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PERM ITTEE NAME/ADDRESS (Include Facility,Name/Location if Different) <br />NAME z 1 _ ,. ;fit t ': CORP <br />ADDRESS '10<41'',J IND PRJJ1:°.l T <br />cn f-' <br />1,424- <br />FACILITY LOCATIIONG , E t ! A;';' <br />"r 7'•i i :J -'.rJ 1. t{1-11 .. ?':. ??z . 1r400 <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) ;. <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO D Y YEA O. DAY, <br />FROM ?r a TO r r u;y <br />MINOR <br />( S! BR DW ) <br />F -- FINAL <br />Form Approved. <br />OMB No. 2040-0004 <br />MESA <br />CHRONIC _ 1'E5T I €dG FOR 001A <br />kl# NO DISCHARGE (XI #•#•# <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION Np; FREQUENCY <br />OF SAMPLE <br /> E X TYPE <br /> ANALYSIS <br /> _?VERAGE MAXIMUM UNITS MINIMUM AVEFIAGE MAXIMUM UNITS <br />C x SAMPLE 4 # # ?S rr #I i% r #. #: t• 1£ 3# - :: ?t C La <br />I Mr PHA'1 FE7' GI ! Ci = T :; MEASUREMENT <br />. -Pc i = r, ; •? <br />PERMIT .I;. Y.•iiTi•# : #• i # - -fi• #'•#•# }-r:•s: R- i.'R'•R'•R HI ONC <br />_ <br />EE CCI?" ': z IT`,=• E1.DW REQUIREMENT MN VALUE TOXCT . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT " <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ?. <br /> REQUIREMENT <br />t <br /> SAMPLE _ <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT I <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT ' <br /> PERMIT <br />r <br />, <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all attachments were <br />h TELEPHONE DATE <br /> <br />SrPH Ell! /TCrU y a system designed <br />prepared under my direction or supervision in accordance wit <br />to assure that qualified personnel properly gather and evaluate the information <br /> <br />? <br />j submitted. Based on my inquiry of the person or persons who manage the system, <br />? <br />? <br />/?? <br />7? •r??- <br />?? or those persons directly responsible for gathering the information, the information Q <br />? ,o <br />I <br />' <br />. <br />r ?C_ C? 5/t ?? <br />V true <br />and complete. <br />submitted is <br />to the best of my knowledge and belief <br />accurate IN J ? <br />( ?' ?tJ l <br /> , <br />, <br />, <br />, <br />tion <br />h <br />t th <br />i <br />ifi <br />t <br />lti <br />f <br />b <br />itti <br />f <br />l <br />i <br />f SIGNAT PR <br />CIPA L EXECUTIVE <br />URE OF <br /> <br />TYPED OR PRINTED , <br />a <br />ere are s <br />gn <br />can <br />pena <br />es <br />or su <br />m <br />ng <br />a <br />se <br />n <br />orma <br />=are aware t <br />ncluding the possibility of fine and imprisonment for knowing violations. OFFICER OR AUTHORIZED AGENT REA <br />ODE <br />NUMBER <br />YEAR <br />MO <br />DAY <br /> <br />I COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SEE rim R _ s=0R. Y' z -A L 0I TE ti PR0CEDURr- IF' THERE IS A STAI DIFF . RPT RESULTS ON THIS OUTFALL. IF <br />NOT, R;3r ;'TAO DISCHARGE" Y. CONIPLE'"E OUTFALL. 00I..t. RPT LOWEST .AT* WHICH STATISTICALLY SIGNIF DIFF LTWN <br />:. t? 'r,r?• -t'sr,:: :c s7irs`r' rC x, tlrs3EVi' t:nDF• ttp:+ Tt'1n1= 1t 0',' ATTA4 H Ci••-iRON TQX TES-1- RPT To DMR. <br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. cjC;f?6 f Ct+11?;I??$ 4?par$riri• PA OF cT <br />O <br />;:.