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PERMITTEE NAME/ADDRESS pnclude FociGrr A'ame/[ocnnnn i/Dijje~enU <br />NAME SEAECA CCAL GCl,FAhY <br />ADDRESSp HAYEH D <br />HAYDEh CU 81639 <br />FACILITY <br />LOCATIOI~AYDtN CG 81E3U <br />ATI'y: G. tiUD ERUYG, GENERAL NAYAGEH <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved. ~ _ <br />DISCHARGE MONITORING REPORT. (p MR OMB NO. 2040-0004 <br />(z-Ibl pr-~BJ ~"yGb Approval expires 05-31-98 ~'e <br />CUUU (SUBH 6i) <br />PERMIT NUMBER • CHARGE NUMBER E' -~ F I N J I FG,~,I 7 <br />MONITO9ING PERK •. CI9ICBAAGE tp BUEEE 65611 GD•IC M~ <br />YEAR, MO YEAR MO DAY <br />FROM ~~p 1 ~ .7 000, Na~ 11 G$fE E E ~~ ~ ~ X+L <br />(zo-zy: _(zz-z3) 12s (z6 v) (2B-29J pa-au ,NOS ~ ~~ - Llucfions before coRtpleting this form. <br /> (3 Cartl Onry) QUANTITY OR LOADIN~C~x. (4 Cartl Only) QUANTITY OR ~~ 0 ~ <br />~ R, ~ ON ~ N FREOOENC SAMPLE <br />PARAMETER (45-53). (54-5r) (38~a5) (as-53) ~ (54-Br) EX OF TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />.691 ANALVS(S <br />(H4-68) <br />69-70 <br /> SAMPLE Xt ( ` ~ 00%i i7r0 +?S;4Ct~ <br />V I S U A L MEASUREMENT <br />84066 1 0 C ~1'~[iM .. ~~ , 15=1 ~ = +Dat ,~ I~.Gi <br />EFt'LU£!iT (:ROSS VALUE EOUII~CMIEN7 - 1~~{"1 1tA)t IC=O a>'lRA ~~;, <br /> SAMPLE <br /> MEASUREMENT ~'~p''' <br /> <br />-' -A6C!~kT- yX <br /> ~I~JIHEME~JT ~ - ` <br /> SAMPLE <br /> MEASUREMENT <br /> F hllt - <br />~ <br />'. <br />~ <br />3 y <br />: <br />- <br /> ~MONfi <br />~P-~~ ~~w <br /> SAMPLE ~ k <br /> MEASU <br />REMENT <br /> ~} <br /> <br /> <br /> SAMPLE <br /> MEASUREM <br />ENT <br /> y <br /> t1(S~~I~N7 <br />~ ; <br /> 6 <br />,6 S <br /> SAMPLE <br /> MEASUREMENT <br /> ~ ~ <br /> ~CiIV~CN1~Nf : ~' <br />~ ~~ <br /> ~ <br />;, <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> - z'- tv4=~ - - <br /> REt~U pMEt~GF ' ?4'±d; <br />? <br /> - <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSO NALLY E%AMINED AND / TELEPHONE DATE <br /> AM FAMILIAR WDH THE INFORM A ION SUBMITTED HEREIN; AND BASED ON MV , <br /> INQUIRY OF THOSE INDIVIDUAL S IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> THE INFORMATION, I BELIEV E THE SUBMITTED INFORMATION IS TRUE, <br /> ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT <br /> PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE <br /> POSSIBILITY OF FINE AND IMPRISONMEM. SEE IB U S C. 4 1001 AND 3a U.S C. SIGNATURE OF INCIPAL EXECUTIVE <br />TYPED OR PRINTED maximum~nASanme~betwse ~6 months entl5ude litres up roST0,000 ena ar <br />P Years.l OFFICER OR UTHORIZED AGENT <br />c D <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANV VIOLATIONS (Reference ell attachments here) <br />TSS b IRGIi LIkIT~ YIIL Er; YAIYEG b SETTLLAALE SGLICS LItlIT AFF'LIFU FCF <=i0YA,2~tF FGFC]F EYfi7; 155 E <br />IF.'Uh LItlI'LS YAIYiU FCF. ~lUYH,lUBH PHECIP EVENT SC EJECT TG 6UBDEh Ct F6CCF IN I.A.T. 631 E GFPA°E - SEE <br />T_H-7-n_ Tnc MnrT4rR lrr. - T-a.TF __. <br />EPA Form 3320.1 (05-95) Previous editions may not be used. (REPLACES EPA FORM T-00 WHICH MAY NOT 8E USED.) C O Z 9 ~/ 99 O E J T - I b c ? PAGE ~ OF <br />