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PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different) <br />NAME .??•G I E E'83 0Q. RC; E w L.,a C <br />ADDRESS {]{??" {}? <br />P, ul. <br />PAUNI (- <br />FACILITY? 15dsF)I1tiS"`S <br />LOCATION P A-0 14I A t?•? I? 1 420 <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 3. Q I L TO I -L w t.f`. 'Q <br />Form Approved. <br />OMB No. 2040-0004 <br />M I NOR <br />(SUBR 11H) <br />F - FINAL OrELTfi, <br />DISCH TO FARMER DITCH <br />NO D, Sia{'••iAI•'eOE I 1 yt?.r'r <br />NOTE: Read Instructions before co pleting this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY <br />OF SAMPLE <br /> EX TYPE <br /> _ ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />?H SAMPLE 1 7# liii #3E s Ib r i£ Y! ?c 3 12) <br />/ <br /> MEASUREMENT 7, 7 s I!7 7 IN <br /> PERMIT 3t`,, ..KF?# $',, ::!, :• f ? s t. .: n . <br />•rl:' -t) T foR13S..03 i0fLU REQUIREMENT rri#t r1iIINIMUrv1 I'ai"??a.C{•'tU1-7 S{I <br />3iW- I Cpt <br /> <br />SUSPENDED SAMPLE <br /> <br />MEASUREMENT '#•t <br />7 . <br />{ <br /> <br />( <br />1 <br />! <br /> <br />rpb <br />0 PERMIT $??k s 3t 3S '?w #€ tt t it # ?' #IE f' ? #x ?i? 7.1-0 !5 <br />EFFLUENT aRnss Vr"+lLL1T REQUIREMENT' sF'i # •;•. =;r" a <°V Hrk AV 1''° G.' <br />50L s. D':a Sr" i'TL.EAa1B. L.E SAMPLE 2£ Lc• F 4t 9k ti5 rs ?f # e# Y: 3i . ( 25) <br /> <br />r <br />/?• -// <br /> MEASUREMENT 2, C91P/+? <br />)C ?: ° '} PERMIT y#yx It k ,z c f'r **1: na a? x r>L ' j1"' mot 0i. :C, / fisS <br />EFFLUENT DROSS V 1._C la° REQUIREMENT: ?a # ti' t ', r3t'4' }f I L Y NX M 1-'-'L <br />MONTH <br />. <br />31L (=,f•-i?} SAMPLE ??u.?•L.q#?. 3r,?? i3#:• 3f k3#» ?'; ?r#?.?? ' { $'?: ) <br /> MEASUREMENT v a C b h& <br />; ' r' 1 £; PERMIT :- f $? t r.;;. :i 3q }y ct2 1£ : Ci s 3'r ? ? art .` T IN <br /> <br />EFFLUENT VALUE <br />U <br />S <br />REQUIREMENT # x so# `3... MAX <br />"t( <br />)') <br />??-, • f t <br />.. <br />1's <br />C`^'I`4I-'(' <br />W, ai't 4"".{.A;1,! UIT OR <br />1=LC SAMPLE { 03) <br />Ifi?lB?f%iit <br />?i ?fir?>ft <br />Ak3eY;3:sP <br />. <br />°I HRU TREATMENT i.IC...AN MEASUREMENT 0.0n3q <br />O, <br />h -r <br />Ct i PERMIT 1RCI?1 C r x.! }?c t n az_ K. T # a:' 3e i!t 3;x i :(?r•I T ri`"t ttr;-r <br />F F t3='N`I"' ?r.0Q,5 VALUE REQUIREMENT r;..y pi !-,Go <br />311- tel5'',i'il;i' SAMPLE n4fikt3r { 741 € °iiil i£• "k#:4# ??#! pia <br />Y <br />VISUAL MEASUREMENT ? 7 <br />34,066 <br />PERMIT r ":z or <br />I`.?a 'V <br />ES= I scI k :3z k G• ?#3£i#? # k- r?r•i i•# to i I 3' . <br /> <br />- ?. ur€3t <br />" t°1. 013"t" F'C t'i3.1;)=, REQUIREMENT' a .. ..s ;"'IAX.. 1;4)=C} s z i'iC31d ?3 <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />7 <br /> REQUIREMENT <br />NAMEITITLE PRINCIPAL EXECUTIVE OFFICER I crrtiry under penalty of law that this document and all attachments were <br />i TELEPHONE DATE , <br /> gned <br />prepared under my direction or supervision in accordance with a system des <br />r? <br />/ . I' I, t ? ec di'' Te <br />1 <br />Imo/ ? <br />J <br />to assure that qualified personnel properly gather and evaluate the information <br />h <br />. e system, <br />submitted. Rased on my inquiry of the person or persons who manage t <br /> responsible for gathering the information, the information <br />or those persons directl <br /> <br />,?'p ey, [ O <br />l/ 'f` <br />P y <br />submitted is, to the best of my knowledge and belief, true, accurate, and complete. <br /> <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />?• <br />Z <br /> <br />T <br />j - <br />. 1 am aware that there are significant penalties for submitting false information, REA <br />TYPED OR PRINTED including the possibility of fine and imprisonment for knowing violations. OFFICER OR AUTHORIZED AGENT <br />CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />: '1 t£ ?' VI r fi'?as `zs L11`1.IT WAIVED FOR 10-YR.• 24HR PRECIP EVENT Si.!?3JF''CT TO 1rUI-JDI-- N OF PROOF REQUIREMENTS lilkl <br />PART I. B. 6. ANY ADDITIONAL DATA SMALL. 13E SUPPLIED TO TfIE DIVIaTC:N WITHIN 48 'HOURS. <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. Des0 /-1 1a/OT-hisj1?;4'4-parcform. " AGE fOF