Laserfiche WebLink
PERMITTEE NAME/ADDRESS 9rLl isWryNa/fanm I/DlBbrwO <br />NAME 'f~iAPF°R '"INIA'G• INC. <br />ADDRESSTf:APPER ~INfi <br />P.O. ~DX ].?7 <br />LNA L:: CO Rlr•25 <br />FACILITY <br />LOCATION <br />ATf:d: A. GORDON PF;T5R5, P3E>/;EN `:", <br />PARAMETER l3 Grd Onlyl <br />!3Z 371 !46531 <br />AVERAGE <br />SAMPLE <br />NATIONAL POLLUTMT DIBCHMOE ELIMINATION BVBTDA //NPDESI Form Approved. <br />DISCHARGE MONRORINO REPORT lOA7Rl N T y 7 D OMB No. 2040-0004 <br />~I-16 17-19 <br />3 - ~ (•i ~ 7 n q';) Approval expires OS-31-98 <br />- PERMIT NUMBER DISCHMOE NUMBEfl P - c { p A I. M n ~: ~ `~ <br />+1J5!-utvr~ Tti cL9~F. G11LCF <br />MONITORING PERIOD <br />YEAR MO D YE MO DAY ,3# 4~ .1T 3CR4A :F ( ~ #r# <br />FROM TO ' <br />!14111 !?Z-Z31 /Z4751 !16171 !Z8-Y91 134311 NOTE: Reed Inetructlarr belor completing ffiu form. <br />TY OR LOADING l4 GN On/y/ QUANTITY OR CONCENTRATION NO FREOUENCV SAMPLE 9 <br />!51.6 /1 I3B-151 /I6531 I5L611 of <br />MAXIMUM UNRS MINIMUM AVERAGE MAXIMUM UNITS I•a s„I u~.l<o,B I ~„ P^, I <br />UU40U 7 0 0 .~:... PERMIT'..~~~: ~ ~:.. .6 ., :. :::~: iL#R .3r~~; ~:4:::::. ;':::::::: :.` ?:.:: .:: .n":~~ :.~:~~~ .. ~E vX:L ~ v:r <br />::FFLUcNT RDSi YdLU. REQUIREMEN7: .:. `' >F.'+## }(I[ti!1:: ^[r . <br />~~ ~ • SAMPLE "' #+• #,• • ( I '11 <br />;i'tJ v P E N n !: I) MEASUREMENT <br /> <br /> PERMIT '. - . . :: :. <br />t:FFLUENT i:R055 rrI1L11 :REQUIREMENT: 4: .?i ~ :::.: :::::.:.:...: eRtk <~~:'.: .:,. .:.,?4 ?>t<•.:. rr ;: :' , r'.;ry:. <br />• r ~ .7 .., SAMPLE ' `"'`•- <br /> MEASUREMENT <br /> <br />UU'~47 1. D D i.i:.PERMIT.. <br />,. t. L`#C <br />, . .. <br />..' Y ~i .~P <br />y. ... r <br />..FFLUt:N: .~3?yi YAL11 <br />REQUIREAAENTr <br />.. ~,::..: <br />::i~<::':' ::.:...:.:.:: <br />r:OC . I <br />... .:~~. <br />`xt'.s7:.: <br />,~~1'~.iIkVT•' <br />::D '!%'.;.P}~: <br />"L/T. <br />; <br />,~ ~ <br />;:; :`. . <br />• - SAMPLE " ~ ~ ~ ~ <br />(A'i F I' ~ MEASUREMENT ~~ <br /> <br />lU4S 1 U U .. ,.. .. ...... <br />,.FOSS YA(.U NIENT:: <br />:RE. ::': ~~ <br />: <br />': <br />~~~°' :~: <br />: <br />~ <br />, <br />' 4F4 ~.:.:` <br />: <br />~~%:'s:;:~r,;..., <br />;~ 3413h <br />;:1(4'C <br />::~ ! <br />7,'~N <br />Jt <br />~lf <br />~~ t!T;/L <br />~ <br /> ... ..: . <br />. <br />: : <br />. <br />~ .:~ <br />~ <br />. . <br />.: <br />. <br />: : <br />: .: <br />. <br />. <br />: `.: ; <br />+ r .. <br /> MEASUREMENT <br /> ' <br />355 1 0 U P aM[;r:•< ....:::::::. <br />:;:.:: ~..:.:.:. :::.: aas <br />,. <br />..PFLUENT GRD YALO ~EQUIRE,EIYT,, .,, ,........ x ,.:.,~ y.x:: 4etCf . .: :: ,.::-t F ~~~.:;.;; 5R'-.11IIL1' RG/L firiiM+ ` <br /> ..,.. ~.r ~~ __,. ..~~. _.. snmrl.t r ~~t.r ~ Yti«~ <br /> THRp. TREII YRENT PLA 11 MEASUREMENT ` <br />. <br />•+ <br /> 0050 1 U 0 ' <br />< . . <br /> <br />.cx <br />PERMIT:i`:>" <br />,.: <br />:::. :.: :....:. <br /> <br />' <br />,. <br />:::::: . <br /> <br />: <br />~ <br /> <br />.. <br />... .. <br />' <br />•:: <br />• .- <br /> E N T G R 0 S S Y A L U _ <br />F PLQE :: <br />REOUIREMENT ,: <br />~:3 (JCi ~.A: <br />~G ;.. r.:. .. <br />~~:X~iY- !!'i RGD „.:II<::e:: r.S'.:..;::'::. <br />.f <br />• ..: <br />::; <br /><::,:... , .:. ,: " <br />: <br />; ;;.:: <br />::: <br />~: A#iR <br /> ... ~ <br />x <br /> "'~ • SAMPLE <br /> :)ISSOLYF.U MEASUREMENT <br /> 0 0 <br />L95 <br /> 7U <br />1 <br />:~ :~:::. P.ER <br />MI.T~~ :... <br />.:.:. :.:.::...~ :....... <br />.. ~.:... <br />~ <br />:~ <br />; <br />~ <br />~ <br />~ 4#C <br /> <br />, <br /> <br />:.. :.. . <br />~ <br /> ~RO55 VAL[ . <br />it F P L U E N T 1 . ..:. .. <br />REQUIR ..:. ... <br />EMENT :. :.::::..~.;:::.:.:~~~:. <br />.. . . ..:.......:. ..: .:: <br />:. <br />:::~: <br />~:.~ <br />::.. <br />:::: <br />:...... ..... . .. 0 <br />FOR- <br />:.:'.: j:::'.r, `.. :: <br />::: ~ A ::~1!,i:'s : <br />: 0a~'LL.Y.:ll1C r <br />G / L <br /> NAMERITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENKTY OF l <br />AM FAMILIM WIT1/ THE INFO AW THAT I HAVE PERSONALLY E%AMI <br />RMATION BIMMITTEO HEREIN <br />AND BA NED MD <br />SED ON <br />/ TELEPHONE DATE <br /> <br /> <br />OrdOll Peters <br />~' <br />r ; <br />MY INOUIRr OF THOSE INDINDUAL9 IMMEDIATELY RESPONSIB <br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMA <br />LE FOR <br />TION IS • <br />~1/~.~.~/{~,(/~~~_ <br />C~ C ~~ <br />'/ <br />970-924-, <br />Ii4J1 <br /> <br />OD <br /> <br />DI <br /> <br />27 <br /> . <br />i <br />IC /General PJana <br />er <br />P <br />~ <br />I TRUE. ACCUMTE MO COMRETE. I AM AWME THAT THE <br />SIGNIRCANT PENALTIES FOR SUBMITTING FALSE INFORMATON <br />IN RE ME <br />CLUDING ' <br /> g <br />eI <br />re6 <br />.L , <br />THE POSSIBILITY OF RNE MD IMPNSONMENT. SEE'te U.B.C. E 1001 MD 33 <br />, I <br />ro rroeoD <br />~~ a. <br />C <br />• ~ <br />~ <br />~ SIONATUIIE OF MINCWAL EXECUTNE <br /> TYPED OR PRINTED . <br />y <br />wo <br />.mul•x.r+~ <br />an, <br />,,,, <br />~;rq <br />y..al OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS !Re/,rent, ell effschmente h,rs) <br />TSS TOTAL IR7N LI""TTS MILT. Hq VIIY ED• AAD SETTL£ABL° SOLIDS L7"T.T API'L T''' ''~R !=l,v-,•,•Ivv •;p sClp cyF NT•_ <br />SEE UURDt;N 7F PRO')'' RF.IUIREMP.NT7 !1NOP.R I. A. 3. PERAIIlTP.E PiUST TA?~ AIL "':A5'1vA,L° Nca;';,^- gL•~1Jrc pF[ <br />IN ACCO'tilAVCE flCl9 REST !IGflY PRACTICES - SEP,_ I. A, S,. _T91S.11DRITDPI'/" C.^.? <br />y.; EPA Form 3320-1 108 951 Pr,vlou..dIGODB may bB used. (REPLACES FpA F M Tit07NFN¢H MAY NOT ~E USEp.I D!I T ] ~ / O n /• r; ~ J _ 1 ~; PAGE i pF <br /> <br />P¢ <br />Z <br /> <br />