Laserfiche WebLink
PERMITTEE NAME/ADDRESS driclude Faulk) A"amelbwanon it Piffennn <br />NAME <br />ADDRESS <br />FACILITY <br />LOCATION <br />ti E <br />Iv I "&E <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOES) <br />DISCHARGE MONITORING REPORT (DMR) <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 />MI <br />J <br />r' <br />SU <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NQ, <br /> <br />EX FREQUENCY <br />OF SAMPLE <br /> <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <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 />U <br />< <br />/I <br />r <br /> MEAS <br />REMENT <br /> PERMIT 7T-Tr <br /> REQUIREMENT <br /> SAMPLE 2 <br />? J? <br />1 Z t z <br /> MEASUREMENT - - <br /> <br />PERMIT I, UN <br /> REQUIREMENT f A` Al'VI UOii <br /> SAMPLE / <br /> MEASUREMENT <br /> PERMIT t- 11 L I , + <br /> REQUIREMENT IDA I L. 'r <br /> SAMPLE <br />I <br />C t <br />I ?.. <br />,R <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT I_ `' - <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certih under penalh of law thal this da umem and all alt:xbmens were <br />prepared under m <br />er.i,,i,,n in accordance oith a % <br />%lem desigmd <br />dirrtion or,u <br />?• TELEPHONE DATE <br /> ? <br />p <br />i - ?.- <br />-) <br />C la mwre that yu.dirwd penonnd prnperh gather and rvuiuute The information _ <br />l ? <br />J <br />, wbmitl d. Nusevf on mr inyuir) of the lwl,,n or penun, wh,, manage the <br />.y.h•m, <br />. ?1 <br /> nr th,ne prisons directly respmsihIe for gathering the infurmati,m. the information <br />\ submitted ice to the bl: t of rn Ann-ledge and tn•1ier. true. accurate. and rnmfdNa - •- - .j - <br />' `"C enalties rnr subrniuing ruts infornmtion <br />12111 Mare that there areci <br />nir-ut SIGNATURE OF PRINCIPAL EXECUTIVE - <br />TYPED OR PRINTED p <br />. <br />g <br />including the possibillty of fine and imprisonment for knowing siolatinas. OFFICER OR AUTHORIZED AGENT <br />- AREA NUMBER <br />CODE YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. " 'f'? (-nis'I.'A 4-part form.