Laserfiche WebLink
q <br />PERkjITTEE NAME/ADDRESS Qn 1.,d. Facltuy N ..ea cwiw, fDyfwenr/ <br />NAME <br />ADDRESS ?lje'i??r2teYu ??rN <br />C)7 G Z CvS <br />NATIONAL Pouumwr wsc"AmE Euw4ATwm syum (NPOES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE mum <br />Form APPro r . <br />OMB No. 20400894 <br />FACILITY 61 T 0 MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />LOCATION <br />FROM <br />/0 o? o f iD o3 131 <br />-•^1 ?? co S iC?'tl? NOTE: Rwd lasbudlons before complel ft this form. <br />i, <br />PARAMETER <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />N <br />O. <br />RIEGUEKY <br />AMPE <br /> C 1 <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYM <br /> 3ov, ? y M <br />AS <br />E 4 <br />03 l0 1 <br />/ 4 c Z.C,) a Q i 3 <br />/? <br />O <br />C <br /> E <br />NT <br />UR . , 1 <br /> <br />f c <br />s <br />/r PERMIT Re- f w^t~ <br />3 <br />b . <br />aS Re (Z <br />?o?? oAcel <br />re-? <br /> z- <br />e "d <br />?w q <br />1 3w 1 ? X : /lbY 30 ZZ &,4)( o.,,m, <br /> <br />t rb, th rw tre di?teV <br />;:,-/o SAMPLE <br />MEASUREMENT (03) <br /> p ref <br /> <br />ez. 6 <br />I <br />PERMIT <br />F <br />Wi <br />E <br />T <br />?v r <br />36 !! <br />V <br /> <br />, F <br /> <br />t <br /> u <br />vo : s ?o WW <br />M <br />M . <br />Cq zL Ma <br />> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />FWAUWA <br /> SAMPLE <br /> MEASUREMENT <br /> psaw <br />?p <br /> SAMPLE <br /> MEASUREMENT <br /> PtsRYIT A#• <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT :.,. <br /> Rf5CUIR?1off <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />FRWW"U i fEtiT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFRCER 1 certify under Penalty of law that this document and all attachments were T ELEPHON E DA TE <br /> Prepared under my direction or supervision in accordance with a system designed <br />to assure that qualified personnel properly gather and ovaluate the mformsuon <br /> submitted. Based on my inquiry of the person or persons who manage the system, <br />or those persona directly responsible for gathering the information, the information <br />n ?r ?C7 77 e <br />?J??ir/a /? submitted is <br />to the best of my knowledge and belief <br />true <br />accurate <br />and com <br />lete <br /> , <br />, <br />, <br />, <br />p SIGNATURE OF PRINCIPAL EXECUTIVE <br /> n aware that there we significant penalties for submitting false informaban <br />TYPED OR PRINTED in <br />ding the possibility of free and imprisonment for kmowmg violations. OFFICER OR AUTHORIZED AGENT NU f YEAR MID <br />DAY <br />N13 AND EXPLANATION OF ANY VIOLATIONS (nwwance all attachments here) <br />l???z S Sae-,e 00gnt-e 0p, ir15'7?i-uG? r?r? e%rcrn ? clZ??? l? <br />F::.. Fon .. . -9,'o Pwv;ous edit ons mati ov. u:,ea. Th;, i. , .t .,•.., te,,•,., PAGE