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!- Form Approved <br /> OMB No 2040-0004 <br /> <br />uwt <br />r HATIONAL POLLLUTMT OiSCHARGE ELIMINATION SYSTEM (NPDES) .., <br />SCHARGE MONITORING REPORT (DMR) i I J T,t_' <br />-1 <br />ore <br />AMITTEE NAME ADDRESS pwa.d.ferwox..r DI _v <br />MH ) <br /> DEL <br /> ascNAnoE NUMeEft FINAL <br />iTON <br />DDRESS <br />; <br />; PERMIT NUMBER <br />?: :-iTF TO DEE R TRAIL D <br /> ? <br />. <br />rJ I A - MONITORING PERIOD . <br />- <br />NO 2 i`1I11i Y AR MO DAY <br />Y R MO DAY . <br />„ <br />AGILITY <br />p _ FROM TO NOTE: Read Instruetiorw beftxs completktq this form. <br />l <br />DCATION <br /> pREOUENCV SAMPLE <br />E <br /> QUALITY OR CONCENT RATION EX <br />Ysls 'PE <br /> OR LOADING ANA <br />PARAMETER <br />M UNITS MINIMUM AVERAGE <br />MAXIMUM <br />UNITS <br /> AVERAGE MAXIMU <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />" <br />'A I L'r' fl <br />- F REQUIREMENT 3 . <br />0DA AVG <br /> SAMPLE <br />R1 `. MEASUREMENT <br />MAX <br />` <br />- PERMIT r d <br />aT <br /> REQUIREMENT ' <br /> SAMPLE <br /> MEASUREMENT c•• <br />(D <br />, <br />A MONT <br />H <br /> PERMIT <br />_ 3DA A'J <br />7DaF_ <br />t? X <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> PERMIT .?,? MA <br />X <br />IL REQUIREMENT <br />ACV V r r. v. . prepareu uroer -y . ;-.ti^r-- -- - <br />to .1m" that q.014 fled P;;;;; n ty Other and eraluale IM InrOrlMtlOn <br />sob, dtted. bawd on my "qulry of ntt Perron or persona aho tnaeate the system <br />thowperaorts dlnrttly respmtelbM for ?atherttsg the Information, the lefortrotlon <br />or - <br />submltted is. to the best of my kne.ledp and betlef, 1,,,. arcuate. and complete. ::5:10NATURIE OF PRINCMAL EXECUTIVE A A NUMBER <br />1 am a.an that there are d?niflcant prnalers for sebmHtlnt ra w Infornutlen. FFICER OR AUTHORIZED AGENT CODE <br />PRINTED lncl?ding the poedblUty of floe and ImpMonmrnl for knowing rtoladom <br />NATION OF ANY VIOLATIONS (Refsrr+ncs sat attachments had <br />TNs is a 4-part form <br />Drevious editions may be used <br />Gci <br />OF