PERMITTEE NAMEM
<br />NAME
<br />l? ZE
<br />ADDRESS ',rARM
<br />P. 9!
<br />rx
<br />1DDRESS (Include Facility, Name/Location ifDifjerent)
<br />`S.= lJ {'?: ?_. tie `JY?x: Y,Ix v •r?
<br />DUN
<br />i? r r F'
<br />FACILITY t o QR y CO
<br />LOCATION Ht RR' a u T l'I
<br />y1 A" %Y-1
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved.
<br />DISCHARGE MONITORING REPORT (DMR) r7 Q + OMB No. 2040-0004
<br />(S)U01i J!,
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />i" .t1_ it Vii'
<br />MONITORING PERIOD 71 Cit!J ice,:' TR I J .7P. C ! N f?, VTR,
<br />YEAR MO DAY YEAR MO DAY
<br />FROM ?: 5.?. 7=3 't TO y .rr I, r; g: c^ _ y
<br />? _I, r i ; , ? ? ? .? r," - - .-. ..... „ . 3 v ..l ? o., :., l"1 fi i : ±-- ?.'
<br />M. ,NGR_ NOTE: Read Instructions bef •
<br />f .._..-..) ;:.: •fi
<br />ore com
<br />letin
<br />this form
<br /> p
<br />g
<br />.
<br /> PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION N0. FREQUENCY
<br />OF SAMPLE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS TYPE
<br /> PH
<br /> SAMPLE
<br />MEASUREMENT ;. :sr;:• ?i_.;::.4.-:? .° f fii%• 12)
<br /> ti
<br />? :1 PE '
<br />
<br />?
<br />?
<br />E Ff M-'r,i M r -,L 33 4DE?.'- I FI
<br />r RMIT
<br />
<br />REQUIREMENT
<br />•
<br />i••.....r:? :,
<br />?
<br />; °?•zK,h
<br />.rJ
<br /> p®1 i?b'a E"':WMr; SAMPLE
<br />MEASUREMENT i_?::?#x:
<br /> C' a Y
<br />PE
<br />
<br />EFF•a UFN 0RQG Vp,,;.es
<br />Iv1x1 RMIT
<br />REQUIREMENT f••k ... i., a f ,.. .. .
<br /> __ SAMPLE
<br />MEASUREMENT
<br /> t335
<br />c r
<br />0 PER
<br />I
<br /> r
<br />.
<br />EFFL
<br />'X-.M = Ll VALI:. M
<br />T
<br />REQUIREME .. r. t 1
<br />
<br />?
<br />
<br />
<br />"? •r
<br /> F I..0vfe _.` ??s)r T 1;31'-'.
<br />THRU Y(?kr ie ?g FL!-W! SAMPLE
<br />MEASUREMENT ,??• //??, ?
<br />6 V.i'e.Y+ r H• T. .: ':I' .: ' M .t x .y w"rI'ii' .a' •?^ n .?i' .'?".'t'
<br /> ?2
<br />t ? PERMIT
<br /> 1rst
<br />?
<br />EFF"_U .E I 6'RME 3 VALL1•
<br />REQUIREMENT -
<br />t i
<br />JC"
<br />E _:tr??
<br /> 01L. lvRt; i Yt ' ?{ .
<br />
<br />V % S4JAL SAMPLE
<br />
<br />MEASUREMENT >i fi .: w ix 94
<br />)
<br />? .i 3 ° a 4#
<br />u ?k 3r +
<br /> 5 1 S?
<br />81-06
<br />•
<br />' PE :
<br />'
<br /> 4
<br />;
<br />F•?1.11?9 . '(i°? µ l0`?I l's:
<br />RMIT
<br />REQUIREMENT
<br />..
<br />s:•:q k
<br />-
<br />i
<br />?? ?:
<br />?`?`a""? r a
<br />... ... .::*•
<br />_
<br />... ... -, ..
<br />
<br />-
<br />h
<br />
<br />
<br />s
<br />tt ,
<br />
<br />t
<br />.:.,..,
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERM
<br /> IT
<br /> REQUIREMENT
<br /> SAMPLE
<br />
<br /> MEASUREMENT
<br /> PER
<br /> MIT
<br /> REQUIREMENT
<br />. NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of taw that this document and all attachments were TELEPHONE DATE
<br />prepared under my direction or supervision in accordance with a system designed
<br />Richard As Munson to assure that qualified personnel properly gather and evaluate the information
<br />Vice 1Qr3idQnt submitted. Based on my inquiry of the person or persons who manage the system,
<br />or those persons directly responsible for gathering the information, the information 970 7 -4338 09 07 08
<br />submitted is, to the best of my knowledge and belief; true, accurate, and complete. GNATURE OF PRIN IPAL EXECUTIVE L7
<br />I am aware that there are significant penalties for submitting false information, -
<br />. TYPED OR PRINTED including the possibility of fine and imprisonment for knowing violations. OFFICER OR AUTHORIZED AGENT AODE
<br />REA NUMBER YEAR MO DAY
<br />C
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
<br />SETT' s::A;_E '-N 11;.r.'?k'S '-.r'?, :1 :FUIRi I?3...'yx; 2i?vl 7--CIP TNE""Nr SU3J>.C-f 713 D A.-;"" 1`a OF PRO0y
<br />PAR 1 E. ANY L??:'?? ?J ?. :.7??S`,t.? ?C'j 1'L?J e]? 1r ? ,_ _ ?' ??.??_?n'T_:..i• TO • _ _,%.. .i`. 3 i .a.. ,+? < .!'i ?,,. ? C3E?t c ?. ? t'-1 x 2E1 `:•i? i-i?i t:.^.
<br />x
<br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. y?, y n ,, ,e,1]}.S;kss& 4?3ai t,6rn1. PAGE OF
|