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PERMITTEE NAME/ADDRE55(lwd.ir.ieWgN+s•MI R?w?I/D(Qfr+n,); <br />NAME <br />ADDRESS <br />K F'R Ca Ell <br />FACILITY <br />-KIr--R i:Cl D I <br />LOCATION L-1-Y LI. S-AND£r S, VP OF OP <br />NATIONAL POLLUTANT 04SCHAPOE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT [OMR) <br />Ea <br />PERMIT NUMBER DISCHAROE NUMB <br />MONITORING PERIOD <br />YE . O DAY Y Q DAY <br />FROM TO <br />. J Form Approved <br />OMB No 2040-0004 <br />F <br />GOSSARD PDIJD TO WIL.EUrl ;1F2 <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br />FREQUENCY <br />OF <br />SAMPLE <br /> E <br />X <br />EX <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMVM?... UNITS <br /> SAMPLE -? <br /> MEASUREMENT <br /> ----- <br />_ <br />` PERMIT T f' <br /> REQUIREMENT <br />- <br />--- --- <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 />N ME/TiTLE PRI IPAL EXECUTIVE OFRCER 'yen ly . . pen. ly o I.w that u,h decnmrnt anti .n .tt.cnmentt were / <br />TELEPHONE <br />DATE <br />prepared under my di-11.n or wp-ltil n In -,d.-with . sytlem dedg wd i / <br />?? to .pure that qu.Hled p-rtel property gather .nd -W..te tM In -flon r` / • :; ,, ; <br />/ <br />. <br />wbmltted. bard on my Inquiry of the pawn nr perscro who rn.n.fe the tystern, <br />? or Moat per-, directly -porKbte for gathering the Inform.llon <br />the Infonn.llon <br /> <br />•. <br />/ <br />. <br />! ??) <br />b <br />li <br />l <br />b <br />i <br />V 1 <br />/ <br />tled 4• to the belt of my ki $ed[t and <br />e <br />ef, Im...rnle. and comp <br />ete. <br />-t <br />t f . so <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br /> I .m.ware that them am slintncwt pen.ltles for wbmtltlnl false Inromutlon• A AIA <br />TYPED OR PRINTED Intltrdlrtt the po.dbltlty of flne.nd Imprtaonrewnr for knowlnZ .ielaUOrr> OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS ANO EXPLANATION yr AN If VIULAIWN5 /lfe/arence as affecnmenfs nlrrei ;R F'F<Ei:i?' ttf; lv I I L,L /AIInr L3 if' EPA Form 33241 (Rev 3199) Previous editions may be used This <br /> is a 4-parl form. PAGE OF