Laserfiche WebLink
PERMITTEE NAME/ADDRESS (Include Facility <br />NA1.1E <br />ADDRESS ?It <br />FACILITY <br />LOCATION <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />I <br />PERMIT NUMBER <br />DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br /> <br /> <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> OF <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX ANALYSIS TYPE <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 /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT 1 <br /> REQUIREMENT <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 />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I,'rrlif>underlnmdl r.fht?th?tutr.d?wn.•m:rndaualwthm.•nn rm TELEPHONE T <br /> <br />pnglarcd under m, direrlion nr super, ision in uccordanaro wifh a ? stem Ae?i>;md DA <br />E <br />e ;,J w ri <br />. e• assure thm yunlifu•d 1x-nwl p-itrrls k;dher anti es:du:rtr the inronnalion <br />/ ' suhmineti. Ifasad ..n nr? iml of he i,er-n,.r Per.om who manage the -tem. <br /> or lhmc lw•r--direclh r? 1w.n.il.lc for L•alherin>; the infurmalinn. the infnrnuliun <br /> whmilkd rs• to the l-t of m, Ln..s.ledge and Iwlicf. Intr. acrurale, : old ...mplrtr. <br />I <br />u a..ar <br />th <br />t l1 <br />SIGNATURE OF PRIN <br />IPAL E <br /> a <br />e <br />a <br />wre are tgnificanf penalti• ha suhmilling fal r in6nrmalion• C <br />XECUTIVE <br />TYPED OR PRINTED includin:Ill, po..ihihn .d fin, ant imprisonment for Ann,siug,h.laGons, OFFICER OR AUTHORIZED AGENT AREA NUMBER YEAR MO DAY <br />COMMENTS AND FXPI ANAT!ON OF ANY Vlfll <br />COMMENT':, AND <br />OF ATIf)KlQ /0. f,. 11 ....,.r.___._ CODE <br />_--- _. .. _...._.. <br />..._ ....., ......v t•....... a:..cc all orro LIIIIIGIIIJ I(C(C? <br /> <br />EPA Form 33220•1 (Rev 3(99) Previous editions may be used 'ritis',14'a .4-0zfrt {bull. PAGE OF