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PERMITTEE NAMEMDDRESS (7&4- FaHhfj)Vm-?Loe.rton I(D(Swwu) <br />NAME <br />ADDRESS <br />:-EKER GC <br />FACILITY ;-CWYO rt:) NE <br />LOCATION <br />.lELL.w D. SAND RC: a VP O C <br />NATIONAL POLLUTANT OISCHMOE ELIMINATION SYSTEM NPOE,SJ <br />DISCHARGE MONITORING REPORT (D R) <br />PERMIT NUMBER dscHMOE Nl1MeER <br />MONITORING PERIOD <br />FROM YEAR MO DAY TO YEARMO. DAY <br />1 I NOR <br />SUBF iC ) <br />- FINAL <br />'ROSPEC 1 BED PID/G <br />Form Approved <br />OMB No 2040-0004 <br />NOTF- Read hrtrue-Near ha1nro nneinlatino this form. <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 /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT --- <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAMEJTITLE PRINCIPAL EXECUTIVE OFFICER ' fe^""' Pe""? ° Iaw that Ulf doru"wM and all oltachwarnts were TELEPHONE DATE <br /> pmpared vender my direetlon a aarp i dslon In eccordanr< with ¦ fyalem designed <br /> <br />/ l to a m IhH que"flyd Penonne/ PtOW117 LstIMr and evaluate the Inf-clan <br />m <br />In <br />uir . <br /> y <br />q <br />sub-It ed. e.erd on <br />y of the Perron °e Penpa who nwere the fystem, <br />l <br />s <br />L ,- y re <br />or tbox pers.ra diml <br />Ponstble for gathering the Informatlea, the Information <br />L <br />(? E <br />C submitled K to the best of my knowkdge and beeef, true. ecrurate. and cnmpktr. J ! / <br />' 1 am swam that there am stgastflesol "Ides for wbmllnng War lnformadon SIGNATURE OF PRINCIPAL EXECUTM <br />TYPED OR PRINTED . <br />Inchsding the poaablllty of nne and Imprleonme,al for knowing eld¦tk n OFFICER OR AUTHORIZED AGEKT CARIA ODE NUMBER YEAR MO DAY <br />GVMMtN I S ANU ItArt.^MA I fvrl yr ^"y •tvt.n 1 lvrro Irtnsrmcs su snscnmsnu nsrv/ a PRE C -r H ? a <br />R PR?t r VE1VT I5 CLAI1IFD. IF CLAM AF',- r T4Y Wi <br />>JTS - SEE I. A..' c ... _; -,- <br />"NL,*TRI.JC T I0N5 <br />EPA Form 3320-1 (Rev 399) Previous editions may be used 145`is a-4-part f6rm WAGE OF