PERMITTEE NAME/ADDRESS /ynclude Fmvliry Name/Cxarion if D~ereno
<br />NAME CYPRUS YAP-PA VALLEY CCAL COhk'.
<br />ADDRESS"1h~:~ 1, 1,d CCU?H, :; 3C~.;'At. i'h:
<br />91U'J r:d:;':' "lflT dAi CIdCL
<br />„r.d000 ~~"~ e0I S7
<br />FACIUTr
<br />LOCATION
<br />3iY,"iC "U •.di.i M. tiii i~L!'Y, l:C'~c HAL R`,i
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved.
<br />DISCHARGE MONITORING REPORT (OMR OMB No. 2040.0004
<br />tz-ts1 nr~s) °`:')" Approval expires 05-31-98
<br />COOO17154 UU2 (~t:_'~' t:~)
<br />PERMIT NUMBER DISCHARGE~NUMBER - I ~ :I +, UU V i i
<br />MONITORING PERIOD ~ L ~' '' L , ' (` ~+.1 i C r L' U E L C ii .'. F; '~~
<br />YEAR MO DAY YEAR MO DAY
<br />FROM :v vv t TO vv v%I - ~1~-,C Iii". (__~ •./%'
<br />Izosu rzz~z3) rza~zs) rzs~zzJ Iza-zsJ r3o-3rJ NOTE: Read Instructions before completing this form.
<br /> (3 Certl Ony) QUANTITY OR LOADING (4 Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER (as-53) (54-s t) (3B-45J (as-s9J (ea-sT) EX of TYPE
<br />(32-a7) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS aNaLrs/5
<br />~~ SAMPLE ~... ...; ... ~F
<br />(J :K-~#%`:c ~{
<br />~~ ( 11) !~ `~l
<br />(
<br />; ~'
<br />t(Ct~
<br /> MEASUREMENT a ,. `
<br />,
<br />' ,
<br />1:uUU 1 U U yg
<br />PERNIIT r':,aR >P G>=" +k
<br />5.5 :,'Y ~ + ;; : t@R;:F %RAB.',
<br />~
<br />:. f'r'LU 6.'~T ;5055 YALUv ,
<br />ppEOOUIREMENT + [ t l~ ~ v#=`~'' n
<br />tyIK ~ ) "r'x~ ~ y y{Y " 5 ~
<br />~
<br />
<br />T': L1 U.rF :' L'A
<br />('END :'
<br />J "
<br />` SAMPLE 'n •n=:,:u ,,F v s:i'.;%47r ,,1 p
<br />~ I' JA
<br />N )
<br />~
<br />"~ ~~ A
<br />~~Tr
<br />:,
<br />~, MEASUREMENT 1
<br />I V 1 rC
<br />)VSSU l~ J U ~ .PERMIT g
<br />~ r ~~~+L
<br />aI~
<br />H ~ c6,• ,. ~
<br />- ,.~•. +, ,~
<br />• H&p '!~ T ,>g~,l=r
<br />-•° O N ~ ~l
<br />r~: ~ •I1AR-
<br />
<br />c E CO:"! .: t' t'S UELOrA
<br />REQUIREMENT
<br />>' ~ f
<br />+
<br />~~ ' -
<br />I` `v'-. ., .~
<br />• n'-;:.
<br />r~ ;
<br />-`
<br />Y:d+~
<br />30DS
<br />~ i~}
<br />~EJ~"rJ; ;<i'-~ "
<br />ryG /[
<br />-
<br />.
<br />A
<br /> ;
<br />.. , .
<br />.,
<br />- _
<br />.. - .
<br />:
<br />'%Ll U:,. '~. L'1 AL
<br />~ SAMPLE ,: `'z i+#Z :t4•nv-=..~ #X+#:=~:C G
<br />O
<br />~ y
<br />L
<br />~ ( 19) (~j
<br />~
<br />' ,.~-~~q /1
<br />i
<br />O
<br />="SPENDS') MEASUREMENT .h, J- °~ : '~ ~~
<br />(C
<br />
<br />~
<br />'
<br />' ~ c;
<br />Y
<br />.'U~~ tiALU
<br />`
<br />LNT C,
<br />: RED I MENT
<br />m ### ,~1k2~Y IIX 'G/I;
<br />'
<br />.' C1 ~ b C. ~: C 0.A .' L t
<br />~ ...
<br />kSAMPLE ..
<br />
<br />- • ~ :<-,,,. >R
<br />~ rnp ~:.up:? .:nrr
<br />
<br />
<br />~ I
<br />( )
<br />
<br />~
<br />
<br />N~ 1R
<br />
<br />Tl ~ h~
<br />', MEASUREMENT - ~ _ ~'.
<br />)u5u> c, c v
<br />% ;~
<br />`'PE[aM1T~- F89` I X
<br />~.?FIR r"'' ' 3r F. i-~E;FCHT -Q j~
<br />~ j{LI1b3
<br />
<br />iELr COIi148N15 r;~~:LU~ ,{~,
<br />REOUIREME~
<br />
<br />.
<br />-.;
<br />~~ A
<br />~~
<br />~' +
<br />1
<br />r`~"••~
<br />;
<br />p
<br />a'
<br />y'$RD~~ AVv'
<br />L/L ,
<br />~;~1
<br /> ~.
<br />w ,,
<br />~ ,
<br />;
<br />y,y
<br />-, .. ~
<br />~U LUJ, 1":LtHtlLr. SAMPLE z'7 rA m r, *A• a-~ #>F>r.#:
<br />~
<br />~ ~
<br />L
<br />I
<br />I 2 S)
<br />~•, `
<br />/~
<br />~
<br />~
<br /> MEASUREMENT ~ n ~ r
<br />)US4~ ~ 1 U U 'PERMIT k r ~ ~ r~ Os+: 7RRFR;3Lt BEi~ ~"1
<br />T ,~~ SP +,'st O NCE/ t $~I'
<br />EFFLUENT GRO55 YALUv R~OUIREIdENT j:- +
<br />~`„~k ~~'_
<br />" ~ !#'•° ~~ ~~ `~ I ~ _
<br />- ;~~.~
<br />~bAS~i tlL/L CET!?
<br />.
<br />~' '
<br /> _ .~~ ,, ~'-
<br />J1L VHEIISL' SAMPLE ~- ~` r,. r„-%#
<br />~ ##Y###
<br />N~~
<br />( 1~)
<br />~
<br />N~a ,t
<br />aln
<br /> MEASUREMENT .
<br />)OSh6 1 0 U ,RERMI `{~?
<br />~ ~_ r. 4## za)'~ 1.. sb~',P,?1~i~r'~I`, ~ ~~';,." C ~3rTIM~. ~~~_~
<br />FF411ENT ";70:r-~ VALUE .
<br />,REQ~'11R~MENY ~ #.~7 >=~JIY' My/i. "iNY
<br />N ~ N~~ ~~~' ~ L ) ~ ~
<br />~~
<br />~ ~~~
<br />(AS f~) MEASUREMENT ` I ~
<br />I
<br />)1045 it U U
<br />-PERMIT' ~;Rans ,+
<br />( ~ t
<br />a C#'t #4ir ~A
<br />~ : RE'F 7 R1aFQ6T C RCE/ r.AE ..
<br />
<br />TEE CO'St BSI-i 9FLOM
<br />REQUIREMENT. _
<br />,~v ,;, ,
<br />G-'~"r'
<br />.
<br />3QCA AfG
<br />,Di1I I.T F`X
<br />'.;/T.
<br />UBTH
<br />NAME(fITLE PRINCIPAL EXECUTVE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WRH THE INFORM LAW THAT I HAVE PERSONALLY FJfAMINED AND
<br />ATION SUBMITTED HEREIN; AND BASED ON MV TELEPHONE DATE
<br />Richard ".4111 s INQUIRY OF THOSE INDNIDUALS IMMEOIATELV RESPONSIBLE FOR OBTAINING
<br />THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE,
<br />
<br />//
<br />,'
<br />Environmental R4ana er
<br />9 ACCURATE AND COMPLETE. I AM AWARE TNAT THERE ARE SIGNIFICANT
<br />N
<br />G THE ,,
<br />""~ ~ 970-070-7712 --
<br />
<br />PENALTIES FOR SUBMITTING FALSE INFORMATIO
<br />, INCLUDIN ~ S ~~
<br /> POSSIBILITY OF FINE AND IMPRISONMENT. SEE 1B U.S.O 4 1001 AND 33 U S.C
<br />i
<br />l
<br />0
<br />M
<br />tl
<br />li SIGNATURE OF PRINCIPAL EXECUTIVE
<br />
<br />TYPED OR PRINTED nc
<br />ar
<br />a
<br />u
<br />e
<br />nes up to 510,00
<br />4 1310. (Penattles untler fosse statutes may
<br />maximum imprisonment of benreen6monrhs entl Syears.) OFFICER OR AUTHORIZED AGENT
<br />O
<br />NUMBER
<br />YEAR
<br />MO
<br />DAY
<br />COMMENTS AND EXPLANA710N OF ANY VIOLATIONS (Re/stance all attachments here)
<br />AL1.`: FiNl: ~i- LIMITS .: Uh 155, IiW la - SP'~~~i L'AP L'c vS.TU`_- ('LOC 'U') :. i•PL7 ',"LY Ir C= 1C-~~i, %I-r i• 1~:~-.C IP !'Y~:1T
<br />CL~I`E.. _::F I.A.1, PS Lti~ F%fo ,s7::~~ `.F "'F'1..' =~F~;;CIRE:°".".~.. .'TL y -~. -. :..~...1` f%, 7i; ~.!.
<br />. u9'FIY •-.1 DITAIC Y'. n: iinL`TT Nq 1. •: ~~1!"n r'14~-C.-, (gym 4i.mC n/
<br />EPA Form 3320-1 (08.95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) ~, ; I, r ~ PAGE OF
<br />
|