Laserfiche WebLink
PERMITTEE NAME/ADDRESS Nntlude Fruilin ttamdl.i+ratiom q UtfferrN <br />NAME <br />ADDRESS <br />FACILITY <br />LOCATION <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />F - FINAL. <br />P'1 I NE Utz A I NAG;: <br />Form Approved - <br />OMB No 2040.0004 <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 <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 /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - <br /> REQUIREMENT <br />AMErrITLE PRINCIPAL EXECUTIVE OFFICER 1 ee'rtiry under rrnalts nr tae that this dtKVment and all attachments errr TELEPHONE DATE <br />N <br /> prepared under ms direction or .upon ision in accordance with a %?.trm designed <br /> to assure that yualiried prrsnnnrl proprrh rather and evaltalr the information <br /> submitted. Bawd on my inyuin or the w-o or pers.rns wlw manage the system. <br /> or th,ese• prrsnas dirmth respatsihle for gathering the information. the information <br /> submitted is, to the hest of m, knowledge and hcllrr, true. accurate, and canpletr. <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br /> I am a% are that there are strairoant prnaltit for submitting false informutirm. AREA <br />TYPED OR PRINTED imitaling the p,whilits oI fine ..it imprisonment for knowing violations. OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />EPA Form 3320-1 (Rev. 3(99) Previous editions may be used. This is a =1-part form.