|
FERMIT7EE NAME/ADDRESS (1ne1rL feYIyN••/Lx,•aw l/nUJ,I.,,q
<br />NAME Tkl::'I t. ~,• I':; .
<br />ADDRESS T H .1 ,I c t ;' ~ '
<br />Y..;. i 7}
<br />Ckh:, CO 61620
<br />FACILITY
<br />LOCATION
<br />A'I'i?:: ~. ;tilt~';.~•. :~E.P_, P;Its/GE,Y nCR
<br />NATIONAL POLLUTANT g5CHM0EELIMINATION SYSTEM /NPDLrSI
<br />DISCNARCE MONITORING REPORT 7DMR)
<br />/?-161 /7-191
<br />~noo3zzls cce A
<br />PERMIT NUMBER OISCNMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />fROM ~. TO •- .,
<br />114711 112-I3) I2L751 ~ /76271 128-791 /34311
<br />Form Approved.
<br />FCNL 1; TO L'EaT ~'JI'~NPfi~'a:~C4
<br />(S /1 c H ~ Y) ApDroveLel~pr4~05-31-98
<br />- F7!IAL
<br />rISLF.
<br />~„>, r:c CISCHARGE ~) %:S:fi
<br />NOTE: Reed Inrtructiorlr beta compMOnp thu form.
<br />PARAMETER (3 Grd On(yl OUAN7ITY OR LOADING 11 Grd Oniy) OUANTITV OR CONCENTRATION NG FAEOUENCY SAMPLE
<br />31
<br />3 115-531 151-611 138.151 !4653 5/-611 OF
<br />-
<br />7/
<br />1 E%
<br />NALr51s TYPE
<br /> AVERAGE MA%INIUM UNITS MINIMUM AVERAGE MA%IMUM UNITS 7191 A
<br />(61-681 164701
<br />< r. SAMPLE :: r.r:~ :~Y ;=a[.oa;< Cr;,',aatl ( 12}
<br /> MEASUREMENT
<br />
<br />J~v~lUll 1 0 0 PERMIT fi(fi*'~I+G~:IL1 >;z~i(4r7L #Crf 6.i ;.. 34A!64~ 9':•0 E&ECT.Y INSIF!
<br />F r•LDEhT GRO55 YALU fiEnyIkEMENTi
<br />
<br />~. ..' ; . '.. ~asz=a MI N:7RIfY
<br />•. ,2! >L.1»U"!::' SU
<br />_.U I $, 3E EAS E SAMPLE rA4ak4."-Lt L14;r4ria aZtoaa ( 25}
<br /> MEASUREMENT ~ -
<br />
<br />~.,~J:III] 1 O U
<br />
<br />' ,:x.:.':.::: RFtIFT:. '.::: ~~.'.~a~`rkt44s .,. ~4'. Q!bt!a,
<br />
<br />•
<br />: ..: .:
<br />•. ;... ..
<br />.
<br />:
<br />~ ~ -~'Y:I C. .~:~. ~. :a}t. ~. ". ::~:..,r ..~ -
<br />
<br />: .
<br />t i
<br />FLUENT GHDSS YALU ~~REOUIREIv1ENT. .: ~ ... .. ,
<br />. ..'
<br />aa~o `. .'
<br />.
<br />.'~. :..
<br />.
<br />~ ';'' ~
<br />3 G
<br />. ~axtr ri'Y
<br />rtl. L
<br />,
<br />':
<br />;' M..H ..
<br />..
<br />•I ~ SAMPLE •-~ .:~.'=r`+~ >a
<br />a eln L' OL>Da ( 14)
<br />
<br />~ MEASUREMENT ~~ ~.
<br />l 36tl2 1 -°
<br />~ ~ '0 PERMIT :: ~ ;. ~:.~~::-::::.t:~
<br />` ~ {`r?rx# lea: : a' ofia - b .. 10 ~ ~ ~ ". p~NTI ~~A$
<br />:"rFLUEMT rSROSS I:~ALU REnUIHEMEN7.
<br />.. ~...
<br />
<br />~ <: <:,::j;.~;:_b
<br />. ~ : ~ ;,::H..:,:;
<br />
<br />~.
<br />
<br />+•
<br />
<br />... IL~SS {'EA% HG/L
<br />
<br />, GWNT.
<br />' Jw, 0 SAMPLE ( Q3j ++Ct Cfifi fi.^, IQ :,T r,-' at•'.: L'=}:'
<br />IHnU Z'REATQ.CYT ?LAP MEASUREMENT
<br />,;irSO 1 0 0 ;' R.:_.,`
<br />t~, eA
<br />~
<br />~ R.A.P.OA7_.:: RLYEf~?..:,: zy>`:' "+i~4AA0 1p;+in~l4 -0.4~fA4d(
<br />
<br />~ 0.3,E 't;EISLY Ip.;TA
<br />*.FFiUE11T GRDS_I YALU ~EG,~ .R,..
<br />....
<br />... ~ :3(fDA.~' AY(+. ~~:~D~JII~L. ,F~~;:~,. NGD -
<br />~ ~ ..
<br />~. Oi'YF#
<br />.. D , AL
<br />P 5.
<br />PL aaa;Yr~:A # .04 aa09
<br />aa ~ ~ 10}
<br />:~::1 :;OLY ED MEASUREMENT
<br />
<br />7u2,5 1 U v `...:.::PE.RMIT..: 4r>x!Y. .Y{/:r; .!.
<br />~ .' 'dlld#L'G fi:aa ~~'>D.4A>0 ::tF'fTt.,AL.`:p ..::,;R~!:FnAT - TRLT 'I~AP
<br />~FFLUE9T GRC55 YALU 'gE4uIREMENI`:
<br />.. '.; ;:f;
<br />.
<br />R
<br />:. .:._ >Raoo
<br />~~ F4F:'.:AV:G? ,;~:1:$Y rY CG/L 'i
<br />.. .,n SAMPLE ~ (;9U) AaCfifiY 0•:aaaa a ¢r,1 rs':
<br />J I =~~ is A L MEASUREMENT
<br />
<br />341~c:~ 1 0 0 PERMIT. ~ ~ ~~ StEFORT ~ Es=1 ~ ~!~?d+?>Daa arfisarf:.. .ale;~~?v0 :y:~rr ENi;LY jt;UA
<br />r.YFLUEXT GROSS YALU! REQUIREMENT INST.!!AX NO=O acrrta
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIT .
<br /> ~6tEQ111REN1ENT~~
<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I cean
<br />AM FA Fr uNOEa PENALT' of uw rNAr I NAVE PERSO
<br />MILIM wITH THE INFORMATON SUBMITTED H NALLY ExAMwED MD
<br />EREIN; MD BASED ON TELEPHONE DATE
<br /> MY.INOUIRY OF TNOSE INDINDUALS IMMFAIATELY RESPONSIBLE FOR
<br />OBTNNINO THE INFOaMATION, I BELIEVE THE SUBMITTED INFORMAnON 19 ~f `~_~~
<br />4
<br />~~
<br />W• GOptOII P~~lre SIONIFICMT VENILLT~S fOR SuBMITTNG KSE N ORMATION
<br />INCLUpNG /~I~
<br />~ 970-824-4401 98 10 23
<br /> ,
<br />THE POSSIBILITY OF RNE AND IMPRISONMENT. SEE 16 U.S.C. ! 1001 ANp 7J
<br />U
<br />s
<br />e
<br />1 1710
<br />(Aw1•bir, uW N.
<br />,sr
<br />E
<br />r
<br />e
<br />IY
<br />t
<br />F 1
<br />D
<br />d
<br />t10NATVRE OF -RINCMAL EXECUTIVE
<br />PRINT
<br />D .
<br />.
<br />.
<br />.
<br />~
<br />u
<br />., m.y
<br />+c
<br />F
<br />in•, Ne
<br />o
<br />/
<br />CDD
<br />~
<br />TYPED OR
<br />E wnnr,I:..,nbw,
<br />Fm~nnrwanr..nrmmn,.,d By..al OFFlCER OR AUiHORRED AGENT CODE NUMBER YEAR MO ppy
<br />V VInnIGnIV I'11.VG ~ 11 I V~ ~~.• •IV G(I IIVI.V I../.I./ILI 11 11~ III/I 11 /II/Y/ .
<br />..EfT'LEABLI. SIJLif15 LIFI: ^1AY yE +pIV?U FU F. >iUYP.,24Hn 7hE~I F EYFtIT - SEF RLTERRA7E LI!:ITATIO!+~ UNC'c?
<br />C.A.1•D, ANC ALSO BUHUcN DF pRUUF HE4Uifi~NEXTS UMMER I.A.3• CII C GFEASE - SFF Z.B.1.(D). TDS
<br />EPA Form 3320.1 108.951 Previous editions mey be used. IREPIACES EPA FORM T-40 WHICH MAY NOT B USE .1 PAGE OF
<br />00^55/57]211-16u6 1
<br />
|