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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 />'' i ''''.'-:::::.; L •,.-' )7..0,
<br />- - .. --- ,, , t. 7: : ''.. -.
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<br />SAMPLE
<br />MEASUREMENT
<br />r f!..._
<br />;,7-
<br />-;-; -.--- -;-: i.--. ,;-: --,-,-
<br />;-;",
<br />:-:.-ki,-;:::--$.1. •:,-
<br />PERMIT
<br />REQUIREMENT
<br />i.:-.,.... ,•-:,..-,--,-; ':-.1-'
<br />i i 2:ii, 0 0: k.' L :7 ::". Li '._ 1.-_
<br />: ' : -,:',' ' '•.• ' r
<br />; 7: •;:- =•• L 1,,, • !..;-,. ••-,,;„• .,-• is,.3,•:.--, 7 ,‘,..=•:: :,;,i.v_ :::
<br />SAMPLE
<br />MEASUREMENT
<br />. ,.... - .7..-::'..-•-:-.
<br />- f ,- **
<br />:-.,,,,--:::-:.-
<br />0.
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<br />r::•:;
<br />• - • -!',-, *
<br />' 2 CI, 0
<br />F : . 1 . z . F O T
<br />PERMIT
<br />REQUIREMENT
<br />:•-.:
<br />- . * :, - , . . - : - . - , r , . . - • : , ' 'A
<br />' --- ',.... : :',, " ::1•_ -,. 7: • :I: ; ....:'"1
<br />0:4 :::: 3 ,1;3; L
<br />SAMPLE
<br />MEASUREMENT
<br />'•r:
<br />:: :: ( :
<br />:•il::-.EV:s..::1--::::;:".:'"CH
<br />•• i.:-....-,..:7
<br />•"-.1'.:-.:r :c..--::-.0-
<br />•.•:.
<br />PERMIT
<br />REQUIREMENT
<br />;,.-:::::-;-,-,.:
<br />-• :,,- - • ;:,..". , •' :".' --. : . .:, F'-: ,. : •:
<br />•_•.•',E
<br />F. -.•-•'-" •_..',.; '...• '‘...." 1 '. •,:,. t,.1•••,.•
<br />SAMPLE
<br />MEASUREMENT
<br />-.:,-:- :::::::.-
<br />'
<br />*:.: L= is. L.
<br />0 73:`1 :00:'..'
<br />-,..:::-:-..-: ;‘,..:::.
<br />-%-:...”-,
<br />C. 1 C"::.;
<br />PERMIT
<br />REQUIREMENT
<br />7•:. 7F,'-•".•'-',71)."- FLAN7
<br />. ,...
<br />;._) r" , ‘ ‘...t . r - 7. F•;,. r =, v,:,_;_jr.:-•
<br />SAMPLE
<br />MEASUREMENT
<br />' Cis:"
<br />.i. -,..i..:•--
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<br />ic.:-0)::i DF:
<br />:-...
<br />.•- if.,-*•:; p.-.--..
<br />.sttr--,.. -..-,**:-., •
<br />PERMIT
<br />REQUIREMENT
<br />,,, 0, 7:.
<br />:-'.:-.; • '. '.'---; 7
<br />r;,- ,•-_•.R.7.7.--, VA; ,.!--::
<br />SAMPLE
<br />MEASUREMENT
<br />* .I4
<br />:
<br />1 a L.- zs L ',.;"
<br />-....• c.: . 1 'F' (:.; ';,:-.;
<br />..:
<br />.DC
<br />;..? C: 0
<br />PERMIT
<br />REQUIREMENT
<br />, -: -,, -,.-:••
<br />:' 7',.. ••:: ';., 0 '-', 7. - •
<br />. , . r. ;.•3i3'-1.1=‘1..
<br />. , ..,
<br />---.....- •••:. • • • •: ..; .., :-••• - - •-•.;:-.= t : ,• ; • ;=-
<br />SAMPLE
<br />MEASUREMENT
<br />-;,:r '; I.:** •:::.
<br />C
<br />,.. • ^5, 4 ,:7 -:::- i' • i':'
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<br />:
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<br />Is.* ir:,:- -i -•.,•.-' .•:;:-
<br />-:•.:•-•..:--k-:•:-F.::•-•t: -
<br />PERMIT
<br />REQUIREMENT
<br />-.- • ... -
<br />r ..:• LI :=-: T ',.:
<br />7 3 ':,• , S •• :' 1
<br />NAMEMTLE PRIN IPAL EXECUTIVE OFFICER
<br />1 p , '"tii.:: . "" 1* L iro:(twh2lmit:1‘,::::::" and 21 i*I I'
<br />m ' , , ,
<br />to moure that qualified personnel properly gather and evaluate the information
<br />submitted. Based on ray inquiry. of the person or persons oho tnatrage (be system.
<br />those pemons threetl) nupuusilde for ipihering the Infornattion, the information
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<br />including the possibility of fine and imprisonment for knowing violations.
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<br />DATE
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<br />97ii--1/itt 12-
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<br />DAY
<br />glein fl
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<br />GNATURE OF PRINCI L EXECUTIVE
<br />OFFICER OR AUTHORIZED AGENT
<br />AREA
<br />CODE
<br />NUMBER YEAR
<br />MO
<br />TYPED OR PRI D
<br />PERMITTEE NAME/ADDRESS (include Fariliiy Nainr/Locotion Darrow
<br />ADDRESS •
<br />.
<br />FACILITY
<br />LOCATION
<br />‘7, 1 r••••
<br />FROM
<br />NATIONAL POLLUTANT DISCHARGE EUMINATION SYSTEM (NPDES)
<br />DISCHARGE MONITORING REPORT (DMA)
<br />PERMIT NUMBER
<br />MONITORING PERIOD
<br />• 2'
<br />•:.••
<br />YEAR MO DAY
<br />YEAR
<br />MO
<br />DAY
<br />TO
<br />DISCHARGE NUMBER
<br />- 7 T. kiAL
<br />,,,,__, -.:„.7.: :,,,::,:c.i,.•,,,.:-.:,::: ! --.. .,:,*_,....
<br />NOTE: Read Instructions before co N pleting this form.
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)
<br />• "T" . 0. II. 1•12, T. 0 , ".•1 •
<br />EPA Form 3320-1 (Rev. 3(99) Previous editions may be used.
<br />0 1 4 14,14.“9rm.
<br />Form Approved.
<br />OMB No. 2040-0004
<br />PAGE 2 OF 3
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