Laserfiche WebLink
PARAMETER <br />(3:47) <br />3 Card 061y) I)UANTIT OR LOADING <br />(46 15441) <br />(4 Card (nly) Q UALITY OR CONCENTRATION <br />(.36 (464.1) (54 <br />NO. 1 <br />EX <br />624.31 <br />AVERAGE <br />1 <br />UNITS <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MSS <br />SAMPLE <br />MEASUREMENT <br />0 6 0 0 41 <br />4t Zt <br />PELMET <br />REQUIREMENT <br />, <br />0, 0 la Al. <br />SAMPLE; <br />MEASUREMENT <br />' <br />:. <br />5 r <br />AA,M <br />4 <br />REQUIREMENT <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />aedutrktmer4T <br />SAMPLE <br />MEASUREMENT <br />' <br />I <br />- <br />PERMIT <br />aabuiRetretrtrr <br />. <br />SAMPLE <br />MEASUREMENT <br />1 <br />' PVramir <br />aebtktriaMIWN't <br />, <br />, <br />• <br />SAMPLE <br />M EASUREMENT <br />.... <br />PIIMMFT ' <br />REDLIIREMENT <br />.. <br />SAMPLE <br />MEASUREMENT <br />PERMIT <br />k SUll4EMEMT <br />. • <br />' <br />' <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />I CRT P' UNDER PENALTY Or LAW HA I HAVE PERSONALLY EXAMINED <br />AND Am FAMILIAR WITH THE NI' ORMATION SUBMITTED HEREON, AND BASED <br />ON MY INOUIRY OF THOSE ININVIDUAL 5 IMMEDIATELY RESPONSIBLE FOR <br />OBTAINING THE INFORMATION, 1 BELIEVE THE S'UBMITTED INFORMATION <br />15 TRUE ACCURATE AND COMPLETE I AM AWARE THAT THERE II.RE SIG <br />NIFICA NT PENAL ncs FOR StlemrTnNo FALsE /NrORMAT ION. INCLUDING <br />THE Posconn.rry OF FINE AND ImmiiSONmENT SLE 1R U S C 4 100l AND <br />33 ll 6 C b I 319 (Par:allows under (44.0 entutes nuo ■,‘ ha. hnrA up (0 $11(000 <br />.,,d ,‘ wri /n voppstosmonr 01 1,(10Not 6 olohth • and 6 ,:lytr,,N,1 <br />TELEPHONE <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />OFFICER OR AUTHORIZED AGENT <br />TYPED OR PRINTED <br />____ <br />AREA <br />CODE <br />NUMBE_Ti <br />PERMITTE.^.7: NAME/ADDRESS (include <br />1,1ririb Warne /Lorutwn milereen) <br />NAME <br />ADDRESS <br />FAC4LITY <br />LOCATION <br />COMMENT AND EXPLANATION OF ANY VIOLATIONS ( efer (new( ( <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM t.VP1316) <br />DISCHARGE MONITORING REPORT DM 10 <br />12 10 0 7.19) <br />FROM <br />PERMIT NUMBER <br />ISCHARCiE Num BEH <br />MONITORING PERIOD <br />vEAR DAY i <br />TO YEAR I MO 1.1AY <br />1 1 <br />00 111 ill II) (14•1 <br />00 1'1 0N-.19, (10 (1) <br />f <br />6141 ,Vo. 2000 001 <br />NOTE: Read instructions before comptedng thi-s form. <br />""*"."'''' SAMPLE <br />TYPE <br />.0,A <br />1(4-0 ) tA <br />3A PE <br />YEAR MO <br />DAY <br />