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PERMITTEE NAME/ADDRESS /Include Faoilit)•NnmdLocarian jDigercml -' Form Approved. <br />NAME 1JATIONAL POLLUTANT DISCHARGE ELIMINATION,~1'STEM (NPDESJ . <br />S f di EC A COAL C C H F i h i p~~s DISCZA6,GE MONITORING REPORJ"jpMR;BJ r 1 NC H OMB No. 2040-0004 <br />ADDRESSp Iyf({EA p ~ ~. ~"~'"'°"~~ Approval expires 0531-96 <br />~sueN wry <br />HA7DEN C(1 8163y ;~_,pERMII~B~R »,.;t~scHARGENUMBER F - FIA/! hCUTT <br />FACIOTY 9~~0~'Oll~ MONITORINGP~RIOD L'15'CHAFEE 7C 4F.7!/GF1 CFFEA <br />lACAT10t~pYDEN CO 81630 YEA MO DAY YEAR MO DAY ~~ <br />,ROM ~ TO `~y ~ ~a: '~ eiC [1_CYlF4E ~__~ ;~~ <br />A T T h: G. b U D b Y 0 Y N~ C E M E R A L h A N A C E fi (z0-z0 3) (za-z5J rzs zrl (ze zs1 (3031) Y NOTE: Read Instructions before completing this form. <br /> (3 Card On/y) QUANTITY OR LOADING (<Certl Onty) :QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46- 3J (54-61) . (38-45J (48-53J (54-67) EX OF NPE <br />(32-37) AVERA"~aE MAXIMUM <br /> <br />; ~ MINIMUM <br /> <br />: AVERAGE MAXIMUM UNITS <br />lsz-c31 ANALYSIS <br />(s4-6B) <br />69-70 <br />YH SAMPLE <br />MEASUREMENT 4 ~i ,i is 10>C r, ~e ~ >a flr)~9 ,,(( [[ L <br />!U' V V ( Ii~ .` <br />/yl ~ ~ ~ <br />G4GU 1 U 1 `:P~9ht(T ~ '~ f o . ;.t: ` <br />-~ <br />Y ~4I1 ,. <br />. <br />~ ~ ~1~~ <br />~ ~1311~ <br /> <br />EYFLUC~T GRO55 YALUF <br />` QUI~ENIEN`T ; <br />~,.._ <br />;-; <br />><>o~r, x <br />~ <br />;~ ., ,~~s ,~:, <br />;, <br />x <br />- ~ <br />~ <br />I ' ~ <br />1{!t~` L <br />g I - ,; <br />:k ~ <br />~ <br /> 1 r <br />-, <br /> SAMPLE <br /> .MEASU <br />R <br />EMENT <br /> r~ <br />y <br /> SAMPLE <br />-~ ` 1 <br /> MEASUREMENT v ~ ~ v "" <br /> 1 .. is ~ <br />~ ; ~ ° <br /> -~Hdl1fAE ANT S' ~ ~ <br /> L <br />u <br /> <br /> SAMPLE <br /> MEASUREMENT (ti ,Q, _ <br /> ~~~A., u v . <br />' <br /> ~+ t <br /> SAMPLE <br /> MEASUREMENT <br /> PER1~At ~ <br />~ <br />~ ~ ~~ ~. <br /> ;R~Qlll{~bM T . t' ~ ~ r _ <br /> SAMPLE ~ <br /> MEASUREMENT <br /> <br /> 1% <br />HEQbl~b~ENT <br />>.- ~ s <br />• • ;: " <br />xl a c` <br />' r. <br />~ m~ <br />ao <br /> SAMPLE ~ <br /> MEASUREMENT ~_ <br /> PERMi$~ ~,. <br />- ..c w <br />~~~ <br />~ ~ <br />; ~ ~ <br /> <br />14FJI EM~ <br />NT- rig <br />+ <br />' ~. ,'_. . <br />~ <br />• . p <br /> t . <br />° .:ate t.. , <br />NAME/TITLE PRINCIPAL ESECUTIVE OFFICER I CERTIFY UNDER PENALTY OF <br />M F LAW THgT I HAVE PERSONALLY E](AMINED AND <br />M <br />T <br />ON MV <br />T <br />' •~ TELEPHONE DATE <br /> A <br />AMILIAR WITH THE INFORM <br />INQUIRY OF THOSE INDIVIDUAE ED HEREIN <br />A <br />ION SUB <br />IT <br />. AND BASED <br />S IMMEDIATELY RESPONSIBLE FOR OBTAINING \ <br /> THE INFORMATION, I BELIEV E THE SUBMITTED INFORMATION IS TRUE. 1 <br /> <br />ACCURATE AND COMPLE-TE. <br />I AM AWARE THAT THERE ARE SIGNIFICANT <br />G ^ <br />` <br /> PENALTIES FOR SUBMITTING <br />POSSIBILITY OF FINE AND IMPRI FALSE INFORMANON. INCLUDIN <br />THE <br />SONMEM. SEE IB U.S.C. § 1001 AND 33 U.S.C. ~ <br />SIGNATURE OF PFjMCIPAL EXECUTIVE <br />TYPED OR PRINTED meximum(~mndsonmem I beMee <br />p n Bmeonms end 5utla lures up ro 110.000 entl a <br />ysers.J OFFICER OR HORIZED AGENT A A <br />p <br />NUMBER•~ <br />EAR <br />MO <br />DAY <br /> <br />GUMMEM 5 AND EXPLANA I IUN OF ANY VIOLATIONS (IiBlBrenOe ell atlaonmenTS OeBJ <br />TSS i; LHUN LIt1iT5 YI11 eE YAIYEC AND SETTLEABLE: 9CLICS LSCIT AFFLIECtCh <=1UYfi.iNhF FFECIi:iAFATp 755 L <br />IY,UF LI8I75 YAIYEU fC6 ~lUiA,24NA YeTECI? EYENT SUEJECT IC cUHDEl~17E F6CGF IH I.A.i. CIE 6 GLEASE-`_EE <br />Tyr l {~ *!w.$ •nlfdi~R-~I"rs-~PF ' @ 1 1_- <br />;EPA ForTll 332¢7 ,((~8 X95) Previous editions may not be used. ~ , Ij~_P,(,ACsES' EPA FORM 7-40 WHICH MAY NOT BE US)=D:) ~ ~ ~ ] a ~ o a ~ ~ 1 i * ~ t ~ PAGE w OF, <br />