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Form Approved <br />PERMITTEE NAME)ADDRESS (lm"Fw i y)V..dVLoeafim 1/D(feewu) NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM /INPOES) OMB No. 2040-OfO4 <br />NAME DISCHARGE MONITORING REPORT (DMR) <br />ADDRESS - <br />L+?r. PERMIT NUMBER DISCHARGE NuMBER <br />RSET MONITORING PERIOD NiOr F i'J F-4 F1: Gijr.dTC RIVR <br />FACILITY aURtu Cf',' • ". YEAR MO DAY YEAR MO DAY <br />LOCATION _F2 ? 7 C; FROM TO <br />'I ES T COOPER, EXEC V NOTE: Reed Instruction before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREQUENCY SAMPLE <br /> of <br /> EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT 9.0 <br /> REQUIREMENT MAX 1`01- <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ' i?E Pfil?', <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT x :. ,. <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />1 O PERMIT ^ "' #if #3F 3F# <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ri <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br />PERMIT I- Ij <br />REQUIREMENT . <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER l renay ¦ c pens ty law that thh document and aQ attachments were TELEPHONE DATE <br />prepared under my direction or super"olon In accordance with a system designed <br />to as m that quahfled personnel Properly gather and eraluale the Informatloo <br />aubmitled. ward on my Inquiry of the person a persons who manage the system, <br />w those persona directly mponsibk ror gathering the Information, the Information - <br />submitted h, to the bell of my knowledge and btlW, true, accurate. and complete. <br />I am aware that there are sIgnincant <br />enalcl a for submittin <br />War Inf <br />rmatio <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />TYPED OR PRINTED p <br />g <br />o <br />n, <br />Including the poasibllly of nne and Imprisonment for knowing +iolalform OFFICER OR AUTHORIZED AGENT CAREA <br />ODE NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Reference d( sttachrrrents hers) <br />T, T <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. This is a 4-part COrrn. PAGE OF