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PERMITTEE NAME/ADDRESS /Include Pan Gn•NumelLOCmlon jDigerenq <br />NAME SENECA CGAL CGEFA6S <br />ADDRESSD i{A M E: k D <br />HAYGEN <br />CO a 16 ~ ' ~ PERMIT NUMBER <br />FACILITY ~. <br />LOCATIO `~. YEAR MO <br />~IIAYDt:N CO 8163U FROM '~ <br />ATTR: G. BUO. B80YN~ CLNE9AL NAtiA~ER rzo-zr) (zz-z3l <br />ELIMINATION SYSTEM (NPDES) <br />NG REPORT (DM9,~ <br />n~- 91 <br />DISG`HAAGE NUMBER <br />NG PERIOD <br />rI~JF, <br />jsueR ~~) <br />Form Approved. <br />OMB No. 2040-000ip <br />Approval expires OS-31-gB <br />t - FI-/1 RCU~7 <br />D1SICtlAACfk SC 161El-dEE CFEEN <br />4#+10 LI9CNA16! j__ j ~~~ <br />E: Read Instructions before completing this form. <br /> (3 CeM Onry) QUANTITY OR LOADING Only/ QUANTITY OR CONCENTRATION ~ O. FREOUENC SAMPLE <br />PARAMETER (46-53) ($4-61J ~ (38-45) (46-53) (54-67J EX OF TYPE <br />(32x7) AVERAGE MAXIMUM lJJJITS. MINIMUM AVERAGE MAXIMUM UNITS (sas3l A~sgl- gS sg-70 <br />SOLIDS. TOTAL SAMPLE ~L;Y~+'G =:t~-?;r'~ 44!10 4 / ~ U <br />v /~ ~ AS) O <br /> <br />DISSOLVED <br />MEASUREMENT <br />b w. <br />70295 1 0 U •' p~ <br />~MIF +aa00aa ~ ~+t~9 ena t(r j`#7 A ~ ~ SCR <br />•°„ ~ ;-c ~, _AAtl - <br />f:FFLUENT GLi055 VALUE ~ <br />~!1'(B6Ci~ENT ~ zt>o>~~ = <br />a ~;. ;~~~.;,A,ytl . <br />bxj;R#- 1!G/[ i~ . <br /> , <br /> SAMPLE <br /> MEASUREMENT <br /> ,PERMIT <br />fl(iEMENT <br />-RE{~ <br />: <br />rtis~z ~ ~ - <br />~ ~~„ -+? <br />-•{ <br />, <br /> E , <br /> SAMPLE <br /> MEASUREMENT <br /> fERM1T <br />' ' <br />? <br />~} ~ <br />' <br />' <br />t <br />r ^^': <br />. <br />. <br /> lUIREMENT <br />;A,~l ~ I <br />' t <br /> SAMPLE - <br /> MEASUREMENT <br /> <br /> <br /> SAMPLE <br /> ENT <br />MEASURE <br />M <br /> J <br />~ <br />• ~U REM~FI '' <br /> SAMPLE <br /> MEASUREMENT <br /> ~ ~ ~ - ny ~ i~~ <br /> T1Gf~ <br />j ~'f'f~s F' ' .. ~ <br /> SAMPLE <br /> MEASUREMENT <br /> " <br /> Hit Uf)3LN1: - - <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 WRH THE INFORMATION SUBMITTED HEREIN. AND BASED ON MV <br /> INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> ' THE INFORMATION. I BELIEVE THE SUBMITTED INFORMATION IS TRUE. <br /> ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT <br /> <br />PENALTIES FOR SUBMITRNG FALSE INFORMATION, INCLUDING THE ~~ '~ <br /> POSSIBILITY OF FINE AND IMPRISONMENT. SEE 18 U.S.G. 4 IDOL ANO 33 U SG SIGNATURE OF PR NCIPAL EXECUTIVE <br /> <br />INTED <br />PED O 4 t319 (Penetties under these sleMes mey inclutle !Ines up fo Et0,000 entl or <br />n6 <br />end5 <br />i <br />r <br />f b <br />rh <br />e <br />i OFFICER OR UTHORIZED AGENT <br />~' ARP/ <br />NUMBER <br />YEAR <br />MO <br />DAY <br />R PR <br />TY max <br />sonmen <br />eMSe <br />mon <br />s <br />y <br />ers.) <br />mum rmpr <br />o COD <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/erence all attachments here) <br />T:iS ~ IhuN LIdITS YILI dE YAIYEL ANC SsTTLEIbLE SOLIDS LICIT AFFLLEL FCE <-lOYR~i~tE LEECiF EYERRp i9. b <br />IPOR LItlITS 4AIYED FC6 ~lUTH~2DRR PRECIP EYFRT SUEJPCT TO BURGER CF FbCCF iN I.A.2. CI1 6 GFEE_E-SEE <br />t C tY/'- t <br />EPA Form 3320.7 j08-95) Previous editlona.rpay not be used. ~ (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) 0 0 090 9 9 C 8 Z3"SE S 3. ~- PAGE 1 OF <br />