Laserfiche WebLink
I ` <br />` PERMITTEE NAMEIADDRESS rlnrlude Furililr \mnr;L.,arr,,,, hif er,11 <br />PIAME <br />ADDRESS NIE <br />FACILITY <br />LOCATION <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPOES) <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 />NOTF- Rparf Inctrurttinnc hnfnra <br />F.,rm Approve <br />OMB No 2040-0004 <br />Chic fnrm <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREQUENCY SAMPLE <br /> OF <br /> EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT a <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE ll <br /> MEASUREMENT C <br /> PERMIT <br /> REQUIREMENT i <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 />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I rrrlif colder prnau „r L... th:,t u... A,.t1n rm.nul au auaelrotem. "eft <br />d TELEPHONE <br />DATE <br /> Prtparrd un <br />er nn <br />dtrrchun nr wpm i.am in acrnrdanre eith .. .. qrm Ar.il;md <br />.: - tu,nwn• Thal yualir-1 penunrid pn,pr•rl. g:uhrr and r. 1-tr thr information <br />- - tit itu d. Bard nu , inywn ur the Irtrmn or Irnun. who nwna)a the -wits. ?` - <br />? <br /> ,.r III- Ia•non• dirtt 11 rr.Iwmihlr fur path-mg Ihr inL,rntal III, mfurmatinn r• - <br />_ / _ -- <br /> .uhmiltrd i<.lo the 1-14- Lnnabdg, and IK-10. true, accurate, and conydelr. <br /> <br />I ant awa, that II <br />nificaul <br />-wii <br />-' <br />-i <br />, h <br />h <br />i <br />ti <br />l <br />f <br />i SIGNATURE OF PRINCIPAL EXECUTIVE ) Q <br /> <br />TYPED OR PRINTED I <br />r <br />g <br />1 <br />,r w <br />m <br />nK <br />r <br />t <br />a <br />.c <br />n(orntali„n. <br />inchxliny the F-ov ,hn of riot and impri-.-.t rut k.- L <br />.ada[i.nn <br />OFFICER OR AUTHORIZED AGENT AREA <br />NUMBER <br /> <br />YEAR <br /> <br />MO <br /> <br />DAY <br /> CODE <br />.:r rTL-L: <br />PART Z . <br />...... : P EVEr <br />DURDEN OF PROOF REGOIRE <br />EPA Form 3320-1 (Rev 3/99) Previous editions may be used. 000 50/