Laserfiche WebLink
PERMITTEE NAME/ADDRESS (Include Facility Natne/Location if Different) <br />NAME il? = 7 C 1'CF <br />ADDRESS <br /> <br /> <br />FACILITY FRiaJ-1-CT <br />LOCATION <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />?/••++ ntDISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM C- 9i? w 3 TO F; ' 1 7 <br />Form Approved. <br />OMB No. 2040-0004 <br />i'I G> LJ t,a <br />Di-11) TROi-17 NOTE: Read Instructions before completing this form. <br /> <br />+^i i F?; ; :9 '! `.`•:°.l'I 3^+:4t:? ?! .'9l.Jt=! Y t :'.tom 't% t"'; L.'_i[..i <br />NQ <br />FREQUENCY <br />SAMPLE <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION • OF <br /> EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />ra.j SAMPLE <br />MEASUREMENT <br />I <br />t <br />s? <br />?? <br />t` <br /> <br />"tr?« ly i PERMIT <br /> REQUIREMENT ,?•rr'r-? j.. sa , , Y. _.? i .. .; +. ..+ <br /> SAMPLE V. <br />n ; , <br />,? <br />r 9 <br />r <br />r t? <br /> MEASUREMENT t; 3 <br />D. ^$ F <br />,1 <br />• PERMIT ?d•tiF f....: YP <br />a• , <br />« <br />4 7 6r 1!i "''d= kl !u_ik' REQUIREMENT <br />t c 1',trL.`!t Te. r: ie; c'. SAMPLE <br />MEASUREMENT I .:..4t? r: .. .. ..;L'Fc nt1r^:vtk <br />. ) g t`c <br />ley P?? <br />?? E p <br />''?'G"SS' t ? <br /> , <br /> <br />PERMIT F <br /> REQUIREMENT <br />17, iq ti. fL SAMPLE ?:,.: ra. :?s.JC.?-.;s.? 'i±.;• = ^ <br />1 i r3? n: ?,' t^i o0 P <br />? <br /> MEASUREMENT 4 r° ' <br /> <br />D <br />ar0 11-2 0 PERMIT : A .. _. _.. ., <br />. <br />r 7; <br />;0 F, REQUIREMENT x .. 1 t l.;+ <br />,, (^ ? <br />rr <br />% " " ! <br />??3C SAMPLE <br />MEASUREMENT iS::.t":_ic 3 sF#»;x. c;;4?$sc?f <br />4 < r'? j <br />???6 <br />h t ti "?:J w <br />? <br />?iOJ1-7 , R 0 <br />4 PERMIT `tom w .aa ki as . . asl.i <br />. <br />t ?, r, ,1 <br />^?r?±r?c <br />+S ."I V' <br />S ? ! GR a REQUIREMENT , <br />. <br />« <br />Dlvl s F 111W SAMPLE <br />11 <br />? <br />ll <br />r > ?? MEASUREMENT . I <br />4g t <br /> ? <br />, <br /> PERMIT <br />• i <br />a <br />3C}a <br />4 <br />t?rl1' w,'4'`'`? °+?i..L?F=' REQUIREMENT {. .r•:i•?:'• `f?`..+.. V41 <br />r <br />' <br />S, <br />t r,.. f???ir? rSw 4 is SAMPLE rat. r???Tiz *. :4'b..:r.> r.. ?,'•.. 1, ., .., ., ? <br />ty n ?? <br /> MEASUREMENT I <br />T t y ! ? PERMIT <br />;"=? , i l t4. 1 VA L REQUIREMENT <br />9 <br />..t. <br />PRINCIPAL EXECUTIVE OFFICER 1 certify under penalty of law that this document and all attachments were -? TELEPHONE DATE <br />NAME/TITLE prepared under my direction or supervision in accordance with a system designed <br /> to assure that qualified personnel properly gather and evaluate the information ?r r <br />? <br />s <br /> <br />, <br />submitted. Rased on my inquiry of the person or persons who manage the system <br />the information <br />tion <br />th <br />i <br />f <br />th <br />i <br />ibl <br />f <br />? <br />,a <br /> <br />/a <br />,e+ <br />I ? ,?, , <br />n <br />orma <br />or ga <br />er <br />ng <br />e <br />e <br />or those pemons directly respons <br />submitted is, to the best of my knowledge and belief, true, accurate, and complete. _ <br /> <br />SIGNATURE-OF ORINCIPAL:EXFCUTIVE t I <br />r ?j (? <br />/ : t? / f!4 (5 <br />? <br /> <br />J <br />? <br />/ <br />1 am aware that there are significant penalties for submitting false information, <br /> <br />OR AUTHORIZED AGENT <br />AREA <br /> <br />MO Y <br />TYPED OR PRINTED including the possibility of fine and imprisonment fur knowing violations. OFFICER CODE NUMBER YEAR A <br />DCOMMENTS AND LAF/LAIVA111LIIV yr AVIT vIVLAMA-40 (nCIGIVIILV all <br />aunt nn/c/.w .?. `? <br />'j1*o-.FtTER!_8' l?lfl it •al+.3 ° ?., WL-i• OPI T TM SEE X. ?. 7a Pn(_)4: 1:?. <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. <br /> <br />n?tl-t`-°f 15?s? 4.- aCtaform. PAGE OF -,q