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PERMITTEE NAMEIADDRESS (Include Facility Name/Location if Different) <br />NAME <br />:?;'.%-:` i w. t-i:.?,._.:?•: Iota , •w i • ?: <br />ADDRESS <br />FACILITY <br />Uv" <br />LOCATION., i'v! i,\? "t a4 L f rr s <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO , i.; Q -3' <br />Form Approved. <br />OMB No. 2040-0004 <br />$':L. l% <br />:?'?•.i*. "1.`i'? ? .L .'"b. ?.. • 1/ yid ? ,.... ?. 1 s. <br />NOTE: Read Instructions before completing this form. <br />a rt7: tr-s:;t ,, 1'., , ; C-AlkN N0 FREQUENCY SAMPLE <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION . OF <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />xy SAMPLE :F :... '• 3 :r•s r{ p:?:.x...ti.•r a w R <br /> MEASUREMENT <br />ln,nPyf r: =) PERMIT <br />t t' h I rr? ?o%' tt= REQUIREMENT ! °'t ' air t r t :r g t ?{ ' r 1, t } <br /> SAMPLE ". ,:.: .: n..... •. '. e.,. ti r k? c tr r_ ? ?' a <br /> MEASUREMENT <br /> <br />n r, n PERMIT f. <.' ;z• t'::: _#411 - <br />::..F; <br />it ... ...... <br />"; <br />t• t <br />o. <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />., <br />t,t-? t i3 <br />PERMIT <br />:? <br /> <br />4 <br />x a b ^ r:>€3 53:51?1,I?w REQUIREMENT i x:; ?3 d .?a kJi:I I ;i ; Fit-! <br />?. '•(`i ?'.,? 1_ SAMPLE <br /> MEASUREMENT <br />2 ? tw I PERMIT <br />r• F g'' F, V REQUIREMENT <br />t :'' S• O:R SAMPLE ? ? •i£•ro: •t>•sFrw• ?z'•I'.-'? :: ?t 'F` :€••?;•S#••;£rK-: <br />i ;,..(1rr= ?p <br />T <br />? 'i`, k+t U A A MEASUREMENT <br />? <br />s I?l3 <br />ti t?f PERMIT i..re ' ?.w ai j ?'J:? J tir .: la1'?: 3 is .. .? .g c''i 6 a?F' 'Y .•~ <br /> REQUIREMENT `? " 1i. 1 1 4 'r p ?cf Y j Y <br /> <br />!„ <br />COIF <br />'s. <br /> <br />t N } "1• ? }? }?. <br />v"^ <br />SAMPLE <br />r7 ! YC _ ' <br />F ? ? ? <br />ii 3:' i •.:r <br />a; a. a %'"-is <br />iY.n 94 H ? <br />T MEASUREMENT _ <br />?A y SU <br />A!._ <br />s, i^ <br />` PERMIT <br />sFat <br />a REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty orlaw that this document and all attachments were / TELEPHONE DATE <br /> Prepared under my direction or supervision in accordance with a system designed <br />q aq <br />,,??r`A? `?"e'• to assure that qualified personnel properly gather and evaluate the information <br />. <br />C` ®d i Fp A 6 <br />?/C submitted. Based on my inquiry of the person or persons who manage the system, <br /> or those persons directly responsible for gathering the information, the information - .'•'?? <br /> <br />Y P l / <br />submitted is, to the best of my knowledge and belief, true, accurate, and complete. <br />SIGNATURE OF PRINCIPAL EXECUTIVE * n <br /> I am aware that there are significant penalties for submitting false information, AREA <br />' <br />TYPED OR PRINTED including the possibility of fine and imprisonment for knowing violations. OFFICER OR AUTHORIZED AGENT CODE NUMBER fE <br />A MO DAY <br />COMMENTS AND EXPLANATIUN Ul- ANY VIULAI IUNS (Hererence an arracnmenrs nerej <br />T0 i ''?:f'S Q 1 i' i ?t_» £;:s :": 3 'f N1 <br />0N, T <br />r . • 3; ,T t.t? _ _??; >r4 € j c c ai 4 S LIZ J CY T r t <br />t t' I ?tza _s s>._?.i+, t r t) ?'? vi :-H 1 .fir vt?? 4 <br />t t A Y AKC 1 l i :,! "L b "44'- .._ ii, L. '.f . , 0 t:jM- U,' 49 ; i!",;VR . <br />rs. <br />?N s 1 S? rm. PAGE ,OF <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. r"I °_ :-. r / _ . • -? .•