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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 />....:`..-•',.. :::.?.....‘'.._ ' .. :' ' 2: .;:..
<br />D I 61-_ ' :' '__.i,r.
<br />rirFLUI:EN ':. P 7.: F: t t -. 1 1' .U!
<br />SAMPLE
<br />MEASUREMENT
<br />:::- • ..-Y..-.:'..-:.-:
<br />. ,!. ;... ,,, -t.... r...
<br />li•-1?*
<br />;....---*- :--
<br />r.... i:•r:
<br />r.1
<br />ol'
<br />,,
<br />MONTH
<br />LJ,"1 0::
<br />ii.***.:i
<br />RI.--..Pt. I
<br />30D
<br />rf...EF or< I
<br />DAILY MX
<br />PERMIT
<br />REQUIREMENT
<br />******
<br />* *
<br />M::.i TE,1
<br />:. i 75 7j. E)
<br />'".;:
<br />r FFLuENT ' EQ.:F. VAL.',...r_
<br />SAMPLE
<br />MEASUREMENT
<br />*** .,-: ..
<br />•-i-: -.:,
<br />*
<br />- g - **1 - 4 , **
<br />-,
<br />U'`...; : .
<br />t.
<br />trm.r. 4..,
<br />MONTH
<br />or ?:-:...
<br />***4: *
<br />N E :2 I
<br />!30r; A AV G
<br />.t!. h!-. wf-c i
<br />DA I I_ Y MX
<br />PERMIT
<br />REQUIREMENT
<br />**I*** i4:-
<br />*** *
<br />+IC:: ..,* .'" : .7 I: :.;'• '.
<br />2; A'ii ;.,1 7
<br />ET FL.L;h:'!" ',, ..
<br />SAMPLE
<br />MEASUREMENT
<br />,:..!...:,....i:-*-.',
<br />---.--i
<br />***** ir
<br />r-i Er uR ,
<br />7 I) A AV g
<br />NI° t• , ....:4-,. ;
<br />f - DAILY MX
<br />t..44=,...
<br />t..7. . ....,t..1mr -
<br />on
<br />PERMIT
<br />REQUIREMENT
<br />..,I: 1..--***
<br />** i, *
<br />TOTAL A:::.i._:(
<br />F-771 : - --;Fr! 1 17.5 . 5 , .',.: 1 , 8 _A- 1 1 - . 7_
<br />SAMPLE
<br />MEASUREMENT
<br />1
<br />.
<br />-!,,...*._;.- .,.-
<br />*** .1 ....
<br />, 4:L.; .t.
<br />',1"7" 'L..
<br />0
<br />p,p,,.. t .: \,Ur-Li
<br />MONTH
<br />F.F.t..iRT
<br />'3 11)A AVG
<br />(JAIL "f MX
<br />PERMIT
<br />REQUIREMENT
<br />c.--#:-1,:***
<br />- : *
<br />::...1.: "-:;,.:
<br />T OT ;L . E:
<br />, ' 3: vpiLur
<br />SAMPLE
<br />MEASUREMENT
<br />'..7': ,' :"."1:' 1:.'*
<br />- ..; %.. ;:.• 1 ::.
<br />'..,:' .1 4 ," :-• • • :,'• • -
<br />ON.,...4:
<br />,.
<br />...,u,nrun
<br />******
<br />HEFLIN I
<br />1-f .Ll'UN 1
<br />PERMIT
<br />REQUIREMENT
<br />*
<br />._
<br />** ** *F.-3
<br />,c=„4 v):i u'.' , •; I" ,--
<br />. 3. ::. .-.'-' i . ,...;
<br />".E FLJr C;IT ',7f:: L a V AL2
<br />SAMPLE
<br />MEASUREMENT
<br />, t..* ....*.?.:
<br />* 3.4
<br />.•
<br />.
<br />;_'%: I I .
<br />** * t•-• i•*
<br />r, I f ,:: ri 1
<br />2 C DA AVG
<br />>1 .t r 1...P.1 ,
<br />.T.:-.A I L. - -i" M::
<br />LIM...L:1
<br />MEIN TH
<br />PERMIT
<br />REQUIREMENT
<br />** li-*** *
<br />TOTAL .. 4' ":i.2 i . :7
<br />'
<br />SAMPLE
<br />MEASUREMENT
<br />!...-i..*.-i"...*:7*
<br />-' --: ..:* ,...:
<br />1
<br />,..-.. p":, k i:,
<br />.. . .
<br />- W - :" -- P - CZ•It; I
<br />r.±.Ht...4i r ; 1
<br />'`f t`:.! t-t;'1 i
<br />DAILY 1- '1X
<br />I.,
<br />11..4 .' k.,
<br />MONTH
<br />iir#r on
<br />PERMIT
<br />REQUIREMENT
<br />; P: ii g
<br />*.:' - i , t• A 1
<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER
<br />I certify under penalty of law that this document and all attachments were
<br />prepared under my direction or supervision in accordance with a system designed
<br />to 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
<br />submitted is, to the best of my knowledge and belief, true, accurate, and complete.
<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 />.
<br />TELEPHONE
<br />DATE
<br />V 0
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<br />1-7 fe I- P,
<br />, - t I u•
<br />i
<br />f i 1
<br />■...." (.--)
<br />kp
<br />-
<br />1-7
<br />(- At" V , r a .
<br />P`'''';:)
<br />SIGNti
<br />(/ OF_Sk INCIP A EXECUTIVE
<br />OF CER OR AUTHORIZED AGENT
<br />AREA
<br />CODE
<br />NUMBER
<br />YEAR
<br />MO
<br />DAY
<br />TYPED OR PRINTED
<br />PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different)
<br />NAME
<br />ADDRESS
<br />FACILITY ; '7. 7 :
<br />EPA Form 3320-1 (Rev. 3/99) Previous editions may be used.
<br />CO
<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 Re erence all att achments ere
<br />MP_
<br />MONITORING PERIOD
<br />DAY
<br />TO
<br />DISCHARGE NUMBER
<br />YEAR
<br />MO
<br />DAY
<br />Form Approved.
<br />OMB No. 2040-0004 +,
<br />17.c
<br />• •
<br />L.Dr_."1\i, CR
<br />it- 0,C,.7E
<br />NOTE: Read Instructions before completing this form. --
<br />c) 7 1$44-4415det form.
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