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PARAMETER
<br />QUANTITY OR LOADING
<br />QUALITY OR CONCENTRATION
<br />Na
<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
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<br />SAMPLE
<br />MEASUREMENT
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<br />k\:,f.t i:
<br />1.7.'ALY '
<br />PERMIT
<br />REQUIREMENT
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<br />SAMPLE
<br />MEASUREMENT
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<br />REQUIREMENT
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<br />UJI." t`.2,!;:t7q5 VALUT....'
<br />SAMPLE
<br />MEASUREMENT
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<br />PERMIT
<br />REQUIREMENT
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<br />SAMPLE
<br />MEASUREMENT
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<br />PERMIT
<br />REQUIREMENT
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<br />SAMPLE
<br />MEASUREMENT
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<br />PERMIT
<br />REQUIREMENT
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<br />SAMPLE
<br />MEASUREMENT
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<br />PERMIT
<br />REQUIREMENT
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<br />SAMPLE
<br />MEASUREMENT
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<br />PERMIT
<br />REQUIREMENT
<br />a
<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 assure that qualified personnel properly gather and evaluate the information
<br />submitted. Based on iny 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 free and imprisonment for knowing violations.
<br />„.•••-"-. ."----....L . ,1,
<br />e. - ---
<br />• - -.1 4.,.%,.' "Ld'... /
<br />\
<br />TELEPHONE
<br />DATE
<br />- ... .6 '
<br />-17/ 1- . 2 121 C
<br />I 1
<br />f 0,
<br />r L
<br />r 7
<br />(4 4 '"e C, E c2-e,
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<br />(- kt V. 6 A fC .
<br />SIGNATURE OF PRINCIPAL;EiECUTIVE
<br />OFFICER 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 - W.-U. it.: 0 F0
<br />FACILITY •
<br />LOCATION 7E1 y
<br />17.!
<br />F;`. t
<br />I EPA Form 3320-1 (Rev. 3/99) Previous editions may be used.
<br />c 1.1
<br />a 75
<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 />ke
<br />MONITORING PERIOD
<br />DAY
<br />TO
<br />DISCHARGE NUMBER
<br />YEAR
<br />MO.
<br />Pi I N TiR
<br />SUM
<br />rxmAL
<br />P 06T TRFINT
<br />Form Approved.
<br />OMB No. 2040-0004
<br />Df3C?Gs. TO LUVSDEN CR
<br />DAY
<br />'44 NO
<br />NOTE: Read Instructions before completing this form.
<br />00049/ 0-noULti-4agiitt form.
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