Laserfiche WebLink
PERMITTEE NAME/ADDRESS iinrfute Fm-ilin Nrerne;]. -arrayrjGi1re.enr? <br />NAME <br />ADDRESS • .A' <br />FACILITY <br />LOCATION W A <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 20404)004 <br /> <br />Y <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY <br />OF SAMPLE <br /> ALYSIS <br />A TYPE <br /> N <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />- REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> ,.- >.. u . <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT t r , <br />1= ; ; •_ ,- .t REQUIREMENT <br />i SAMPLE - <br />I-;F l <br />1 TRFA'll•lr"` MEASUREMENT <br />_ Ri <br /> PERMIT , <br />c F T-11 L IEN T Gi REQUIREMENT <br /> <br />-.1 _1', •". - SAMPLE <br />j 1,I <br />- <br />'. MEASUREMENT <br />, <br />_ 7 <br />1 olk. PERMIT I <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT <br />TLE PRINCIPAL EXECUTIVE OFFICER <br />/T I ccrIlIN under penaity t+i law that this dueutvrnt and all attacturtents were TELEPHONE DATE <br />I <br />NAME ared under my direction or supervision to accordan.e utth a systrm designed <br />re <br /> p <br />P <br />tion <br />l <br />t <br />th <br />f <br />l <br />d <br />iiiehard A. Munson orma <br />y gather an <br />eva <br />ua <br />e <br />e in <br />to assure that quahfi d personnel proper <br />Based on my inquiry ul'the person or parsons %% Ilk) manage the system. <br />suhmined <br />d <br />t - <br />the infnmation <br />rtne the mfimtation <br />ibl <br />fo <br />th <br />di <br />tl <br />h l <br />? ' <br />en <br />Vice Presi . <br />y « p tns <br />r ga <br />c <br />ose persons <br />rec <br />e <br />or t <br />d <br />l <br />e ll _ <br />j <br />Y. <br />J3 Q <br />O <br />04 C <br /> hcf, true- a.curate, an <br />comp <br />ete <br />,uhnuued ts, to the best of my knowledge and h SIGNATURE OF PRINCIPAL EXECUTIVE <br />:nn aware that there are significant penalties for subnunmg false information, OFFICER OR AUTHORIZED AGENT AREA NUMBER YEAR MO DAY <br />Worn nR PRINTFD 1.1 Iudw.• the possrbilav of line and impri,omnem for knowing vtolanons. CODE <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br /> <br />1 his 1: a 4-)dirt tin in PAGE ".