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PERMITTEE NAME/ADDRESS (/nclude Fnrilin~Name~[orm~on i/Di[(erem) <br />NAME SFAHCA l-OAL CCMFANY <br />ADDRESSD K A Y E: R D <br />HAI06N CO 81639 <br />FACILITY <br />LGCATIONHAIDFli !`~'~~~1610 <br />ATTN: G. SUD BFUrN, GFNF9AL ~EIA~Y6 <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (OMR; <br />(z te) f1J 9) <br />cauDac i a u r <br />PERMIT NUMBER DISCHARGE NUMBER <br />a~~ at <br />(2819) l303p <br />Form Approved. 4 <br />MIN 0 R OMB No. 2040-0004 <br />Approval expires OS-31-98`~ <br />~SUBA NY) <br />P - PIINI B~UT7 <br />ACUTE iEI TE~IlIG FCfi C1]A <br />~~~ NC CISCilAhGE ~~) ~~~+ <br />NOTE: Read Instructions befor-completing this Corm. <br /> (3 Cerd Ony) GUANTITY OR LOADING '~ GICard Ony/ QUANTITY OR CONCENTRATION <br />~ NO. FREOUENC SAMPLE <br />PARAMETER (xs-53) (sx-s t) -~ (3a-xs) <br />~ (x6.53) rya-sT) EX oF" TYPE <br />(3237) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />f6z-6J7 ANALYSIS <br />(64-68) <br />69-70 <br />LCSU STAT9t 4tlKH FCU SAMPLE ~:nnoec ae04A>a >F:aoea rasaan ( 13) <br />C£NI001PHNIA MEASUREMENT .~ <br />TArijb 1 U D PERMIT. ~~~~~ I ~Or tQD~{~ ~'~~i14 `- $$/ki3$ P kE- G 'INL1 t 'fiAic <br />FPFLUFST GRUSS iALUF "REQUIREMENT: =' ~`:% xa• <br />°1 ' <br />~ tC4~i „ <br />}~~- <br />~ '-< :~ <br />~ ' CE17 <br /> s~ <br />e_ T - <br />, , <br />q~ <br />c <br />_ <br /> SAMPLE " ''~'+'~= ,y,~ ~ • <br /> MEASUREMENT <br /> 'PERMIT ° ~ - ~ ~ <br />~ '' ~ ~ ~ <br /> <br />^REQ(IREMENT- <br />`, <br />T • .) <br />-"1 <br />t~,r 'w _ <br />b - <br />. <br /> SAMPLE <br /> MEASUREMENT " <br /> .;FEFIMR - <br />- - .. 3nz ,I r x F ,,~ <br />~ r< , - <br />~ <br />~ <br />~ . <br /> .FiEOUIREMENT ~ ,~>€ " <br />~ {r ~ ~, <br />~ " <br /> ~, <br />~ , <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT'. - - ~ <br />?•r <br />~` r:'•. ~ <br />i~r~~ _ ;;';~~'.y <br /> <br />REQUIREMENT <br />~ -• <br />~ , <br />, <br />~~ <br />~~ <br />* , <br />Xr~ ~ ~ <br /> . <br />. ,~ <br />, . ~ <br /> SAMPLE <br /> MEASUREMENT <br /> ",-.PERMIT;: - "_ . .'~ ~~"~'~ ~ ,3 ;". _ <br /> REQUIREMENT - . <br />;-:",~~~ y,,$-" - ~t ~. "~~> L ' s; . ; , <br /> SAMPLE <br /> MEASUREMENT <br /> ' ~.. PERMIT" - ~m.~,rr~.~~~ e <br />;" <br />~ - - <br />~ , ~ , <br />` 7. <br />; <br /> "REQUIREMENT ~ -. . - ' <br />.~r" " <br /> , . .: + f } <br /> SAMPLE .. <br /> MEASUREMENT <br /> "":PERMIT" <br />~ "` •~~" t ¢, e:. -~ <br /> -REQUIREMENT -' <br />- - i t"". ,tt .+-,~d; / <br />NAME/TITLE PgINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMIL <br />AR WITH THE INFORM LAW THAT I HAVE PERSOHALLV E%AMINED AND <br />ATION S <br />BMITTE <br />ERE <br />AND <br />ASED TELEPHONE DATE <br /> I <br />IN: <br />P. <br />U <br />D H <br />ON MY <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING " <br /> THE INFORMATION, 1 BELIEVE THE SUBMITTED INFORMATION IS TRUE, <br /> ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT <br />PENA <br />S FOP SUBMITT <br />T <br />NG F <br />UD Y.l <br /> L <br />IE <br />I <br />ALSE INFORMATION. INCL <br />ING THE <br />P <br />' ~ ~ ~ <br />X <br /> <br />OSBIBILT <br />OF FINE AND IMPR50NMENT. SEE 18 U.S.C. g 1001 AND 33 U.S.C. <br />SIGNATURE OF P INCIPAL EXECUTIVE V <br /> <br />TYPED OR PRINTED 4 1319. (Penettles antler Ihese sfarulos me include Imes u to Ef0,000 end or <br />my~imum impnsonnrenr of SeMeen6monlhs ends years.) p r <br />OFFICER OR AUTHORIZED AGENT <br />AR <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/erence all attachments here) <br />SEE YAkT L A.4 FGN CEIAiLS OP TP5T PHOCFDUNE. REECAT LCYEST DILUTIGN (i EFFLLd-7) YF]C6 I` IE7NA1 TC SU,: <br />Of TEST ONGANIS115 (LCSO) ANC ATTACK ACUTE TCCICITI TESI P.EEONT FOAM TC DUF. COFIEs CF All IIECRMAIICI <br />EPA Form 3320.7 (OB-95) Previous editions may not be used. (REPLACES; EPA FORM T-00 WHICH MAY NOT BE USED.) QD 13I~ 9 9 Q ~ Z ~' L~E S ~ PAGE 1 OF - <br />