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PERMITTEE NAME/ADDRESS (Include Facility Name/Location ifDierent)
<br />NAME # . ,, iir.I. 3 El,) t l?fiF'.
<br />ADDRESS idHIRL_WIN PROJECT d
<br />FACILITY
<br />LOCATIONt±. AT E`h_ ,
<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 i ;. Tp ?. :.
<br />Form Approved.
<br />MINOR OMB No. 2040-
<br />( TIUBR DW )
<br />M IESA
<br />€' -- FINAL Ci. RONIC WET TESTING FOR 001A
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<br />NOTE: Read Instructions before completing this form.
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<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 />FPA+- prepared under my direction or supervision in accordance with a system designed
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<br />submitted. Based on my inquiry of the person or persons who manage age the system,
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<br />SIGNATURE OF P INCIPAL EXECUTIVE
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<br />including the possibility of fine and imprisonment for knowing violations. OFFICER OR AUTHORIZED AGENT AREA
<br />CODE
<br />NUMBER
<br />YEAR
<br />MO
<br />DAY
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<br />COMMENTS AND EXF'LANAI IUN Ur A14Y VIULAI IUIV, (rrererence an ar[acnmenrs nere)
<br />?, `?kf,'C' i. OF cat nI?" FOR DETAD S OF TE-'T ?`trOCEDUF=. F21^ LOWS': ;T % A, T WHICH STATISTICALLY SIC:f`1IF i IFF
<br />+,F ",•1-TACH CHRON TO)` TEST RPT TO DMR,
<br />LET4.'FE^a LET 9, Cn?.!1" E3 SIN » ?lI)F + ,,+ R1- 1(:2.; USING CODE
<br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used? 00225 /0"894-41,PA300nn. PAGE -?I OF
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