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PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different)
<br />I4 NAME-NE :7 C
<br />ADDRESS .)yira .. s1?13L! PRO JEC-F
<br />FACILITY m,
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<br />LOCATIONGA F}_ ?;= l ry `
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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (DMR)
<br />F, _ 41
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD ..
<br />YEAR MO DAY YEAR MO DAY
<br />FROM ;, C TO 1,
<br />Form Approved.
<br />OMB No. 2040-0004
<br />C C '_f 731•' i'?::;r •1 ., ..
<br />f7 MESA
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<br />NOTE. Read Instructions before completing 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
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<br />SAMPLE
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<br />V E Y MEASUREMENT
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<br />PERMIT
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<br />SAMPLE
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<br />©tyMAr{ MEASUREMENT
<br />11123 1 PERMIT #.?#### §?t#?t c f 3F 3F DF#3£ #i# 3F#lt t4 200 REPORT tE EKLY -OM!'05
<br />F ')'s"ST• C''FC,r', ) REQUIREMENT ! s OU_A PTV I3, IL.. t fI_
<br /> SAMPLE .tzt ...??. d..>r u :b? ,. :{ # i s? •3t t 17)
<br />28, j•O'!••Ai MEASUREMENT
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<br />1 1 50 3 i C, 0 PERMIT #r? ik ? # kF ks ? ?t 3F 3F# Ki tt 3Fit it :i # # # 3* i # si i? 3i sE ?i C I f tw ? E 1^,I _Y ?JI 7F' {.:?Lm+
<br />F F'L UEN T C=;R t-',m: 3 'JALtJE REQUIREMENT #: f #• f I?mot l l_..l 3:d }(
<br />iR A fl T t'i 9, TUI'VAL. Ar-3 C :=- SAMPLE h :F ii ii i # ;t t i y : ?t =# i 3t k = t 26)
<br />B MEASUREMENT
<br />rG' PERMIT #'#3fr### if # 'h # k #3t si#34: 700 ? 100 b? t? f41_Y s?7lltat?
<br />:FFL.Us. NT GROSS VAL..C F REQUIREMENT ?.3[ tt # :300A AVG ) . t€ -o !_ y rix ic-,1,[r.
<br />LOW, IN :C:iiCAJI'r OR SAMPLE ( O:') 3 #3#?#st3t t?lt•?tt#9t +; ,• *:? ?:????t
<br />: HRU T F.E A rMENT PLANT MEASUREMENT
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<br />5 0 0150 1 PERMIT C3 R)`I='??T" #3fiF##IS #f#71 f3Exf ? #it=?E## ##lt 4 0NTIN ECLJRDR
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<br />EFFLUENT GROSE; VAL.t r. REQUIREMENT aODA AVG DAILY MX 1G•T #### S.7UldC,..?''
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<br />DISSOLVED MEASUREMENT
<br />70295 1. 0, t:') PERMIT ii #if sf?F# 3F?#?Flf# E t## ###### REPORT REF'F?l?it (' 4 h?L.Y ir?A13i
<br />EFFLUENT tGf?C3?`+•,'"s 'v'!•?tLl1!` REQUIREMENT L-iz-tt # ?UL?x;
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<br />EMAND ;,017) MEASUREMENT
<br />31017 1 (i r.+ PERMIT K $F#3t 3F# ##? ? ti3 flit 3t ttiE# 3@#t3E 34iE38 1100 200
<br />t?S?`LY
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<br />EFFLUENT G?tOS j VALUE: REQUIREMENT k ## 30UIr4 A{JG
<br />DA ti_1' I1X
<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all attachments were TELEPHONE DATE
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<br />??''? prepared under my direction or supervision in accordance with a system designed
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<br />submitted. Rased on my inquiry of the person or persons who manage the system, i
<br /> or those persons directly responsible for gathering the information, the information 111 '.
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<br />Piz submitted is, to the best of my knowledge and belief, true, accurate, and complete. SIGNATURE OF PRINCIPAL EXECUTIVE ` -?? "? t •'? ' ^
<br />
<br />-
<br />TYPED OR PRINTED 1 am aware that there are significant penalties for submitting false information,
<br />including the possibility of fine and imprisonment for knowing violations. OFFICER OR AUTHORIZED AGENT AREA I
<br />CODE NUMBER YEAR MO DAY ''•.
<br />COMMENTS AND tXF'LANAIIUN UI- ANY VIULAIIUrvS (lieference all arracnmenrs nerej
<br />{3Uft4Ft1' '._.'r ,`ar^e1'''11=i.!TNG & R..EFORTING 'lN5•i"wJCTION1 " E I_ C. 9, PAGE 9. OIL AND GREAS). --- SEIE x C. 15.
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<br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. 0 OO 7 4 /0-Y6RLg g,41 P 1110 tvnn- PAGE Z2 OF g,
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