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PERMITTEE NAME/ADDRESSp~J. rrWryNw/larlm YD~p....q <br />NAME T9AFrFd ~'T~T.'1~:. T:L. <br />ADDRESS TRAYPi/! "I~^ <br />L'. i). ~'i~e i,7 <br />CFiAI., <br />CG ..:F' Lb <br />FACILITY <br />LOCATION <br />n'C'Iti: W. GOriU7^~ PEPEfi_~ :'=:.5/.: F':+ aii <br />NATIONDISCHARGEDMONRORING REPORT ~OMR PDESI <br />I7-161 17-191 <br />C 00 5 <br />PERMIT NUMBER DISCHARGE NUMBFA <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM ~1 TO <br />126711 171-731 /14151 /1677/ 118-191 13631/ <br />form Approved. <br />ACllTE 4FT TESTZNE~+R'~4~°3~DA <br />(S O P_ P ~ wl) ApprovslLa>fplrad 5-31-98 <br />F - FTA.AI J <br />!TNCR <br />t=~ 9C Cr:5CN1<RCE XX ^~'''~ <br />NOTE: Reed Inetructloro befor i tomplstinpthis form. <br />PARAMETER l3 Grd Onlyl QUANTITY OR LOADING /1 Grd On/Yl QUANTITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> /15-53! !54611 l3B-151 16653 15451 <br />EX of <br />TYPE <br />137-37) ANALrsls <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS /s7-sai 164681 169-701 <br />LC.~U STATr.E 4dH~t SC SAMPLE ;:;IpY,:{r,l d.xGlb#'r rC;~t:i :,z#;:0~:: ( 23) <br />E.t I G D A P h N I A MEASUREMENT <br />AM.1L 1 0 0 ~RERMIT =k Jsa#~%u -.rC#1k 10tiR~ ~ VI#n ~l O.©.~.~ -0d+C rQ11'~ ~ 4A~bld#.: F.R- .~ TNLY r~A~ <br />- r r <br />tFF'LUGNC ~AJ55 YAI,J' REQUIREMENT <br />#C#V <br />$; :Yit <br />RT ' <br />i. •~jlr ~~f ATHE 96F!d AC SAMPLE <br />.... ....-. <br />..... Fw::r:.`•': LXC4AA OXri'kd# ( Z3) . <br />PIri~P9AL::S MEASUREMENT <br />:nirDC 1 0 U :~ PERMIT ': ;:r,'r::: 'tnt~>:c#LI. #6# i'(}Q;:.::::::' ... <br />: ~ ~ ..>!#4:¢I(t•~:::. ~~~ ::~ ~b#:~#Pf~.#.~.~ ER- ... .TilLY ~ ;~Afi <br />:;FI'LUE:IT .,ROSS YALU :REQUIREMENT 00#k . <br />[S fl.. p~rt[~~ ~ CENt <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br />' MEASUREMENT ~ <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> . ~ PERMIT <br />- REQUIREMENT ~ ~ 1 <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT . <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~~ <br /> REQUIREMENT. <br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER I cERrI <br />AM FA FV uNDEn POIKTr of <br />MILIAR yNTH TXE INFO LAw THAT I NAVE PeasoNAdLr E%AMINED AND <br />RMATION SUBMITTED HEREIN; AND BASED ON TELEPHONE DATE <br /> Mr INQUIM OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE fOR <br />EVE THE BUBMITTED INFORMATON IS <br />011 <br />T <br />T <br />I BE <br /> <br />W• Gordon Petara ~ HE INF <br />MA <br />Ig1, <br />LI <br />OBTAINING <br />SIGNIROANT~ENALn 5 FOq SVBMITTNO FALSE NFMOtNAAT110N INCLUDIMNG <br />~ <br />970-824-4401 C <br />98 <br />10 <br />Z3 <br />Pr~aident S Coastal Manager THE POSSIBIDTY OF RNE AND IMPRISONMENT. SEE 10 U.S.C. f 1001 AND 01 BIONATIIRE OF FRINCMAL EXECUTIVE <br /> U.9.C. f t S 1e. //1YIYLYA u1aV 1M+r RrfvOr. nlrr Alrk•!. rxr.. r0 ro S 10,000 <br />' <br />OFFICER OR AUTHORIZED AGENT A k <br />NUMBER <br />YEAR <br />MO <br />OAV <br />TYPED OR PRINTED srnrr+wanv..nsmmn..,es Ew..l <br />w~:idroa.irw:rsron CODE <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRe7rr~nce se Btnenmsnts nets/ <br />:. EE I. A. Z', PP 7-9A FCR DETAILS OF 2F.5T Pi?OCc'UUAc. RE?03T LC°C - STAT1`TTCAL Fr-IMT ESTI".ACF: eeICr CS <br />Lr:CHAL TG 5v: ;1F TEST ORGAFIStl:i, AWO ATTACH ACUTE TOXICITY TFET 9EFCF7 FOR!". TC CMi7. CGPIF.S OF 0.LL <br />:urn-NSTrnx nn .T ~ m ~ t <br />EPA Form 3320.1 108-95) Previous editions may be used. IREPLACE6 EPA FORM T40 WHICH MAY NOT BE OSED.1 Q 0 C 7 C / 5 A C 113 -10 5 6 PAGE I F <br />