|
PERMffTEE NAME/ADDRESS p,di FrWryNr'facrla~yDrprtnp
<br />NAME lRAPP::It PIINZYG, I4'=.
<br />ADDRESS T { A t' Y ~: ? ! I .+ ~~
<br />P.O. 6JY 187
<br />FACIITfY
<br />LOCATION
<br />a: TN ;r. GJRGOrJ PETiiRS FdS- ;'+ t;
<br />PARAMETER
<br />'~U STATRS 48HR AC
<br />cRIJDAPHNIA
<br />•. I, .f -, 1 u p
<br />;'PLUEyNY GROSS YALQ
<br />~U STATRE 96H$ ~
<br />~Ie;tPaALes ~.~.;~;
<br />.N6C 1 U D •:
<br />': Rf IIFYT CYASQ Q~.r EE
<br />t
<br />AVERAGE
<br />NAnoNA<FOUVrMr ascxlUlaE EUMINAnox lYSiEM NPOES/
<br />DISCHARGE MONITORING REPORT /OAR/ M I N O R
<br />` (SU°R Hy)
<br />PERMIT NUMBER ascNMOE NUMlFR P_ P I N A L ~ MO F I! T
<br />MONITORINOPERIOD STET TESTING FOR 023A
<br />YEAR MO DAY YEAR MO DAY
<br />FROM pp 12 G1 TD 0 12 31 tx Np DISCHARGE ) ( '~~~
<br />NOTE: Rud Irwtructlaer b~l« wmplNtkp this 1«m.
<br />ANTITY OR LOADING f NO, rREOUENCr SAMPLE
<br />Quality or Concentration of
<br />MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS EX i11/Kyy~ TYPE
<br />: ... ::..
<br />s:.:±z~l~xzi;~ :.aY:x lbb:0`i~#33'• `;:::'~?dt~.`. ,,.~o.z,°...<........~:> F.R- ~' . RLY . ~RaB
<br />
<br />.:
<br />~'
<br />'
<br />~ •.
<br />'
<br />~
<br />~ )
<br />~
<br />.. :..:.:
<br />i'
<br />'
<br />~R
<br />~x~o~ ~-
<br />.:: ., :. .
<br />... ..
<br />.. . ~1<~:
<br />L .
<br />~:. l~
<br />I~1
<br />F 'k
<br />~ .
<br />iii k:y::151:
<br />...
<br />~
<br />
<br />ENT
<br /> u~r:`#F.s ~.a~~-'~
<br />,,:. ; . 1.(,n.0001,. 4`+Clalgf`~ "-+,
<br />'$!~E~ SR^ ~ :~ RLY NAB
<br /> ;' +':'[: MN V11 TO . . :. :.: .. ::...:..:. ,
<br />.
<br />:.1::: tYn;.. ,.,L P1YT :e.,'.:: .,: .
<br />
<br />
<br />;'.~: ~:;~:..: ~~:::•. ~ ~; 'l;:i; .. `.;f ~:,: :`V~r ~:: .:. ?.': ~:~`~~:9'~::, ~"~',' :: :'::::..r ~. 'f<::gg~'?-.w .'%%kE~;;.;i%:i:':j~;: ~i:'";:'`.`: ~ <,'~:; si;: (<,`: ':.: :.'' :.'
<br />,-
<br /> :...
<br /> ;kEUV.IRfMENT;,
<br />r.~.:~:,.:. `aw :. .. ,.
<br />........: '.,'.... , .' .
<br />:... :..::. <..:. .
<br />
<br />:..:
<br />
<br />
<br />
<br />...:
<br />::.::..
<br />:.
<br />
<br />NAME/TITLE PRINCIPAL EXECUTNE OFFlCER I aennf• er Pn. lfn brlMl Nh tlarmrN •M •N nIwN:IrnU .ert
<br />y:ep•M rndnr rtf al~u,n«wpr.xl^n In ..re:a.:u•, .Im ••pln:n dm,n.e
<br />~
<br />TELEPHON
<br />E -_
<br />- - DATE
<br />
<br />W. GQLd01l YeX~rt -'- -- ~ --~---- ln•vurt n:•19u•IIIIApronnd em~J~1, Rv.::/tr.lu•Ie~1:Nnlnrn~.lbn-- --
<br />-w:nAinid~iad-nn mllnqulrfolNeyennnarpenn:N,nawW~e1MSY+l.m, /-
<br />~ ~..f~
<br />970-824-4401
<br />UI
<br />pl
<br />16
<br /> or IM1q• JrrtnN tlllecllf rtap•MY• Ter E•INMnE t^e INf^TUllm,!^n Inf^nrnen
<br /> President/GeASral Mauagar ~b~lo.nu.1.ln.n..lnrm,.n„rtlE•.nes.x.r.1....,n,,..I...:,e~:n,IM.
<br /> I,N.,,nrt Nnl men.n NMnunl pn•INn r^r wrnmllu^E rube bfnf,INlbn ~IONATUIIE OF Mi1NCMAt EXECUTIVE
<br /> ,
<br />Inr*rm^
<br />I^
<br />^
<br />rlm
<br />wn
<br />n
<br />n
<br />n
<br />i l
<br />N
<br /> TYPED OR PRINTED E
<br />rp
<br />•^N:
<br />nr•:n
<br />:
<br />y
<br />enl ror
<br />I
<br />b
<br />«.bE .la.uoln oFNCER OR AUTNOPREO AOENi CODE NUMBER YEAR MO OAY
<br />COMMENTS AND EXPLANATION OF ANY VI06 TIONS (Rdrna1 ~N uaehm~nts h~f~)
<br />~'"'. Z.A.2, PP. 7-9, POR DETAILS 'OF TB3T PROCEDURE. REPDkT LC50 - STATISTICAL PpIRT ES?IhlATE yNICR IS
<br />L=:PBAL Tp S0~ pF TEST pRCAHISHS, AND AT?ACH ACUTE TOYCITY TEST REPORT FORM !0 UMR, YHEN YET 2ESTING YOT
<br />E AF m-gt(j~i'~'/g9)'E'Fddtbds'~ttlor35`t11~y Ue~USC~unv. r ~~a.. - un rrnn. PA[iE /+~
<br />non.. ,, ,,,'Chls.is.a4-nan_fnn+'
<br />
|