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PERMITTEE NAME/ADDRESS p--&,kFartheyNww?[.or.tron (/D(P wd) NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (/NPOESJ <br />NAME - DISCHARGE MONITORING REPORT IDMRI <br />ADDRESS l__ . <br />3 1 : i i PERMIT NUMBER ascHAnoE NI.I <br />.'iEE?.ER <br />FACILITY O? V?" I `1 MONITORING PERIOD <br />LOCATION '1EtKER ?, YEAR MO: D Y Y A DA <br />FROM TO <br />4FL.LY 0 :iraiaOEi?S, VP OF UH.- <br />MING <br />Form Approved- <br />CWS No 2040-0004 <br />NOTE: Read Ir»dvctimw before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION No. FRE0UENCY SAMPLE <br /> OF <br /> <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS EX TYPE <br />" <br />- SAMPLE <br />MEASUREMENT / <br /> <br />d PERMIT :- - <br />'At -': REQUIREMENT I NST i`1.A HUN f t <br /> SAMPL E <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 /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> <br />PERMIT <br />REQUIREMENT <br />NAM E PRINCIPAL EXECUTIVE OFFICER ' Cer'IY ` v Pen' 1r ° I" lho thN docvtmeof and all attach is were TELEPHONE <br />l <br />DATE <br />Pnpand under my dlrecl <br />mt or sups,-Won In amordanct with ¦ 1711em ddpned, ' - _,_-- - <br />l <br /> <br />C Y ( la aamrn Thai quailned personnel Property gether and eeaiusle tai Inrnrnuuon <br />ru <br />I <br />r <br />p <br />d <br />e <br />d <br />i > 1 <br /> <br />- <br />- m <br />nqu <br />! <br />le <br />. <br />ase <br />on me <br />ry o <br />the person or pennru who m¦n¦1e the System, <br />Th <br />?1 <br />f e <br />_ <br />1 or <br />ar penwe directly -poredblt for gathering the Informalon• the Information ,, <br />J e' <br />'F' T <br />' - a <br />f I <br />' ` <br />;. '" <br />) <br />t <br /> fubmilted Is. to the best of mf knowledge and better, Irv,. --ft. and compkle. f i <br />/? <br />• <br />, ( <br />? , V . <br />- I am swan that then an dgdits"I penalHa for suberdifing W. information. SIGNATURE OF PRINCIPAL EXECUTIVE <br />y . , <br />TYPED OR PRINTED Including the posatbiiile.1 fine and Imprisonment for knowing .Iolauom OFFICER OR AUTHORIZED AGENT COE <br />NUMKR YEAR MO DAY <br />CVMMtN I S ANU tArl-ArrA 11VPr Vr Arm i •wLP% 1 tVnD Inero/Ince on Irrecnrnorlrs nerel <br />r --:R PRFCIP i:VENT IS CLAIMED. IF CLAIM APPRQVEP i:., lW1CD. <br />177 SEE I. A. 2. <br />13 I-R' lt: T ION <br />? <br />EPA Form 3320-1 (Rev 3199) Previous editions may be used Q! r'- ) . Thig ii -a 4-paO orrn. PAGE pF