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PERMITTEE NAME/ADDRESS pNiri FrdlryNaWlo[allw l/Oiff..nq <br />NAME 2ai1 i'F c=. .. '~I~: ~., i.... <br />ADDRESS T d d F' I~ i !i ; 4~ <br />P.O. Fl.i io7 <br />CHdI., <br />;, r; i ~ 2 G <br />FACnrrv <br />LOCATION <br />6TT.Y: Y. '„O ~Ii U'1 PT,"~. N(:, .'~: :':i/, 'S 7~.T <br />NATIg1AL pOLLUTMT D19CHMGE ELIMINATON 9YSTEM /INPOESI <br />D16CHARGE MONITORING REPORT (DAdRI <br />l7-rbl /7.191 <br />~~CU 5 <br />PERMIT NUMBER DISCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAV YEAR MO DAY <br />FROM .. TO <br />!76711 l17-731 /1<-751 (76-771 118-19/ !3431/ <br />form Approved. <br />ACUTE MET TESTINGQE1~L3b•~~ADOs <br />(S,~op ~~) Approvdi>yp~r~ia~05.3L-98 <br />F - FI~~L <br />"T_HCF <br />NOTE: Reed ImtruNarr belori ompletinp thu form. <br />PARAMETER 13 Grd OnlYl QUANTITY OR LOADING l<Grd Ontyl QUANTITY OR CONCENTRATION NO, FREOUENCr SAMPLE <br /> (46531 (5L51 (38J5) f<b-53 15Lb1 EX tr TYPE <br />/37-371 y9 <br />MA <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS /s?-sal les-881 (64701 <br />LL STA:I~E 4;fr14 ACI SAMPLE ::: C;~;:: ;:GO#;: ~r>:Ar.:': C•A.A;er,r.: ( 23) <br />I:EkIODAdh::IA MEASUREMENT <br />;A."..ib 1 G U PERMIT =:1-:r,:t_ x.+x~a>;.i:, o~-:: 1Q0. •ASOQO ~Itt»~?p. F:R- ?NI:L ':kAH <br />FFLUENT (;k055 YALU .~tEQUIREMENT aonA s, R: V"itL~E RT <br />iL'hu 57AfItE 95H:2 AC[ SAMPLE .........- <br />.. ~ . .. ;.:'iauL`.ir ~ f/Op+IA*. *.L*I~sl: (231 <br /> <br />P >_ ?i t P ri A L :: S <br />MEASUREMENT . <br />~ <br /> <br />:AI.bC 1 O C <br />~.~.PERMIT <br />.:~..r:; <br />::=+.~TY4# <br />G~"•r,: <br />iflC -: <br />~~~ ~~ .. <br />>tAir.rOA+'J~. <br />:.~.:-.>€4~l~##+4r.::~ <br /> <br />ER- <br /> <br />~. <br /> <br />~.T;~L~Y <br /> <br />~~?At~ <br />_FhLUEhT GRU$$ YALU '~EQUIREMEN7 ,<+5rr~ !1~ MlLi3 EY <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~ ~~ <br /> REQUIREMENT - - ~ ~ ~- " <br />~, i SAMPLE <br /> MEASUREMENT ~j~ <br />s~ <br /> PERMIT ~~ <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> .REQUIREMENT ~ .,.. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQVIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I OERTI <br />AM FA FY UNDER PENALTY OF UW THAT I HAVE PERSONALLY EAAMINED MD <br />MIUM MATH THE INFORMATION SUBMITTED HEREIN; MD EASED ON TELEPHONE DATE <br /> MY INQUIRY OF TH09E INDIVIDUAL9 IMMEDIAT0.Y RE9PON4ELE FOR <br /> <br />W <br />Gordon Petar• OBTAINING THE INFORMATION, I BELIEVE THE 9UBMITTED INFORMATION I9 <br />I AM AWME THAT THERE ME <br />TRUE <br />ACCURATE MD COMPLETE -~' <br />~~/~ ~'~ <br />. . <br />. <br />INCLUDING <br />PE <br />NG FKSE INFORMATION <br />T <br />FOR <br />B <br />TT 970-824-4401 98 IO 29 <br />_ <br />President 6 General Reneger , <br />91GNIFICMT <br />NAL <br />IES <br />SU <br />MI <br />I <br />THE POSSIBIDTY OF FINE AND IMPNSONMENT. BEE 10 U.S.C. 1 1001 MD 37 gIONATUIIE OF PRINCWAI EXECUTNE <br /> U.B.C. 1 131 e. /MrbYr ,ANr e.,. ,nruw, AMY ircA,dA h,u y ro t 10.000 <br />TYPED OR PRMITED .nsam..x..nbs+l~o++l.+rwbn...,smmsl, rw6r+.1 OFFICER OR AOINORIZED AOENf CODE NUMBER VEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANV VIOLATIONS (Rderence ell ertechmenra here) <br />_2. L' I.A.2, PP 7-9, FCH pdTALLS OF TEST PAOCnVURE. kEPOHT Lt,`C - _T AT]ST IC?I. PC1`,T %ST?HATE: YHICH I" <br />L3THAL Ti) 50~ CF TEST ORCANIS!IS, ANil ATTACH ACUTE TOXICITY TES; AFFCfi7 FOFI! TO CrA, CUPIFS OF ALL <br />~,r nkM lT Tilli.M v u <br />EPA Form 3320.7 108-96) Praviou~ editions mey be used. (REPLACES EPA FORM T30 WHICH MAY NOT BE OSED.1 - ~ ~ - -~ - ~ - PAGE OF <br />OOIOQ/9Q [113-1056 1 ~ <br />