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PERMf1TEE NAME/ADDRESS rInrludr Facilin awn, ruann i/ Ili((rrnu <br />NAME <br />ADDRESS <br />FACILITY <br />LOCATION <br />%[: 304 <br />I=ra, I r4EER <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDES) <br />DISCHARGE MONITORING REPORT (D R) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />Form Approved. <br />OMB No. 2040-0004 <br />?sLtvTT <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREOUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br />MEA <br />-4 4'" <br />:4 <br />T <br />) <br />(,4 r` I <br /> SUREMENT . <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br />A <br />R <br />M <br />T <br /> ME <br />SU <br />E <br />EN <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br />MEASUREMENT <br />'+F? <br /> <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br />"- <br />- <br /> MEASUREMENT r.; - <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br />I?? <br />r <br />J `7•^t? <br /> MEASUREMENT . <br /> PERMIT , :r a rt ; _ ?.. r <br /> REQUIREMENT <br /> SAMPLE <br />T <br />- J5 <br />' <br />Ci <br /> MEASUREMEN - y <br /> PERMIT <br /> REQUIREMENT - <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER I .rrtif.% under penally of law that this tl,wumc•nt and :dl attachments were <br />pre <br />ared under n <br />rrski- in arcarda., with a -1- desi <br />diraclion or u <br />ned _?, _ TELEPHONE DATE <br /> p <br />q <br />p <br />g <br />I <br />th <br />t <br />th <br />s <br />l <br />th <br />tio <br />t <br />lif <br />d <br />l <br />d <br />l <br />i <br />f <br /> <br />C ? <br />1 <br />? <br />. <br />?? <br />- - n A 'sure <br />a <br />qua <br />ie <br />per.nnne <br />prnf <br />erh ga <br />er an <br />r <br />e <br />n <br />orma <br />n <br />e <br />a <br />ua <br />submitted <br />Ram- dun me m <br />utn of the person or p-on% who manage Ihr .,slrm <br />? <br />_ <br />_ <br />_ <br />, . <br />. <br />q <br />_ or those ro,.ons direct) responsible for gathanne the information, the mfornmtion <br />r <br />- <br />? <br /> snbmiu d is, too the heat of me knnwiedee and belle!. true, aacurale, and complete. c <br />_ <br />I <br />I 1 j <br />_ I <br />.m ,,,are that there art st <br />nirwani <br />,ualti- I- uhmillim! false information SIGNATURE OF PRINCIPAL EXECUTIVE <br /> <br />TYPED OR PRINTED . <br />g <br />p <br />. <br />irwludurg the puscihifily of fine and impri-run-t for knowing violations. <br />OFFICER OR AUTHORIZED AGENT AREA <br />ODE NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />1 / This is a 4-part fonn. <br />EPA Form 3320-7 (Rev. 3199) Previous editions may be used. -•