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PARAMETER
<br />QUANTITY OR LOADING
<br />QUALITY OR CONCENTRATION
<br />NO
<br />EX
<br />FREQUENCY
<br />OF
<br />ANALYSIS
<br />SAMPLE
<br />TYPE .
<br />AVERAGE
<br />MAXIMUM
<br />UNITS
<br />MINIMUM
<br />AVERAGE
<br />MAXIMUM
<br />UNITS
<br />' . 4 '. ''. ,; N C 4 D ;
<br />V) T. SSOC I-31...E
<br />:::"...F - I r Or VA!...V
<br />SAMPLE
<br />MEASUREMENT
<br />IV .1 L
<br />L L
<br />MONTI' 4
<br />,s:.1 t.i:
<br />h:t..1 1
<br />LA i: i... '' c' M/
<br />PERMIT
<br />REQUIREMENT
<br />,,
<br />-... ...
<br />( AS 0 F.. )
<br />2 i, C C..
<br />tiFF11,1:::;17' C:?.:"Z CiFiS VALI; 1::.
<br />SAMPLE
<br />MEASUREMENT
<br />-*--:1. :4-::; i;Z-ii•
<br />:. -:
<br />:i
<br />-...'i.ii-:.1-
<br />'.1••;-5•*;.
<br />( ati..7.) :,
<br />OGIL
<br />Itv-, ;.,u;'Irun
<br />MUNTH
<br />-:::--=,'•ii--:;••;--.'
<br />! 7;.f ON t
<br />,:;t:T. :•.V0
<br />NI: t•-' iii t
<br />1 M:
<br />PERMIT
<br />REQUIREMENT
<br />'' i ::-.1---:i -,,,•
<br />-:: :, . 5 ' '" :: "
<br />C AS E :i
<br />kr 1• '.' 5
<br />' ." .. .F i7j.,!FYIT OF OHS VALUE
<br />SAMPLE
<br />MEASUREMENT
<br />.i.3.1.
<br />-
<br />g--.i?-.4.*
<br />**-3
<br />( P. 7 i
<br />NG/L
<br />HCMTH
<br />,:::,-'::::', :-..',!:
<br />:
<br />PERMIT
<br />REQUIREMENT
<br />:- .;• .:- ...-:J %:;.
<br />.1. ..-. ,. ;,..
<br />'RYE P.F Ck.T•iiMA;ajoi.;
<br />SAMPLE . 4 . .-r. --- ki . ..1 - * .= ; .
<br />MEASUREMENT
<br />* ,- - .A - -:,,.
<br />N--:_:*
<br />•A
<br />,.7.
<br />i e.:i7i 1
<br />, , ,, r , ,,.A . ::
<br />,umr
<br />c.t.;L:'L.L
<br />i';!.:
<br />PERMIT
<br />REQUIREMENT
<br />..-,;:,' :f-: • :,- .
<br />TilT... R:ZeCVEi AZLE
<br />• ; :!. . :. -- J... ':.; ',
<br />Erri.u.o.47 071: ,,, AUK::
<br />SAMPLE
<br />MEASUREMENT
<br />'!,:-*-
<br />: --i.*:.•:`:. :I.
<br />.N''
<br />:.: - . - ;: , :.i.:*
<br />.,:-.i.••:::-.:i.*:..r
<br />.
<br />: ;.•2':L..; '
<br />UC,./L
<br />#.t,
<br />, t17 - .1
<br />APT
<br />.-*-:-:.--:q.-.,-
<br />• i i
<br />.0i.', 0.,VP
<br />1 t 17 1 jrt i
<br />I MX
<br />PERMIT
<br />REQUIREMENT
<br />.. '.
<br />- I Di .`.:... e::L.r..;',.;
<br />VTR;. . .'..
<br />-, c' r.*:
<br />f_AJT c•4 "iALME
<br />SAMPLE
<br />MEASUREMENT
<br />.**-:.*
<br />'..:;
<br />1
<br />::
<br />Dcr*Ii.,:y - 'r•:
<br />PERMIT
<br />REQUIREMENT
<br />fs: ' ..1 L ' ,.*': : ii-'
<br />1 RF: AFtl...E:
<br />r *7..:. :' ''. 'S 1.-4
<br />FrFij i7 ti=‘:L.V:
<br />SAMPLE
<br />MEASUREMENT
<br />--/...i -7.
<br />...
<br />...:1.*
<br />.t•
<br />-4--
<br />.
<br />:;''..t."'"'UNI
<br />.:A -4k1(1)
<br />--
<br />iJA:i:..."V H;c.
<br />PERMIT
<br />REQUIREMENT
<br />-:..-.1--
<br />. •.. -74. :, '..- ,...•
<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER
<br />I certify under penalty of law that this document and all attachments were
<br />designed
<br />prepared under my direction or supervision in accordance with a system des
<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
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<br />I am aware that there are significant penalties for submitting false information,
<br />including the possibility of fine and imprisonment for knowing violations.
<br />c.,..\ ),"
<br />e........ & t. _
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<br />TELEPHONE
<br />DATE
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<br />SIGNATURE OF PRINCIPAL EACUTIVE
<br />OFFICEROB.AUTHORIZED AGENT
<br />AREA
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<br />YEAR
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<br />DAY
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<br />NAME "■.::• •
<br />ADDRESS RI._ 13JE.0 T
<br />R. •
<br />F ACILITY I. R !AD
<br />LOCATIONAT
<br />t.es. E X EC: VP i'rin
<br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used.
<br />00 6142.'-:.
<br />FROM
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (DMR)
<br />PERMIT NUMBER
<br />YEAR
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
<br />MO,
<br />MONITORING PERIOD
<br />DAY
<br />TO
<br />•
<br />DISCHARGE NUMBER
<br />YEAR
<br />.t.
<br />MO
<br />)9I SF
<br />(SUOR ON)
<br />— 11.NAL
<br />POST TRmNY
<br />000 46 / 0 IfthiRS§ca-4145aff (form.
<br />MESA
<br />DSCHG TO 1...UMDEN CR
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<br />Form Approved.
<br />OMB No. 2040-0004
<br />PAGE p, OF—
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