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PERMITTEE NAMEIADDRESS,bulude Farilitr Nainelhwarian if thff:rrnll <br />NAME <br />ADDRESS i M I id E <br />f; ; ?' 4 33 <br />FACILITY 1 N (J <br />LOCATION <br />.E; H 1 <br />DISCHARGE MONITORING REPORT (DMR <br />) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />Oh48 No. "040 000a <br />-H Ju L. <br /> <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 /> SAMPLE 1. . <br /> MEASUREMENT <br /> PERMIT ii <br /> REQUIREMENT ^IF':.X i i tl M <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT t # ?s r. <br /> REQUIREMENT i >- - _ <br />- SAMPLE <br /> <br /> MEASUREMENT <br /> PERMIT > t, x•? tt. ,1, .i- 3-#i° r?-#? > <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <br />;., SAMPLE <br />•AT PL i. ," • MEASUREMENT <br /> PERMIT REPORT P <br /> REQUIREMENT t7 AVG IH' i <br /> SAMPLE eft. ?# 4) #3 ; <br /> MEASUREMENT <br /> PERMIT R;?:POR T ai E a##tr r }_ C:F: J.' `:.. <br />1131 <br /> REQUIREMENT -"T T L; <br />? X <br />" i <br /> : 4 <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER 1-, ""'I''' 1" n•,II. 1.1 la,. 111.11Ihlad.nlllnrnl ?Illl all Jll.nhllll'lll lu•n /% TELEPHONE DATE <br /> Pnparrd colder un dinv hou ar .uprn i.nm m as runlJnr. -lh a -lrm d"itt. d <br />??)) 1.: u.aue limi'l lifad Pa-mu'l Pngw•rl, r!a16a•r and -1-i, tier udnrmutiun <br />a.t <br />, <br />1 h <br />th <br />m <br />1 <br />1 <br />4 <br />h <br />' <br />/ / ! j <br /> r jivr <br />m ur Prn,m <br />. <br />o ma-Lw <br />e . <br />r <br />, <br />.u1-ittrd. <br />6- <br />- n,-, inquiry <br />t <br /> .r Ihr,.. Il.rwma dirrrlh ra•.pmdMr G.r valltt-t;2 the u1Grt'uwinnl, thr inrar'mali,m <br />! <br /> <br />- ,• !s <br />f .uhmitled i.. n. Ihr M•H'd - Amrol. Ace and 1.0" 1, 111- ...11'.w Jnd -rrphte. <br /> <br />OF PRINCIPAL EXECUTIVE <br />SIGN <br />ATURE -? <br />' <br />7 <br />-, - <br />?? <br /> I ,in .-jr, Thar Iherr, .ur ?il;nilia and rmnalur. for .uhmiumc Ild.a' inrnnllulnm, AREA <br />TYPED OR PRINTED including the ("?.ihlhn .d linr and inq,ri., nulenl R.r l nolline ai. 1:diona' OFFICER <br />AUTHORIZED AGENT <br />OR CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION VI- ANT VFULAI IUND (Kererence air arracnmenrs nere/ <br />°I'IF !`'Jt,47- -.VE3JE.:CT True 1Z1_[^7,F!J OF' PROOF Rr0JI9,F_=t1!'-NT9 ?N <br />PAGE <br />:Thit;x?} p vt lc?rm. <br />EPA Form 3320-1 (Rev 3/991 Previous editions may be used. OF <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)