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PERMITTEE NAME/ADDRESS Onclude Facdiry NnmP/LnCnIIOD i/D$erea) <br />NAME NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved. <br />S E A Y C A CC A L C G M F B N T DISCHARGE MONITORING REPORT (DM9 <br />~9) <br />( <br />~ <br />d I h 0 H OMB ND. 2040-0004 <br />ADDRESS <br />DHdMER D ' <br />~ <br />' Aoproval expires OS-31-98 <br /> : A (SL'EA 6f,~ <br />BATDEN CO d16J9 PERMIT NUMBER DISCHAgGENUMBER F - FIAlL H0~T7 <br />FACILITY MONITORING PERIO~1~ •~ ~ L I SC H A F. C F 7 G T E I E/ ~ A G f C F E E 8 <br />LOCATION <br />ddlDEA <br />CU 81630 YEA-~ MO DAY YEAR MO DAY <br />9fit <br />` <br /> FROM TO tl MG Ll CNAhCF ~~~ tCt <br />_ <br />A TT Y : G. BUD EI H U M N ~ C F N E H A L M A N A G k N (zo-zr ) (p4 25) ~ (zs z]) (ze-z9) (ao-31) NOTE: Reatl Instructions before completing this farm. <br />PARAMETER (3 Card On y) pUANTITY OR LOADING- j4 Cab Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br /> (46-53) (54-61) (3a-45) (4B-53) (54-61J EX OF TYPE <br />(3237) AVERAGE MAXIMUM MINIMUM AVERAGE MAXIMUM UNITS <br /> <br />lszt,~l <br />ava.ysls <br />(64-68) <br /> <br />69-70 <br />F U SAMPLE ~ A'C A~ b t. J>r r fi { L t~ r::~ ( le) <br /> MEASUREMENT <br /> r <br />UDUOU 1 0 1 PERMIT ~~"#: i10# z~+a .~ I 004 . Y Ef iSY`Y <br /> <br />LPYLUEtlT GfiUSS YALC <br />AEOUIPEMENT <br />'~ <br />~ ~ ~s. <br />;CpfY <br />w ~ <br />~ <br />°'~;-,, .~ <br /> <br />~daa~x~ <br /> <br />L <br /> <br />lC11TF. , <br />FLUiI, lY COItUUIT CF SAMPLE 1 03) s <br />s• ~ oa>a>san ,p <br />TtIHU PHEA YdBYt PLd N7 MEASUREMENT <br />SUUSD I U 3 ~~' PERMI~~ Af: URT AEPCAT O 1R a; Y99 CEI IISTA <br /> <br />EtFLUEnT GROSS YALC <br />~!lIR~Ii~NT <br />jQnd dYG <br />DAILT !!I <br />tCL <br />,~; <br />~~ -s <br /> <br />•~ <br />rtse- <br />lC~TA . <br />UIL AND GBEA3B SAMPLE a~:ca+t:: ( 70) saaa+~o ~ ' sso>ar~a 90rtxtC <br />Y I :: U A L MEASUREMENT _ <br />auUe,b 1 U 1 r~~gMtr ,' ~ 04o>olao AEFQNT t~=1 eoaooa ; ~ +6L: IICtl/ IS 1 <br />tF'fLUENT GROSS IALU QUIRYME¢A, INS1 l:d71 lC=U e' ~pa.:;~~ <C>04 bCllTE <br /> SAMPLE <br /> MEASUREMENT <br />... ,..~EIiMIE ~ <br />~EM~Nfi ~ ,. I ,:. , <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> 7 -"~~}~~~~ - - <br /> ~LG1UlAEMBN}' <br /> SAMPLE <br /> MEASUREMENT <br /> ~i6RMItr <br />- <br />' <br /> ~~'t~!lJRSM~NT~ ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> B~ RMY~ - , - - <br /> l~~~U~IEMEN~ ~ ' <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALtt OF <br />AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSONALLY E%AMINED AND <br />ATION SUBM <br />TT TELEPHONE DATE <br /> <br />INQUIRY OF THOSE INDIVIDUAL I <br />ED HEREIN. AND BASED ON MY <br />S IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> THE INFORMATION, I BELIEV E THE SUBMITTED INFORMATION IS TRUE. <br /> ACCURATE AND COMPLE-f E. <br />PENALTIES FOR SUBMITTING I AM AWARE THAT THERE ARE SIGNIFICANT <br />FILLSE INFORMATION <br />INCLUDING THE <br /> , <br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE 1a U.S.C. 4 1001 AND 33 U.S C. <br />SIGNATURE OF PRINCIPAL EXECUTIVE rT I <br />V <br /> 4 t319 (Penenies under these sraMes mey rnoluda lines up ro E10,000 entl or <br /> <br />TYPED OR PRINTED <br />marimum lmpnsonmenr of heMSen6months entl5ysers) OFFICER OR AUTHORIZED AGENT ARE4 <br />CODE <br />NUMBER ,~ <br />YEAR <br />MO <br />DAV <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/erence all attachments here) <br />TSi; G IkOF LIrLTS VIII 8E LAI760. AYD SETTLEABLE SCADS LIt!IT AFiLIEC iCF <=1UTH,i4MF F6IC22~lIFtITp TSS G <br />IdUN LIMITS l4dIYED FCF )LUTA~20H8 PH2CIP 2YFNT SUE~P.CT 1C 6UFDEY C! PECCF IN I.A.i. GI1 a CFfA:E-Sfi <br />r rz r Inc rnuisrayic~c V• i_G l 0 <br />EPA Form 3320.1 (OS-95) Previous editions rriiy.n.Ot.be used. ~- ~- (REPLACES EPA'FORM T-40 WHICH MAY NOT BE USED.) ~ ' ~ PAGE OF <br />Q O C 92~1;F~32~3 1 <br />