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PERMITTEE NAME/ADDRESS (Include FacilityArame/Location ifDierent)
<br />NAME
<br />ADDRESS KAI-%$K
<br />P. 0.
<br />I_.`IiIrii,gC) co ;i 226
<br />FACILITY
<br />LOCATION
<br />?,T'?`f?:3 • t.:'='rr:?+r':Y` €i t?F?. i '? S;.:S.ic;.t':ns- n ?•rr rrraE-s
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (WPDES)
<br />DISCHARGE MONITORING REPORT (DMR)
<br />PERMIT NOME ER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM c--- ?,,2.• Q 3, TO U 0(-1 ECr
<br />Form Approved.
<br />OMB No. 2040-0004
<br />vCtyIS
<br />;?t'nritt C= j TF" I E TO {.r Ai ?iN,) T ,A}.,,) a;i
<br />' N' i FJ r.C>-i? R2L'1? 1 a zt?,
<br />- - - -
<br />PARAMETER -- -
<br />QUANTITY OR LOADING ..v ?. ncau wau ucuuns oeture compiezing xnIS TOrRI.
<br />QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE
<br />OF
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS TYPE
<br />-1
<br />P1
<br />1 SAMPLE
<br />MEASUREMENT r v•$i TMrv .i': .r Y.'. ., X.. a'n' E L
<br />
<br />
<br />IF1=•3=•I_ JIF- MT i' r7 ^ 1? .EJ.: PERMIT
<br />REQUIREMENT
<br />r 7
<br />ci
<br />4
<br />" i t !:`
<br />
<br />iz 3
<br />
<br />t S",
<br />SOL_ I DS, S. TT ?E 1!'rI_H SAMPLE
<br />MEASUREMENT 5 c n• ?
<br />00545
<br />'
<br />%
<br />J 0
<br />IF-FFLL;=NT1 GJDSS PERMIT
<br />REQUIREMENT t ., x. t: '... r , s > w
<br />
<br />i •rr: :'r ..,
<br />
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<br />
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<br />t tr
<br />
<br />
<br />r ;
<br />r
<br />01 L ANyC: G:•iE-: Z) SAMPLE
<br />MEASUREMENT
<br />'? C "i
<br />7
<br />?,;t ?
<br />c:.
<br />?r F@,_I)r?wT g', ors vL,.?s
<br />" PERMIT
<br />REQUIREMENT .... 't?. ? r?E•
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<br />" fs r x. r .
<br />a
<br />LOW, 1H vii:}'
<br />TP"7RU T 7ATNEN`T f~I czi+',j? SAMPLE
<br />MEASUREMENT
<br /> -
<br />I FI i9
<br />UESM-° DIY PERMIT
<br />REQUIREMENT ,
<br />?k.:r, C' n .- .._ di ?s i8 t tit ,:
<br />}) i9;vY' k ;tit:. 1?
<br />
<br />V T SVeC L SAMPLE
<br />
<br />MEASUREMENT w
<br />14
<br />
<br />0
<br />VA W". PERMIT
<br />REQUIREMENT
<br />
<br />r ..
<br />
<br />>
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<br />
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<br />i
<br />
<br />
<br />fic
<br /> SAMPLE
<br />MEASUREMENT
<br />
<br /> PERMIT
<br />REQUIREMENT
<br /> SAMPLE
<br />MEASUREMENT
<br />
<br /> PERMIT
<br />REQUIREMENT
<br />NAME/TITLE PRINCIPAL EXECUTIVE O FFICER 1
<br />ertif d
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<br />h
<br />h i
<br /> y un
<br />c
<br />er pena
<br />y o
<br />aw t
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<br />s document and all attachments were T ELEPHON E
<br />
<br />prepared under my direction or supervision in accordance with a system designed DA TE
<br />L,
<br />?Cl3c3TGs?idT1SOY1
<br />Vice President to assure that qualified personnel properly gather and evaluate the information
<br />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
<br />
<br />submitted is, to the best of my knowledge and belief, true, accurate, and complete.
<br />GNATURE OF PRINCIPAL EXECUTIV
<br />-70
<br />4
<br />723
<br />8
<br />09
<br />0r? p
<br />08
<br />r TYPED OR PRINTED 1 am aware that there are significant penalties for submitting false information, E -
<br />1
<br />33 (
<br />
<br />
<br />COM ENTS AND EXPLANATION OF ANY VIOL
<br />including the possibility of fine and imprisonment for knowing violations.
<br />ATIONS /Reference all affachmanfa haral
<br />OFFICER OR AUTHORIZED
<br />AGENT AREA
<br />CODE
<br />NUMBER
<br />YEAR
<br />MO
<br />DAY
<br />vCI-I L, 1, t,;tV c i I? iF'?'?,? -:.?a?. tv i TG :_'??tr`i i.f i?..L<s C-)
<br />PARS Z. B. W. ANY a 1! 4s11 °1l._ r i €'1 itifj? i 1 pJiJI- :.f;)? ? I L S? F"I I :i.,rSltt ZIi ate? IN - Z ,?`c
<br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. , "'h.'c., •q,.;. G.?^oo:-t,,F;;-r PAGE
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