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Form Approved <br />PERMITTEE NAME/ADDRESS ilneludr Facilii0apti,4Ir w n if 140,rnlu NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />NAME `l <br />ADDRESS l I NF tt ` <br />'4 COONTY ; Ic,._.; :. - PERMIT NUMBER DISCHARGE NUMBER <br />?F.ERVS - MONITORING PERIOD <br />FACILITY M I N <br />YEAR MO DAY YEAR MO DAY <br />LOCATION ?PER?IS l n FROM TO <br />.. ?.-r.,-',' 94. T 91 r nIC cnrn t nl;= NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, <br /> <br />EX FREQUENCY <br />OF <br />ANALYSIS SAMPLE <br /> <br />TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />f , SAtJ1PLE <br />MEASUREMENT y i <br /> <br /> PERMIT <br />REQUIREMENT ; ... -i• :., .. <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT <br />1 <br />L/ <br /> SAMPLE <br />MEASUREMENT l L <br /> <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT \ J <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT <br /> SAMPLE <br />MEASUREMENT <br /> <br /> PERMIT <br />REQUIREMENT <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER I -rail, uudrr penulh of IJ« tbJt Ihi\ I-ini i and :dl allJChmrnl. \4rrr <br />prrp:a,ed un I,, m\ I,rraiunl ..r .Ilprr\i.inn m un nrd.nl4 r «ith a .rHOm dr\i_nvd TELEPHONE DATE <br />_ ?-I <br />,. 7-• ?! , : r\l ?-•, I.r u..urr thus .114a1iri4d 14rn.rnln•1 pr..l«?rl\ L:I1114'1' Jnll v\:1114n1r the infrrrtnatiuil <br />--Intl"" 14--d .nl m4 ,jow, rr( Ihr prr.n....r prrvm. «hu rnun.4la Iha• .\.tcm. <br />Mrfl?jidl• fnr L' 1lhrrln, 1110 IIIrnrRIJllr rtl, Ihl' Illr«rlll.ll llm <br />. <br />4• <br />tr <br />n? dlfra ltl rr. <br />IIn ?' I <br />__ --i- .- _ - / . <br />? ''F"-' ?- `?' "/ <br /> <br />/ <br />• <br /> n <br />I <br />nr <br />. <br />I <br />/ <br />.Ilbllilll vl 1\, In 11/r tk'.I n( nl\ Anr.«14'IIQa' Jnll I4a'III'f, trtlr, .1a4111".Ifr„ImI a'n111I11a'll'. <br /> <br />OF PRINCIPAL EXECUTIVE <br />SIGNATURE ?,?I'? <br />7?' / r./ <br /> <br /> <br />- <br /> <br />J«un 1h.1 11n an•.ignificanl prn.dnr. I- whmittmg fA- Infnrlnuurm. <br />I nm <br />OFFICER OR AUTHORIZED AGENT <br />AREA NUMBER <br />YEAR <br />MO <br />DAY <br />TYPED OR PRINTED mclndul for Iw..ihilil\ ur f nr and Impri.onnmm R.r Ann«mc \inlutinll OE <br />COMMENTS AND EXPLANA I IUN UI- ANY VIULA I IUIVO (nr,w,v,,c c ml ouoa r.r4,c.o ?F : -IREC IP E'V'ENT SUBJECT TO BURDIEN OF PROOF REQUIRE"IENTS <br />_7) TO THE LIIVISION WITHIN 40 'HOURS. <br />J0O <br />(Rev. 399) Previous editions may be used £ifa? t + <br />- .. 1