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PERMITTEE NAMFJADDRESS Qnclude Pantry Name/Locarion ifDigcrtnq <br />NAME dOpIE RP,SOURCES LI!IITED <br />ADDRESSBONIE HO. 2 t1IAE <br />P.O. BOX 4B1 <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM MPDES) <br />DISCHApGE MONITORING REPORT IDMR~ <br />n-+el rn- v1 RINOR <br />PERMIT NUMBER DISCHARGE NUMBER (SUBR pC) <br />F - PINpL <br />Form Approved. <br />OMB No. 2040-0004 <br />Approval expires OS-31-98 <br />DELTA <br />FACILITY reuAaa CO B142H MONITORING PERIOD DS OP SR/RIAP. DRNC TO DEER TRL <br />YEAR MO DAY YEAR MO DAY <br />LOCATON <br />,,~~_//,~ <br />BONIE <br />CO H1~128 FROM 00 O7 O1 To ="+ ~O D~ gCR1RCbE <br />rm <br />NOT R <br />i <br />hi <br />f <br />~l ~~'_ <br />t <br />~ <br />d <br />. <br />s <br />o <br />e nstructlons <br />o st <br />ng t <br />r <br />c <br />r <br />ATTN: pILLIAR A. BEAR ~R.. RINE S6R Ros+) rzz-z3) a+zsl (zazr) t?azel r3oal) <br /> (3 Card Ony) QUANTITY OR LOADING (a Card Ony) OUAN7ITY OR CONCENTRATION NO. FAEOUENC SAMPLE <br />PARAMETER (+6-53 (54.61) (38J5) (46-53 (54.61 IX OF TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNRS aaaLrsls <br />&70 <br /> l6zs31 (64-68 6 <br />PB SAMPLE C?rsaY Y#O### #####G ( 12 <br /> MEASUREMENT ~, <br />00400 1 0 0 ~~".,~ERM ~ ~ ~ I <br />~~M" ,-!#?I $#t <br />~:~, <br />~ <br /> <br />E FLUENT GROSS IALO <br />QULR ~ ~ ~ <br />,. •~ •"a , ~ <br />..fix y <br />t <br />IDS, TOTAL SAMPLE ##'r##Y ###### ####s# <br />( 19) <br />S PEYDED MEASUREMENT <br />00530 1 0 0 "~ ~ ### ~` ~ ~~ <br />EPFLUBNT 055 IALU T ~' <br />_„. <br />~'~`~''" ~~ ;- #~## ~~ i~-` - -t= <br />SOLIDS, S TTLEAdLE MPkE #r*.#=# Y#Sa## ###e## ( 2$) <br /> MFASI)REMENT <br /> ~ <br />0054$ 1 0 0 ~:,, T „ ~ ~'. #'_~ arr .~a\i'r . <br />~-~ ~ :. <br />' <br />EFFLUEYT 6QDS5 I-LO (i1rCiU1gEH1EN'f ,`._ v#Y# :`{. .~',~ _ <br />~ ~ "°~ <br />: °'Y r ~ - ', k <br />IRON, TOTAL'. SAMPLE +####= : ##C## ##+:## ( 19) <br />(AS F~) MEASUREMENT <br />O1D45 1 0 0 -' E MrI ~~3s1#~ T, ~ # ~ <br />, ##; ` ' ~,; ~ <br /> <br />` ~`~ <br /> <br />' <br />` `, <br />;~. . <br />EFPLUEIIT GROSS IALO AE@UI~IEMENT = , <br />+„w, ###r r ~ <br />"~ ,f' "` ap <br />t ' ;ru <br />OIL AND GREASE SAMPLE #+.~G#=' ###C+# ####dr ####:# ( 19) <br /> MEASUREMENT <br />035 B 2 1 0 0 pERMIr~ <br />~ , ##al 'E7~##>F ~= " a#s , . <br />r'.- <br /> <br />EPPLUBfT GROSS IlLO <br />REOUIREMENT <br />.- , <br />- <br />tr## , " r <br />~~. ~ <br />~ ~=~ ~ <br />_ <br />r <br />Fri, IN CONDUIT OR SAMPLE ( 03) ##~##* :i.`;e#r# ###t Y# <br />SHEATNENT PLAN MEASUREMENT <br />$0050 1 0 0 `- - pER1dl ' :I Off! ~-` ~~E?6~!*-. r A R <br />, <br />~.. "~ ~ ` #~s <br />EFPLUEBT GROSS IALU ~3EQUIREMENT. _, ~ A NGD ~ a ~'"< . <br />~ <br />.•i,+c. ~''s'~`r"'.'~~ ###t 5,a. <br />SOLIDS, TOTAL SAMPLE $##+## #####C #tt#t## ( 19) <br />DISSOLYSD MEASUREMENT <br />70295 1 0 0 ~:"PRgMIT' r ? *##~ ''.~1?°~ ~~s ~ ~" ~~ ~# .. <br />EFPLUENT GROSS IAL NEGU trMEtrT ~~T -.i`: -.. a . ? ~# x - '•. ~~t ='Sx ~,. : <br />NAME/TITLE PRINCIPAL IXECUTNE OFFICER I CERTFV UNDER PENALTY OF <br />AM FAMIOAR WITH THE INFDAM LAW THAT I HAVE PERSONALLY E%AMINED AND <br />ATION SVBMITTED HEREIN; AND BASED ON MY TELEPHONE DATE <br /> INQUIRY OF THOSE INDNIDUAL S IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> THE INFORMATION, I BELIEV E THE SUBMITTED INFORMATION IS TRUE, <br /> ACCURATE AND COMPLETE. <br />PENALTIES FOR SUBMnTIN I AM AWARE THAT THERE ARE SIGNIFICANT <br />G FALSE INFORMATION <br />INCLUDING THE <br /> <br />POSSIBILffV OF FINE AND IMPR , <br />ISONMENT <br />031 AND 33 U <br />SEE 16 U <br />S <br />C <br />S <br />C <br />4 /~ <br /> <br />§ 1379 <br />d <br />P <br />ti <br />N . <br />. <br />. <br />. <br />1 <br />. <br />. <br />. <br />r <br />lu <br />I <br />l <br />d <br />0 <br />606 <br />tl SIGNATURE OF PRINCIPAL IXECUTIVE Q <br /> <br />TYPED OR RINTED ern <br />es un <br />er <br />es mey <br />res up b 31 <br />. ( <br />ess smN <br />nc <br />u <br />e <br />, <br />en <br />or <br />meUmum lmprisonnlem of beMreen6monrlu end5years.J OFFICER OR AUTHORfZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerence all alYechmenfs here) <br />SETTLEABLE SOLIDS LIRIT -PPLIES ONLY IP <=l0IR,24HR PRECIP EVENT IS CLAI!lED. IP CLAIN APPROIRD fl2 NQCD, <br />TSS E IRON LISITS IiIIL ^OT BE APPLIED TD REPORTED HE-SORENE\TS-SEE Z.A.2, PG 5 POR BOADEN OP DROOP <br />orm Z 0 ~ Prewous a Itions may o be se ~ ~ • ( CES 7 .) • PAGE OF <br />- 00049/990x1 9-1 ~2'- t <br />