Laserfiche WebLink
r, Ak! <br />ADDRESS <br />:+c I LITY <br />LOCATION <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />FROM YEAR MO DAY TO YEAR MO DAY <br /> <br />NOTE: Read Instructions before comoletinq this form. <br />PARAMETER QUAN TITY OR LOADING Q UALITY OR CONC ENTRATION NO. FREQUENCY SAMPLE <br /> ? OF TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS <br />SAMPLE <br />MEASUREMENT <br />PERMIT F; <br />REQUIREMENT h: r ; . <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 /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME=LE PRINCIPAL EXECUTIVE OFFICER rmfy under penalty of law that this do ument and all atuachmem, were TELEPHONE DATE <br />_ p:cpared under my direction or supcn Won in accordance with a s%-stem designed <br />` i <br />' - to assure that qualified pcrsmnel properly gather and esaluate the inibrmation _- <br /> submitted. Based on m y inquiry of the person or parsons who manage the system. <br />-- or those persons directly respon-sihlc for gathering the informal ion, the information <br /> submitted is. to the best of my knowledge and hehcf, true, accurate, and complae. <br />) <br />l <br />l <br />i SIGNATURE OF PRINCIPAL EXECUTIVE <br /> am awara t <br />,! ! ,rc arc mgrttt <br />car,t p,m, <br />.nes for submimng false mfotmanon. <br /> <br />TYPED PRINTED <br />m, (udme r.,irty of tine and unpnvmmcm for knowing violations, OFFICER OR AUTHORIZED AGENT AREA <br />CODE NUMBER <br />YEAR <br />MO <br />DAY <br />1"r)RARACKITC AKIn CV01 ARIATIn KI !IC AAIV %/Ini ATI/IRIC /o,.1.....--- -- .. .._t_-__._ ___ <br />":-1 T'+! "R!--: L lMr7S WILL RF WAT`)ED FC RECIP FV-'r•.IT _ cRE I. A 1, Pte. Ft'1R RF!YUFRF;r'F'tr <br />PAE OF <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. r.- -- 'his isa 41an forni.