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PERMITTEE NAME/ADDRESS (include Facility NanwAacation ijDif/etwnt) NATIONAL POL UITANT DISCHARGE ELIMINATION SYSTEM WOES) <br />NAME &7; 4?pr ? / .561 e DISCHARGE MONITORING REPORT (DYR) <br />ADDRESS so00 ev., <br />1o PERMIT NUMBER DISCHARSE NUWEH <br />FACIUTY T MONITORING PERIOD <br />LOCATION YEAR MO DAY YEAR MO DAY <br />0 <br />co s ;cam ?„ _ ?? IOM 101 p 1 - "J /o 13131 <br />C = \?? ? ` Fo,,ppro <br />001 ?i, ?? N o1, o0Z A, oo3 A OMB No. 2040.0%; <br />cn? A, M N o4, 0o y W, too, R, oo8 R <br />idd Nos, oo'?A, MNOq,, 07-5A, 0864, <br />/?/I ,t) Z(n, O ZCo W, O AS A <br />NOTE: Read Instructions before oompbtinp this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION No RIEWBICY <br />F <br />OF <br />SAMPLE <br /> E <br />X <br />TYPE <br /> AIIALY= <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT :. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> ?IiREJ)IEIfT - <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT r a <br /> „ <br />, Y <br /> Ni6tAENT .; • <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT 747 T <br /> REDUIR6j1E1?1? - ? °4. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ,y.. <br /> REGIlIREMElIT _. ?s ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />RiQU1RFrMElLT ,.. .. .. <br />NAMEMTLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all attachments were TELEPHON E DATE <br />Je o77` ( <br />t]? yt S`? c' prepared under my direction or snpervwon m accordance with a sysum designed <br />to assure that qualified personnel properly Wtba and avduate the mfom uon <br />, submitted. Based on my inquiry of the person or persons who manage the system, <br />e <br />, or dwae persona directly tespownble for gathering the infa®adon, the information <br />G/? V 1 <br />1rJ77 e- er submitted is <br />to the bat of m <br />knowled <br />e and belief <br />accurate <br />and com <br />lete <br />true f o 0 <br /> , <br />y <br />g <br />, <br />, <br />, <br />p <br />. <br />I <br />h <br />i <br />f <br />i SIGNATURE OF PRINCIPAL EXECUTIVE 9,z) 675-43 <br />F <br />TYPED OR PRINTED am swats t <br />at there we s <br />gnificant penalties <br />or subm <br />tting false information, <br />including the possibility of fine and imprisonment for knowing violations. <br />OFFICER OR AUiFIORUED AGENT <br />MUMMER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND E) LANKROW OF ANT VIVLAnvNS (finerenee aft amenmews nere) <br />!'??'cz? S? ffloY? ?iy? o? irrS?r??f fo r?'°r? ejrvr, l c?t??? <br />T PAGE OF <br />iY:.1`. ??c scQ, kv. .. . .1 .v.n f.,., <br />E'r^, •'OffJ. i,V?i F'7rv,Gi1S EC,;tGl:o ii