUMBER <br />YEAR <br />MO <br />DAY <br />COMMtNIS AIVV tAF'LAI4Aiiur4 ur mmT vtvuyrtuma Irreverence an auacnnrents nere? <br />EPA Form 3320-1 (Rev. 3.,99) Previous editions may be used. <br />iE - SEE : <br />PAGE OF <br />_?! Ws'is a 4-Dart torn;