Laserfiche WebLink
PFRMITTEE NAME/ADDRESS S,NLA,Fxrery Nadterurow+/Ddrswp <br />NAME aGn....A )?,L J!!PA>r'( <br />ADDRESS G fi ~L s .: N L, <br />r1AY~%~'+ CO H1639 <br />FACILITY <br />LDCATIONdAY.r .,N .'v a1b30 FR( <br />l~l'1: ,1u~. is' CL: -.rxl. t. A:, Ai: e.D <br />Forth Approved. <br />Q~+~B 33040-0004 ~• <br />:' ri rt 0 M 1~ a L''i •i E J: LAp~ro~~Ite~3ryifb~05~31-9~ <br />('"II'-~ k51) 1234 ~i <br />F - '~NA1. ~ <br />": 1:>"N, <br />NOTE: Reed Imwedo/r betor~i'dlhpNtfnO thb Corm. <br />PARAMETER l3 Ord Onlyl QUANTITY OR LOADING !1 ~ ~OnNI QUANTITY OR CONCENTRATION N0, FgEQUENCr SAMPLE <br />l31 <br />371 !06531 1566/ 35-151 !1653 !5/-6/1 EX Y513 <br />WN TYPE <br />- AVERAGE MAXIMUM UNITS UM <br />INIM AVERAGE MAXIMUM UNITS lszen . <br />I <br />l54-5e1 ls3-7o1 <br />T t::'F'tl: L' ~i~TRi: /:,~~' SAMPLE :v~Ct400 ;..~,+G C: :,: 4:ly a,":~{ 3C4:. r;; ( '3~ /-~ ~ <br /> <br />Ln:. L:cdl.,,+hPH!+ln <br />MEASUREMENT \\ <br />,, <br />l! <br />` ~V <br />'`.l -v~, <br /> <br />1'i::'Si L ~ PERMIT 2##4r9c'>#.:'.:.: .i-GkYa'rh0+ r, •:r< <br />,. <br />L.S.!!' <br />• ~/#{+D#5t a+g#';Y~~s.1 t:?- 'CitLY :.8+1~. <br />• REQUIREMENT ,s ` '" ~ <br />:.cr'r~L:i .,APRL' 71`.f,T SAMPLE ..:::r._k 4xaoaa =krtr.:p, ,.:r.., ( <br />,~~ ~ <br />- ~ ~ <br />L n r. r t " .: ' H A L $ 5 MEASUREMENT ~ ~ -v, <br /> <br />9'L:L•Ll. > 1 0 PERMIT :2:Y;:~::t:a ';.OIYIAk4019r 19t11f ~~,.U ':' b#>RrF~'+'x #4~~i~+1k. . F:?- 1'RL.I : :k~9 <br /> :REQl11REMENT <br />~~~ . . <br /> SAMPLE ~ " <br /> MEASUREMENT <br /> PERMIT <br /> REQUIflEMEtdT~~ .•~:: ~: <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~~ <br /> REQUIREMENT .. <br />:.. ; <br />:.. <br /> SAMPLE <br /> MEASUREMENT <br /> :. PERMIT .. ~ ~ .:~..~~. <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />~ <br />NAMERRLE PRINCIPAL EXECUTNE OFFICER I cERnFY UNDER PEHN.TY GF uw THAT I HAVE PERSONAUr EAAMI NEO AND ~ <br />TELEPHONE DATE <br />AM FAMILIM WITH THE INFORMATION SUBMITTED HFAEIN: AND B \ <br />ASED ON <br />MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIB LE FOR \_ <br />~ <br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORM ATON IS <br />'~ <br />~ <br />- <br />TgUE, ACCUIIATE AND COMPLETE. I AM AWAAE THAT TH EME ME <br />I, <br />~ ~ <br />SIGNIFICANT PENALTIES FOR SUBMITTING FN.SE INFORMATION, IN CLUDING <br />' _, ~ ~ j <br />THE POSSIBILITY OF qNE AND IMPIUSONMENT. SEE t8 U.S.C. E 1001 AND ]] <br />I7T <br />E <br />E <br />VE <br /> u.B.c. !tats. rnn.a:a umu rn,s mnma m,r iNA,r, n., w ro ttD,aoo gIONATURE OF PAI AL <br />X <br />C <br />I (' <br /> <br />TYPED OR PRINTED <br />,nsn muimnr MP~ismwN Of afvwnsmonFM1, rgeYAVa/ <br />OFFlCER ORA ORD:EO AGENT <br />CODE NUMBER EAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS !Re)srencs eN ertscnmenrs here! <br /> <br />~' <br />EPA Form 3320-1 108-961 Previous editions mey be used. IREPLACE6 EPA FORM T40 WNICN MAY NOT BE USED.1 0 @0 7 5 / 99 0 9 ~. 4-0 9 2 3 PAGE 1 of <br />