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PERMITTEE NAME)ADDRESS (7--6&F.r&yN..?Ler.et.. yD(Qw..r) NATIONAL POLLUTANT DISCHAROE ELIMINATION SYSTEM ((NPDES/ <br />NAME DISCHARGE MONITORING REPORT /DMR1 <br />ADDRESS <br />BOX a..i PERMIT NUMBER DISCHAAOE NUMBER <br />7i'iFRSET , <br />FACILITY i`4BORN CRK -. r . i K Jam. t i i ' : MONITORING PERIOD <br />LOCATION -IERSET YEAR M DAY Y AR MO DAY <br />FROM TO <br />,MES T. COOPER, EXEC V <br />MINOR <br />(SUBR MH. <br />F - FINAL <br />SURF RUN( <br />Form Approved <br />OMB No 2040-DO04 <br />s, 5 <br />NOTE: Reed kwilructiom before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREOLIENCY SAMPLE <br /> <br />E OF <br /> X ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT M IN I MUM MAXIMUM MONTH <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT i. <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT r v .. I . <br /> REQUIREMENT 30DA !+?•'i. DAILY MX MONTH <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT ,.:... .. - ; •, -,. <br /> REQUIREMENT 30DA AVG DAILY MX MCJHT <br />:. SAMPLE <br /> MEASUREMENT <br /> <br />`32 1 PERMIT z 7717 1 , <br />-NT C REQUIREMENT I NS-T 7 ',IT <br /> SAMPLE <br />REA T MEASUREMENT <br /> <br />1 0 O PERMIT <br />ry <br /> REQUIREMENT 30DA F.'. ; I LY MX MONTH <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT = ,.. : ,. _ . <br /> REQUIREMENT .9R'TR AVG DAILY MX <br /> <br />NAMERTTLE PRINCIPAL EXECUTIVE OFFICER 1 Krtrly Y r pen. ly O .w that thisdocument and .N attKhments were <br />TELEPHONE <br />DATE <br /> pRpared Ynder my dlrselton or w <br />per.r>lon In sKCOrd.nn with .system designed <br /> to a.sYK that g..Hrled personnH properly gather and e•.lu.te the Inrorwsatlon <br />berdlted <br />B <br />d <br />m <br />1n <br />.lr <br />f th <br />e <br />o <br />e <br />h <br />--' ! <br />- wl <br />. <br />ase <br />on <br />y <br />q <br />y o <br />e p <br />rson <br />r p <br />rsons w <br />o manage Ow system. <br />= _ <br />? or those persons if <br />tly reMporrdbie for gathering the Information, the Inrorrnatlon <br />- mbmltled b. to the best of my knowledge and beikf, true, .rcunle..nd complete. <br />1 ¦m .w.re that Ihrre .re slrnfn . 1 prr,.tn.e f.•, ruhorinn <br />W. Irene m,l on <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br /> f <br />. <br />TYPED OR PRINTED fndudtng the posslbnu, r nor r- k-i„f jN.uont OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLA I IONS (Reference all sttschments here/ <br />ABLF SOLIDS LMT APPL_TF^ FOP =TQYR, 24HR PRFCTP =1JF_NT. <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. This is 8.4-pan fonn. PAGE OF