Laserfiche WebLink
PERMITTEE NAME/ADDRESS R.,A.+ierlMryN?+rLor¦elew tfDj&-,c4 l ./ ZONAL POLLUTANT OISCHAAGE ELIMINATION SYSTE7yt rNPDESI <br />NAME DISCHARGE MONITORING REPORT (DMR/ <br />ADDRESS <br />_ t PERMIT NUMBER DISCHARGE NUMBER <br />KER <br />FACILfTY f- ?u MONITORING PERIOD <br />- l?i^fl YEAR MO DAY YEA M <br />LOCATION O DAY <br />FROM TO <br />=LLY D. BANDS-RSA vi OF ?. <br />v <br />Form At. <br />MINOR RECI IV ED OMB N, ' <br />t SUB.( <br />Y t: T "T <br />Vi Reclamation, <br />IlAidiCfg asld'Sa?ety ' _ <br />NOTE: Read kistruedom b*fw* complNinp this tam. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION No. FREOUENCY SAMPLE <br /> <br />EX Of <br />YPE <br /> ANALYSIS T <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE .. I I ) <br /> MEASUREMENT <br /> <br /> PERMIT - - <br /> REQUIREMENT SAX i MUM MCNT, <br /> SAMPLE <br />r MEASUREMENT <br /> <br /> <br /> PERMIT <br />REQUIREMENT <br />17 r? ? `? • 1 X <br /> SAMPLE <br />_ <br />- <br />1 <br />t <br />K <br /> MEASUREMENT . <br /> <br /> <br />- PERMIT <br />Jf? r".."(31 <br />DP. (!--'l MX <br />r - REQUIREMENT <br /> SAMPLE i ?) 11 <br />( / f <br />/ E <br />Ill ''? MEASUREMENT J <br /> <br /> <br />I PERMIT <br /> <br />REQUIREMENT <br /> <br />3C'? l--,V it <br />A <br /> <br />D!`e [ ' `. tiI X <br /> <br />i.7:4 <br />T <br /> <br /> <br />- <br />44 SAMPLE <br />T I <br />Id ?. r / <br />( <br />' <br /> MEASUREMEN -- <br /> <br /> PERMIT <br />REQUIREMENT T iVc' ct 7. _ <br /> -- <br />-4 SAMPLE <br />MEASUREMENT <br /> <br /> <br />i r PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> <br />NAMEfnnE PRINCIPAL EXECUTIVE OFFICER 1111.1y ¦ rr penalty 0(l.- hat this do[v 1 ¦nd all ¦tt¦chnwei, -m <br />Prrp.rrd under rnT dimcilon or wp,-WM In n ml.rerrr with ¦ sTflrm ddgned - <br /> <br />JJr?G- ?J r ~ <br />TELEPHONE <br />DATE <br />__ _ <br />?- % '?.' to wun th¦t ?u¦Mf1M personnN ProprAl [¦Ihrr ¦nd r, ¦lu¦It lM Infnrm.llon <br />!awd nn enr In <br />sob"lled <br />uir <br />of oK <br />erson m <br />ersoen wh <br />rr <br />lis <br />l <br />r ) _ -` <br />- <br />= <br /> q <br />¦p <br />. <br />y <br />p <br />p <br />o m¦ <br />t en <br />r <br />n ?? C ! <br />- w the r pre dlrrrnr -,tPoledble ror gathering the Inforwullon• the Inforu¦non -. e j - i :• - i - 'R ?- r <br />,L .. : : f7 ?- /•?, wbinltted b, to the ee?t of ny kn¦wUdg. ¦nd etMef, I-, ¦c„ent.. ¦nd -pkte. <br />I ¦,n .w¦re that Ihrrs .re dgnlnont <br />.mes f <br />e,emflnn <br />e <br />raker lnr <br />rm <br />tbn <br />SIGNATURE OF ?RtNCt?Al EXECUTfVE <br />J <br /> p <br />n <br />or r <br />r <br />o <br />¦ <br />, <br />f AREA <br /> <br />TYPED OR PRINTED <br />frirl"nj IM po,°el°'r o <br />f1m and lasprimn nt for li-Int .Wstic,e¦ <br />OFFICER OR AUTHORIZED AGENT l <br />CODE NUMKR <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Refero fco sp •ftechmonts hertrl <br />`t' : r <br />_,1=NT IS CLAINED. J•. , <br />I F r L Fa j n I.I_ ,}- 1. <br />r JEE I. A. 2, his 7 <br />L ?.J •' -- ?.I - ?iL <br />a,. ,!'S TRUC7IONS <br />EPA Form 3320-1 (Rev 3/99) Previous editions may be used .? C: (} ='-`' PAGE -