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PERMITTEE NAME/ADDRE55 (/icY4 FavBryNr~fanm I/D~i,wrl NATIONAL POLLVrANT fxSCHAROE ELIMINATON SYSTEM /NPDES) Form Approved. NAME T N A "` p ,-^ R ^ I N I `I G P INC. DISCFIARGE MONITORING REPORT rOMR/ N * Tf ^? OMB No. 2040-0004 ' 1-161 l7-l91 ADDRESS T R A ~ ' f! R ! I N ° ~ (S 11 n o 11 c) APProvel expires OS-31-98 P .. j. 't'1 X 1 'i 7 y PERMIT NUMBER DISCHARGE NUMBER P - • i N A 1. ~ 1 " ' reel rn wT C~c no v..~~..~-.~e FACnITY -- - - . _+-. MONITORINGP RIOD • „ • •.~ +„ ,•~„ VVL~~• YEA MO D YEA MO DAV LOCATION I ~Ik4- FROM - TO - - #fiC Nn ~I SCfl A>1 r'F' I . 9 T I' Y : :I . ;; ; R p ] h (' rti T R P :• P R E S / G ° N 17 •. R rso2n ru-Y31 ra<- 5r l1627~ ne-zs~ r3a37 NOTE: Reed Inetructlarle before omp6tinp this form. PARAMETER r3 Grd Onlyl QUANTITY OR LOAOINO !<Grd Only! QUANTITY OR CONCENTRATION ND FREOVENCV SAMPLE 116.531 r5<-611 138-I5! /4653 r5i6/ OF I31-37I EX ANALYSIS TYPE AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS lst.s.Tl r6I-681 r69-701 SAMPLE •- ~ - ~ - ~ f ~ ?) MEASUREMENT OU40!1 1 7 0 '. PERMIY,:... .... . IR :; :-::.:.:. .', FOR ,.:. . . ,.,, :. . YPFLUENT '''^';S YF.LI! :REQUIREMENT ::.... .. ':::'::::.:::'.:.::::' ,::.. IItfifi ........ SSIR:~)1.~'IS}7.1f:::' : ::.:. :.::::..:::.. M !5:A1lS~kt!,,. ~/ . .::. . :...:... L •)+ SAMPLE ~ # ( 1 U) SU.iPI'-iG^:/ MEASUREMENT 0530 1 1 :.;.PERM % ::: ::: ::: :i' ..: ::•`:'qr i ' " tsfi ;i:.. Tn . : 91C:E :' iRRl1:lt":'. EFPLUEN +:P f1 T 75 YAL .. ..... ...... ....,: :° :.REQWIR6 < ..::..:::::::~~ . .... :pi"~.:::: ~ .~'::'..;';.. :::.::.>::.:.,; .:.;:;: ...:: . :.i.~i~~: ,::: ~::i: x:::.: . ~~: .:;.;.':.:::;.:e:.:::..... :.......:..::::.:..:..... ~ ~' :':'fps:;:*:!:'':.;.'.1....,... >::,:::;:ef:::.:.:..'.: .:.: -':::;; ~OI~i4:=::...~'s: ' '. ft.AS1,T:.!I!'~: Mr/L :::. '.tla~•1`1!I , :':..:.:..:.':.: 7 F ' •~ SAMPLE Y ° • ~ ~ /. MEASUREMENT / UOS4S 1 U i. r':PEFiMfT;..::: .. .; .:' .::... .: ,. : .: .: !. : *d'# ~ ' : ; r: ~Ft.P!1V'1'.::. - ~ RJ~P. > EFf'LUF.NT n 1±) i i 7 R L I+. ::REQUIREMENT: .. .: ...:...:..,. .. ,:: ': ,.. .. :,.: :.: .. . ,:... y. . :,.~ .. ~. . ... . • ° • SAMPLE ~ r • ~ ) (A.i F :1 MEASUREMENT O1'JUS 1 CI J ;, ,:PER..MI.T ... .: : . .. EPFLU~lY GP]55 YP.I'1. :REQiYIREMENT: :.. 3 ~ s'-:;~;~r:;.::;:<f.; ,::~OtJA.!11/;r,:; ~f,,7~:IL.T.:.tt.X ~G/L ''~'.; '::i'si...:. L ~ ~ SAMPLE ~ ~ •"'Ot .+ ( , O MEASUREMENT .3582 1 D 0. :~: "ii1PER„(yll .; ;:;; ,.~. . ..... k .. . :;::'~`:: ~ .. .:.......::::: ... ... ..:... . . ... .. ... .. .. :. ..:~ '..: .:. : : " ~6RR - ` ' ' ' IPLOENI' GRO55 JALO . aLfIFiEMENT• ••R . . . . . , .. . .s:; '.. _ • •: Y30fc - li>' :::. ~::'::':~:.::.:~:.: ' ~ ": '-.:. .<'.:ai Via; t,,.~i r.'.;: ~ : ~~lST: HAX rr;/L `' C !!~'k" + ,,, ,.. , , : ~ ~F, ;; +r : P - ~ ~ SAMPLE flRU TREATNEMT ~'LAk MEASUREMENT 'PERFAI,1~;~:::i:: :: : ! :- :'::':~I':...'.:,:~:..:%i".,'~: -.t ........ .. ... °.:: : i': ~~i :~•~...::i ~;:r;..;~~ >~~.~.. ~<...: i'r(- ~:. ~~ <:- : ::, ~: .., .. ~.. 4: ~ :~:~:~; :.: ~'T :~:.'3" :~ EFPLOENT GR]55 YSLO ., . . . ;FlE:QUIREMENTg ::3OD.:r~?~.~~`,#"ar;:S . . . .. :.:~}:~ix::~:1~'~..:.T:. BSD , : .:..r,,::,....~:. :.. .:.... :..,.,...:Pa;;:.. <'`.: . . . . . . ......: ... :..~ :•;? ::.. ... .:.: .:•: . : .':::":..:'::. YiOQ .... .. . . . • ' SAMPLE DISSOLYF.D MEASUREMENT 70295 1 ') 0 PERMIT::..::.. -'"gy`p`..: :.; :~;:.,. .. ... ;: afia . F.FPLUE T REQIlIR.EMENT . .: :::.. .. ::::.: ::: :: ::':: :.:': ;: ..:.: s...:.::. :::;:;:::.:: :;': :. .. . . NAME/TiTLE PRINCIPAL EXECUTIVE OFFICER I CERTI AM fA FY UNDER PENALTY OF UW THAT I HAVE PERSONALLY EXAMINED AND MILIAR WITH THE INFORMATION SUBMITTED NERDN; AND BASED ON TELEPHONE DATE ~ . W, Gordon Peters MY INDUIRY OF THOSE INDINDUAL9 IMMEDIATELY RESPONSIBLE FOR OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION I$ _ ~~~ „[~.L-~ / 970-824-4401 OD OL 27 Presidenr_ General H6na er g TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT PENKTIES fOR SUBMITTING FALSE INFPRMATION INCLUDING / , THE POSSIBILITY OF flNE AND IMPRISONMENT. SEE 18 U.$.C. 1 1001 AND ]J U S C E 15f e lhI1M111 1 r nO • d 60n M A l ro S IO OW BICINATURE OF PIIINCN'AL EXECI7TIVE TYPED 011 PRINTED . . . . + A lrM . M / My c , . MN. +p , MWO//II.IiINV.I/Ip1ldMIMtO/bMN11QIIpI1Nl r1.16Y1Vtl OFFICER OR AUIHORI2ED AGENT AREA CODE NUMBER YEAR MO DAV a,vmmcnla nnv ...~ _.-.~.,....... ..~ .-.~.. .~ ............. ~.~.......... .., .........,....... .,.... '~„ ;, TL;?AL IFl'19 LTMTTi PILL OF: UAIYEDF AND SF.TTLP.ABLF. SOLIDS LT4TT APPLI°[` F]° ~=~MPF?4ND PFiP,CIP FY°!!T- SF,~; b11R7%:N ]P P40DF RE'JOIREI1EyT5 ONDER I. A. 3. TDS ~DgITORTR6 - LR.3. 9Tt. - ;Pz'fSF - `~F.P ?. R. 1.(D). 30 JAY GvF.RAGF. IS RIG~f8S7 ROHT9LI AYGRIyC DORIIIG PERIOD REPDIl.iED. mey be k. vn.evnm rrN @m~.n m!te~nvr pe Mawu .Da1~D/9'1 DF721-103'1 I