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PERMITTEE NAME/ADDRESS (rnclude Factliry Nmne/Location iJDi$erenr) <br />NAME BOYIE RESD08CE5 LI!lZTED <br />ADDRESS gOYIE N0. 2 ~flNe <br />P.O. BOx 483 <br />FACILITY PAOYIA CO 81428 <br />LOCATIOIJ„ O Y I E <br />uu CO 81428 <br />NATIONAL POLLUTANT DISCHARGE ELIMINATgN SYSTEM (IJPOES) FOrm Approved. <br />DISCHARGE MONITORING REPORT (DMA OMB No. 2040-0004 <br />n-fs/ nr.;9/ MINOR <br />Approval expires OS-31-98 <br />(sDBA Yc~ <br />PERMIT NUMBER DISCHARGE NUMBER P - FINAL DELTA <br />MONITORING PERIOD OSCRG OF SR TO DEER SAAIL DTCA <br />YEAR MO DAY YEAR MO DAY _ <br />FROM UO 91 0 TO 00 03 31 ~~~ nA0 DTSCRARGP 1 1 ### <br />is 1 I ^ : ^ 1 L L1 A O d • d ~ rs N J R • :~ I N E ~ G A (2P21/ (2223) 8425) (2x27) (28-29) (30J1) nv L e: Hasa Insrrualons Defor emmpleung mis form. <br /> (3 Card Ony) QUANTITY OR LOADING (4 Cfvd Ony) QUANTITY OR CONCENTRATION N0. FREpUEN SAMPLE <br />PAAAMEfER (4653) (54-6/) (38<5) (46-53 54-81) EX OF TYPE <br />(32377 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />l92 eT) ~~/s <br />84G8) <br />6&70 <br />OIL AMD GREASE SAMPLE #33#5# (gq~ ~*~*~# aaarTx #O#~It; <br />Y I 50 A L MEASUREMENT <br />84066 1 0 0 " • PERMIT '+~~ !` _ - ES=1 . 3r3 <br />EP LUEYT G8055 #-L0 REQUIREMENT ;'+,` _D : ` . . $.; <br />. ~e, w ~ <br />. ##~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT w'~` ~'~~ .~'_~- ~ ~~ <br />5~ <br /> REQUIREMENT :-~- .tr ~' "' `-""^t s,° <br />,- . a ~.' <br /> <br />. <br /> i~ ~ .",.... .+h ~ <br />k .,.i . <br />. <br /> SAMPLE <br /> MEASUREMENT <br /> ' PERMIT -~-~ }-s~..-. ,• ~.= y~ <br />` <br />i r~'t,• <br />k <br /> REQUIREMENT - ` ;f,~ -T1 ~"i`! ,~ <br />`~~:" . <br />° Wy <br />', <br /> ~ <br />. ~ <br /> SAMPLE ~ <br /> MEASUREMENT 6 - <br /> , ~, , i~h. '. <br />~. <br />~~ <br />~ ~' ~< <br />; . <br />° : + ~ <br />` "". <br />~ <br /> REQUIREMENT . <br />. <br />.~ ~ ~ ;# ~, <br />`~Er ~ <br />A , <br /> SAMPLE <br />.. Ill:' _'". j.~V)!'~' r <br /> SAMPLE <br /> MEASUREMENT <br /> NT ''F t . - ly ~~~ ~" ", i Y r 'y. <br />~{ <br />~"+ <br />3 ~ ~ <br />` <br />~ " ` ". - <br /> REQU REME ., r <br />;1 ; <br />r ~ <br />, .. .. y ": ~, <br />€ <br />..:~ Fe <br />.t, ,i~ <br />t .,. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT g~ .x? f <br />` I a ~, 4e"~ a ~e E,° 1, i" ~`` <br />P ~ ''trE ?~'„ <br />F <br />I ~;, ~ ~, V` '~#'.; <br /> REQUIREMENT ~ „x.•, + ~ +- _ ~ <br />;I <br />. ~-;; ~ ~ ~; - <br />NAME/1'ITLE PRINCIPAL EXECUTIVE OFFICER I CERTI <br />AM FAM FY UNDER PENALTY OF <br />ILIAR WITH THE INFORM LAW THAT I HAVE PERSO <br />ATION SUBMITTED HERE NALLY L7(AMINED AND <br />IN <br />AND BASED ON MY TELEPHONE DATE <br /> INQUIRY OF THOSE INDIVIDUAL ; <br />S IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> THE IN FORMATION, I BELIEV E THE SUBMITTED INFORMATION IS TRUE, <br /> ACCUR <br />PENALT ATE AND COMPLETE. <br />IES FOR SUBMITTIN I AM AWARE THAT THERE ARE SMaNIFICANT <br />G FALSE INFORMATION <br />INCLUDING THE <br /> <br />~L~ <br />POSSIB <br />1 1319 , <br />ILTIV OF FINE AND IMPRISONMENT. SEE 1B U.S.C. 41001 AND 33 U.S.C. <br />Po <br />ttl <br />tl <br />l <br />0 <br />SIGNATURE OF PRINCIPAL EXECUTIVE I~ U~ Q ,~ ^ <br />`L <br /> <br />TYPED OR PRINTED . ( <br />re <br />w un <br />er Brew smMes may inc <br />ude <br />nas up ro 510,000 end a <br />maximum lmpnsmmam of beMeenBmwxhs end5yeers.) OFFICER OR AUTHORRED AGENT <br />r.DDE <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerence ell attechmenGs here) <br />.iETTLEABLE SOLIDS LISIT APPLIES ONLS IF <10IR,24AA PRECIP EVENT IS CLAISEiI. IF CLAIl1 APPAOIED BT YQCD, <br />TSS 8 IAOR LISITS YILL l10T BE APPLIED TO REPORTED d6A50AEAEl1TS-SE$ I.A.2, PG 5 FOA BDRDH^ OP PROOP <br />orm ~ PreWOUS a Itions may no be 3 ~ • • ( CES 1 • PAGE OF <br />nmm~i4onaT~-~~» ~ <br />I t, <br />