PERMITTEE NAME/ADDRESS pnciude Faciliry Name/Locarion ifO fferenQ
<br />NAME BOOZE RESOURCES LIBITED
<br />ADDRESSBONIE NO. 2 ttiNP.
<br />P.O. BOY 493
<br />FAGUTY PAONIA CO 81428
<br />LOCATIONBOYIE CO 81428
<br />A2SN: MILLI ~~! A. BEAR ~R._ MTNP. McR
<br />NATIONAL POLLUTAM DISCHARGE ELIMINATION SYSTEM (NPDES) FOrm Approved. ~~. may:
<br />DISCHAS GE MONITORING REPORT (DMF;B) OMB ND. 2040-OW4, a
<br />RINOR Approval expires 05
<br />PERMIT NUMBER DISCHMGE NUMBER (SOBR NC) , i
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<br />MONITORING PERIOD DS OP SR/RIME DRNG 20 DEER
<br />YEAR MO DAY YEAR MO DAY
<br />FROM 00 O4 0 TO ''Yr EO DISCA~IRCbE 1 #+#
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<br />PARAMETER (46-53) (5461 (3B<5) (96-53 !5.1-61) IX OF TYPE
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<br />~ 6370
<br /> ~) 89,.6
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSO NALLY EXAMINED AND TELEPHONE DATE
<br /> AM FAMILIAR WITH THE INFORM ATION SUBMITTED HERE IN; AND BASED ON MY
<br /> INQUIRY OF THOSE INDNIDUAL S IMMEDIATELY RESPONSIBLE FOR OBTNNING
<br /> THE INFORMATION, I BELIEV E THE SUBMNTED INFORMATION IS TRUE,
<br /> ACCURATE AND COMPLETE.
<br />PENALTIES FOR SUBMrI'TIN I AM AWME THAT THERE ARE SIGNIFICAM
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<br />COMMENTS AND EXPLANAI ION OF ANY VIOLATIONS (RBtBTanOe ell attachments here)
<br />SETTLEABLE SOLIDS LIeIi APPLIES ONLI IF <=lOLF,20RY PRECIP EreNT IS CLAI!lED. IF CLAIe lPPRO~ED BI NQCD•
<br />255 6 IRON LIRITS HILL NOT BE APPLIED TO REPORTED 1lEASORBRENTS-SEE i.A.2• P6 5 POR BORDEN OP PROOF
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