Laserfiche WebLink
PERMITTEE NAMEIADDRESSpm&&FeeoyN..?L etimtfD(p6,%w) <br />NAME <br />ADDRESS <br />i3+_IA <br />-R.SET r <br />FACILITY ! >r <br />LOCATION <br />::LV, ( <br />OOPER, EXF-C <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOES) <br />DISCHARGE MONITORING REPORT IDMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved <br />OMB No. 2040-0" <br /> <br />i <br />NOTE: Reed Inetructione before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, PREOUENCY SAMPLE <br /> <br />EX of <br />Y <br /> ANALYSIS PE <br />T <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT cry. <br /> REQUIREMENT v1AX I MI-1 <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT o. 41 ### ;: RFPf3RT <br /> REQUIREMENT -A)A A*V"wr <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT tx srx <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ` E; RhPUR <br /> REQUIREMENT i':• <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER ' """? " ' pe""y ° '" `h" this d°r""1f"""d all ""`h"""" wefe TELEPHONE DATE <br />prepared under my directlon" WPeretslon In accordance With a system deatgned <br />To e " that qualified personnel Properly Lather and eeduele The Informallon <br />submitted. Seed on my luqulry *(the perwn or perwns Who m all* the systrm, <br />w Those perwrzi directly rnpondbk ror gathering the lnImr atloe4 the InrormaTlon <br />submitted h, to the belt of my knowledge and belief. true, acevrate. end cempkte. <br />I <br />th <br />t th <br />l <br />dn <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />t <br />ltie <br />f <br />b <br />t <br /> em .Warr <br />e" are s <br />irr <br />con <br />a <br />Pena <br />or e <br />ml <br />dng retie lnformatkm, <br />s AREA <br />TMpW OR PRINTED Including the podbi8ly of nne and Impolm ment Aw knowing .iolethnn OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Reference ed attachments here/ <br /> <br /> <br /> <br />EPA Form 3320-1 (Rev. 3M) Previous editions may be used. This is a 4-Part form. PAGE OF