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PERMITTEE NAMEIADDRESSifnrGrG, rmitrlr ?Jqu l•„dr,n d Nr?!Ir,v+n <br />NAME <br />ADDRESS <br />FACILITY <br />LOCATION <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DAfR) <br />PERMIT NUMBER ED CHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO 1 -+ . i <br />Form Approve? <br />OMB No 2040'11 <br />F I wF;L ;' N-i'RE <br />EU PIl i->5: ri TO NA-F UR I TA -RK. <br />L. <br />NOTE: Read Instructions betore'cb pletinq this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> <br />E OF <br />TYPE <br /> X ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> <br /> PERMIT iS L)=/ <br /> REQUIREMENT - <br /> ( <br />, 1 <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE ..- <br /> MEASUREMENT <br /> PERMIT ?. :r#1i itx-shit f sr r :. C]NTIiI ,1-?i:. <br /> REQUIREMENT <br />- ' PJ T <br /> SAMPLE )3 ; t tr <br /> MEASUREMENT <br /> <br /> PERMIT 'R s.. N <br /> REQUIREMENT <br /> <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT ;-? r -PC''T ° tTi <11' <br /> REQUIREMENT <br /> <br /> SAMPLE 94' <br />rr 4 - <br />ti rat -: ; <br /> MEASUREMENT <br /> <br /> <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I,, rail" nndrrpen.I"aflu.,thatthl•dwnln.'m:111d.dl.lll,l,hnlt'nt.llrrt• <br />re <br />r ur <br />a <br />d und <br />di <br />I <br />r <br />• <br />nnl i - <br />man <br />amh <br />..Mm d <br />d TELEPHONE DATE <br /> p <br />p <br />re <br />r <br />• <br />m <br />.,-n n <br />.ulw <br />n l. <br />.... <br />e, <br />. <br />r.hnt <br /> <br />L '; <br />r 1--ow, III:11 Iltl.llllltd p.'f..nlnl'I ,11'••pl'1'I\ ?allll'1' .111.11•.:d11Jll' Iht' Inral lilannll <br />.- <br />C <br />J • udnuiltr 1.1-0 i-I ,„ as% ilnluu 1 of the Iw'r.•n. ar Iw' at , uhm mamhe the -Iran. ?(J <br /> nr tln nc Iw'n.?n• d!, ?•eq? rogwa.ihlr far ¢etl-ms: the inrunnalion. Ihr infnrmuli, n <br /> uhrnilled i, I•, III, i?r.l of nil Anna led?r ..IM hail'(. Irne..-U. At'. ulld 0.nlpiel.. / ?, :,• <br />1 ' ?? J <br />- - 1 :+m uwArr 16 <br />11 Ih, a un• •iL'n ificanl ,w'nahio. l......hntitri,w <br />rule inh-wiun /SIGNATURE OF PRINCIPAL EXECUTIVE + ` <br />TYPED OR PRINTED . <br />. <br />. <br />iueludimi Ihrtte', ,51. a frn.• uud nnpri..mrtncm h.r ...... OFFICER OR AUTHORIZED AGENT AREA <br />NUMBER YEAR MO DAY <br /> CODE <br />LUMMtNIS ANU tAYLANAIIUN Ur ANY VIVLAIIVIVJ trrererence an arracnmenrs nerel <br />EPA Form 3320-1 (Rev- 199) Previous editions may be used PAGE OF