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PERMfTTEE NAME/ADDRESS (Include Faciliry Name//neanon ijDifferent) <br />NAME 9(i+a It: RF.~^•';^" _ I'. ~t;T=~'t <br />ADDPESS 80i1I:: 80. ~~ I ` t <br />P.U. e~x ,ja{ <br />PAUNIA ^_O 91429 <br />FACIL)TY <br />LOCATIONflOMi `: CO 814 28 <br />:dPfN: aILLIA'• .4. ''c+(. );t.. 'tINt~ MG3 <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM MPDES) Form Approved. <br />DISCHARGE MONITORING REPORT (DMRI OMB No. 2040-0004 <br />tz-ts) (+r- a/ MINOR Approval expires 0531>88 <br />~ (SDPH MC) <br />PERMIT NUMBER DISCHARGE NUMBER v _ gT NA1, QdLT+I <br />MONITORING PERIOD ^3CHC OF SR TO DEEP TR4I 1. DTCd, <br />YEAR MO DAY YEAR MO DA _ <br />FROM 9Q 47 U1 TO 94 n9 30 y« `,7 DL`_CNARG@ ~./~ :: t+ <br />rzazp Izz-z3) (zazs) - tze-zz) rzaze) Ooar) Y NOTE: Read Instructions before Ltbm leting this form. <br /> (3 Certi Ony) QUANTITY OR LOADING (a Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER ~ (ae-53) (sa~st) 38-as) as-53) (5a-B1) EX OF TYPE <br />X37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS IezeT) ~~ 6B)S 69-70 <br />OIL AHU ~,H F;A `•t' SAMPLE ~SYu:~ ( 94) >zr3~~`-rF #~fii~G ,.., '-`, 00 <br />V I :i U A L MEASUREMENT <br />44066 1 0 0 ~sPEgMIT i p4tRI Mb# -' ~'. <br />y ES=1 ~ .~fi tll# ~;~'.~' ,r glS~i ~ eon '~~` - - . <br />EPFLUz:tiT -; ~_? :~ VALE R~~[uAEM~hi1' r <br />~`+ r x t+- <br />" ~ 10=0 „-'~ .°r .t ~,~ / z~ , <br />. ~,~ ~-,~_~' ~##'.+ } '` ~" ~ `'~-g° <br /> SAMPLE - <br /> MEASUREMENT ~- -~ <br /> <br />3Q F~ yy <br /> <br />y <br />9N~~'~ <br />1~ t' x <br />X <br />~.'yv' 9 <br />J' .fie <br />1 ,. r t <br />~'~-f±' <br /> Ax <br /> SAMPLE _ ~ <br /> MEASUREMENT <br /> `;PE <br />~ `Y ~ ,~ ,, <br /> REOUIR NT <br />x <br /> <br />- ~ <br />. _$ <br />1 SAMPLE ~ ~ <br />~ / <br /> MEASUREMENT ` ~ ~ <br />r <br />f/~ ~ C, <br /> au <br />eE } <br /> RE <br />l <br />i~T a :., ' ~'~~ .... .. ~ , .., <br /> SAMPLE ~ +~ <br /> MEASURE <br />M <br />ENT <br /> ~ <br />,t '~r4 ; <br /> EMENT '~, ~a ~4 <br /> SAMPLE ~° <br /> MEASUREMENT <br /> . ,':PERMIT? <br />y <br />~ <br />~ <br />4 <br />~ <br />.l' s F' <br />_l <br />"° <br />3 ; 4 .i <br /> .flE4UlREMENT ~ <br />` ` <br />~; ' ' <br />,; <br /> SAMPLE <br /> MEASUREMENT ~~ <br /> PERMIT .: t :~ d a;;,= <br />~ <br /> iiE~U[REMENT x „ ~~ <br /> . <br />NAME(TITLE PRINCIPAL EXECUTIVE OFFICER I CERTFY l1NDER PENALTY OF <br />AM FAMILIAR WITH THE INFORM lAW THAT I HAVE PERSO <br />ATION SUBMITTED HERE NALLY EXAMINED AND <br />AND BASED ON MY <br />IN TELEPHONE DATE <br /> <br />INQUIRY OF THOSE INDNIDUAL <br />S IMMEDIATELY RESPON ; <br />SIBLE FOR OBTAINING ~] <br />/. <br />~ THE INFORMATION, I BELIEV E THE SUBMITTED IN FORMATION IS TRUE, <br />F <br />A <br />T ~ <br />/ < <br />~ ACCURATE AND COMPLETE. <br />R I AM AWARE THAT TH <br />TI ERE ARE SIGNI <br />IC <br />N <br />LUDING THE <br />N <br />IN ' 1 <br />~ I / <br />ii~C /An~ 1 i J~/~ r Y ~Jl ( SUBMITPN <br />PENALTIES FO <br />POSSIBILRV OF FINE AND IMPR , <br />G FALBE INFORMA <br />O <br />C <br />ISONMENT. SEE 7B U.S.C. § 1001 AND 33 U.5.0 <br />d <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />~ TJ <br />"7u7 % S~ 7 ~!Q <br />/%J <br />/ U <br /> <br />TYPED OR PRINTED or <br />§ 13te. (Penelfles antler these sretufes may Include firres up ro 510,000 en <br />maximum lmpnsonnrent of beMSenBmonfhs entl5ysers.) OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/erence ell attachmen4s here) <br />S6TTL6ABL1: 5)t.l.DS LIT'7T APPLIES ONLC I~ C=lOVit,7.4HR PRF.CIF ?V~+TT TS CLAT;!OD. tF rLALM APPPOVED `•.I BCD, <br />T55 E IRON LInITS YI[L vOT :j ': APPLII?D TD RFPORTP.D !IEASURP.YpNTS-SPF. T. A. 2, oG ~ FOR dURDF9 OF F40Gf <br />EPForm 20.7 (GA-95 Previous editions may no be use ~ ~ ~" a (F~EP CES A T" I AO BE ED.) - ~ 001 0 6 / 99 0 71 2-1 ~ 2 2 PAGE OF <br />