Laserfiche WebLink
PERMITTEE NAME/ADDRESS (/ndade Facili8•,VamelGocmion i/DiperenU NA. <br />NAME lSINREC, INC. <br />A.DDRESSNO R?H THOH PS01 CS~~$,E•.'lIIYES <br />2768 COdBA35 C6IYE, SUITE 101 ~$ <br />GRAND JUNCTI011 C0 61506 <br />FACILITY <br />LOCATIOftI,AAHCYB-LE CC E1623 FROM <br />A']'TY: J. E. STCYER, CONSULTING EAC. <br />mAHr DISCHARGE EUMINATIQ S TEM (NPDES) Form Approved. f t <br />ARGE MONITORING REPO R~ OMB No. 2040-0004 <br />+el ~- 91 f I NC E Approval expires OS-3T-98 ` <br />` 9 u (SUE6 NC) <br />NUMBER: GE NUMBER F - FI-.11 '.EIT~tR <br />MONITO ING OD CHHalIbC NEi '4ESTIN'C FCF CCIA <br />d0 DAY ~ YEAR MO DAY ~ I ~ -~ <br />c ~ A~~1`14=j~3SCAAFCE ~__~ eaa <br />z3) (zo-2sJ (zs z7) (2s 3s) f30 31J NOTE: Read Instructions before completing this form. <br /> (3 Card Ony) QUANTITY OR LOADI _ ~ :Onty) QUANTITY OR CONCENTRATION <br />( NC(. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-e1J . <br />- (38-45) (46-531 (54-67) F~ OF TYPE <br />(32-37) <br />AVERAGE <br />MAXIMUM <br />INIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS ,' ~~ <br />" ~1 ANALYSIS <br />h-68) <br />69-70J <br />EFFECT STATEE D!Y SAINPGE'" 044a?~ oACaat ~cox+aa~ ~1oi~PiC ( ;3) ~ <br />Hh CEH IODAPH6IA MEASUREMENT ds~~ <br />~ ' <br /> <br />C P! H S U G <br />::', ... <br />>a : <br />3 r =~ <br />ii0. "' <br />iNpi# <br />i ~ <br />~' <br />C ~~t <br /> <br />"EE CONhENTS EELCN , <br />.,[3~ <br />~ <br />epee <br />6N tAb <br />~ <br />~~'~`~ <br />f6T <br />~~~~ <br />:~>':~ r <br /> SAMPLE ~'*' ! µ ~~ <br /> MEASUREMENT ., <br /> <br /> - - ^'- ':} ~ K ' t t~ ~ <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> ..: .. <br />- . <br />.. r,.+,... <br />,.~ <br />,k <br />ri . <br /> Ai <br /> E <br /> SAMPLE - C-s <br /> MEASURE <br />ENT <br />M <br /> <br /> ;4 <br />. <br />3X'~< fER a`;.. T'~'. '., <br />. y,'y" I r GS <br />. <br />'F!-. <br /> ~ECy~I Et~~ <br />,. . - - <br />y " ~. ~ 2 <br /> SAMPLE -- <br />~ <br /> MEASUREMENT a:~ <br />, <br /> <br /> <br /> <br />-, SAMPLE <br /> MEASUREMENT ~~~~~ <br /> <br /> ,. l <br /> ~§AMPLE <br /> MEASUREMENT <br /> ~ <br />~~" ~ ~ ~ ~ ~ _ a <br />r ~ _. - _ _~ <br />~ __ <br /> <br />NAMEJTITLE PRINCIPAL EXECUTIVE OFFICER 1 CERTIFY UNDER PENALTY OF TELEPHONE <br />LAW THAT 1 HAVE PERSONALLY E%AMINED AND DATE ' <br /> AM FAMILIAR WITH THE INFORM ATION SUBMITTED HEREIN; AND BASED ON MY <br /> INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br />t ~r <br />t/~ THE INFORMATION, I BEIJEVE THE eUBMITTED INFORMATION IS TRUE, <br />V ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT <br /> <br />( I <br />- t PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE <br />POSSIBILItt OF FINE AND IMPRISONMENT. SEE 18 U.S.C. 4 10e1 ANO 33 U.S.C. <br />SIGNATURE OF PRINCIPAL E%ECUTIVE <br />~ ~~ <br />0 <br />( <br />~ DDe entl or <br />se statures mey inclutle lines up ro SID <br />tties under rn <br />4 t379 <br />P <br /> , <br />I <br />ene <br />e OFFICER OR AUTHORIZED AGENT NUMBER YEAR 'MO DAY <br />TYPED OR PRINTED mevmum imPnsonmenl of bemsen6monlhs entl5 years.) DE .- <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments Here) <br />SEE I.B.S YOA TEST FIICCEOUBA. APT RESULTS CF LET},ALITL GEAIYAIICNS AS °+`.EFFECT", CFC]7A E FFFFGGUCTICA <br />UEHIYATIOYS AS `TC13C1SY". 6PT LCirEST % EFFL AT ~NICH ~TATISTICAIIY `_IGNIF LIPF EETIIFE] 7E~1 E CE~T,FCI <br />Si r~ M ~, ~ ~ ~ £ r + ne rnne yrr ~ ,7a ~ turn. .t ~`~ <br />L ~n'~>~c~s-c. <br />EPA Form 33261 (08.95) Previous editions may not.be used: (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) 0016 9/ 00 C ] 11-16:4 G 1 dF~ <br />