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PERMITTEE NAME/ADDRESS ancludeFacifit Name/Location if Different) <br />NAME `'_..? ; s2s`'it?r L 1JftP. <br />ADDRESS Wr`)10?l. U,IND t'ROJEC" l- } <br />FACILITY d<-`31_..L tt z t`?(t.ai t.: <br />v? <br />LOCATIONC,ATI, JAY t _ I 1 71 <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR hkC4 DAY YEAR O_ D Y <br />FROM v . u s TO <br />Form Approved. A <br />OMB No. 2040-0004 <br />MINOR P <br />(SIJBR DW 4? <br />F - r INr'tt__ MESA <br />i1 HPi.:?I. T(,- ,,- Tv T TN0 FOR 001A <br />NO 01SCHAR.'GE :("V1 <br />NOTE: Read Instructions before comoletina this form. <br />PARAMETER r QUANTITY OR LOADING QUALITY Oti CONCENTRATION No. FREQUENCY SAMPLE <br /> OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />" 0 x ?. ',..,. T'i" . <br />SAMPLE ?-- # •i= i s # #• • it ir'i? d;:• 2c # 3 ti{• r <• •fr it• fi• , e. -GT <br />IM>rrF1A1 c3 wNIfK(:s<I? MEASUREMENT <br />61 42'1 71 a PERMIT IS ? ? ? ? # # r x ? ? > i~ tt # # ? Yr? ? HR ONO 1 t- ; - <br />SEE Cr?ti..1E fTS BE.i_01r REQUIREMENT ? n (`z1 VALUE A_U? T CJX',:Y <br /> SAMPLE . <br /> <br /> MEASUREMENT <br /> PERMIT - <br /> <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE _ <br /> MEASUREMENT .. ?' <br /> PERM )T <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br />r MEASUREMENT <br /> <br /> PERMIT <br /> REQUIREMENT T ; <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all attachments were TELEPHON E DATE <br /> <br />5? ?f 4I (©/V 7 prepared under my direction or supervision in accordance with a system designed <br />to assure that qualified personnel properly gather and evaluate the information <br /> submitted Based on my inquiry of the person or persons who manage the system, <br />/'' or those persons directly responsible for gathering the information, the information r <br />] <br />7-? <br />. /r tfC? C) <br />I-TZ E 7 1' P? <br />submitted is, to the best of my knowledge and belief, true <br />accurate, and complete. <br />7 <br />? , <br />q7?/^ Z ?=Y <br />Q <br />/0 <br />/ <br />' <br />13 <br />? , <br />I am aware that there are significant penalties for submitting <br />false information SIGNATURE OF PRINCIPAL EXECUTIVE CJ G <br /> <br />TYPED OR PRINTED . <br />, <br />including the-possibility of fine and imprisonment for knowing violations. OFFICER OR AUTHORIZED AGEN AREA <br />NUMBER <br />YEAR <br />MO <br />DAY <br /> CODE <br /> <br />{.7VMMCIV I.S ANIJ r.Ar-W17N1 w17 yr mrvi vivLF\11vvi-z (rtelererlGe dlf dildunmenits nere) <br />rF i"rlt< OF t=I ry''.7"i FOR DETAILS OF' TE.:L. PROCEDURE RTC' LOWEST is AT WHICH STATISTICALLY SSGNli T3IFF <br />BETWE N T ST. & CCNT U SING CODE ; "S" RPI IC25 UE-31NG CODE "F". ATTACH CHRON TOX TEST RPT TO DMR. <br />PAGE <br />II EPA Form 3320-1 (Rev. 3/99) Previous editions may be used. 00226 /Q A,4a-4IjZf$f om1. F