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PERMITTEF~~ /NAME/ADDRESS pMi4 F«NryN~/Locanm yDlAlrrniq
<br />NAME rIERR G'):{L ~~,^, ~l Vr
<br />ADDRESS G AH~i{ M [ 4 %, ,
<br />P.U. d.)X 7731>7
<br />sT(:.aN.liJdT ,Pere .; ~a 9D417
<br />FACILITY
<br />LocnnoN,l,LDcY :,~ I}r)4;D
<br />.11 PV; .,tJri~° `!. ?'„"I'?I:_~)ti. 9INF Amu.
<br />NATIONAL POLLUTMT OlSditilROE ELIMINATION SYSTEM (NPDESI
<br />DISCHARGE MONITORING REPORT (OMRI
<br />17-161 117-191
<br />~JG650037
<br />PERMIT NUMBER DISCNMOE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAV
<br />FROM U U J l TO U 11 S
<br />tl67U /7TJ31 IT4T51 lT6171 /T8-T81 /3Q311
<br />Form Approved.
<br />POND C/TRIG TD CA~~RJNoa 30x0-000pR
<br />(SUER V M) PProvaj exgirj a 05-31-98
<br />F - ervAL t
<br />tIINOR
<br />NOTE: Read Inetruetlone betor' eompletin0 this loan.
<br />PARAMETER !3 Gerd Onlyl QUANTITY OR LOADING I~ Gerd Onryl QUANTITY OR CONCENTRATION NC FREQUENCY SAMPLE
<br /> M6531 !546/1 138-451 !46531 5461 EX DF TYPE
<br />l37-371 MMY45
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ls7-s]1 15e-881 168-701
<br />i'li SAMPLE #:kvrk t:r ::kri: ... ;k0 ( 12)
<br /> MEASUREMENT
<br />J~4JJ L 0 0 ...PERMIT ~ #n1x~k} ##r"-4?.0 #~`•~ 5 x?~`-r ~~`r
<br />9.U c~
<br />S..KLY r e
<br />'Y;,T.J
<br />d7t'LUfitrl ;, P.~55 YALOE REQUIREMENT #LAS Rl.tII I!!ti!! lIAY MU IK SU .
<br />~~JLIi15, SEITLdABLE SAMPLE rX#rC~t #S~Sr: a#G##= Y:O;t fit= ( 25)
<br /> MEASUREMENT
<br />)U~LL7 1 D D PERMIT ~kAcrtt~0~ ~~:~iSL#3#p. #3G ~ S.xGs}C1,Ytt ~L19rtt1pi.4 Q~es~.. ..{ :'NC.B/ tR'AB
<br />..f'tLJ~R1' GRDSS YALJ^, REQUIREMENT ~ ~ ~ 4.r 3 ~ ~ DA L ~~ MY L/ HONT~
<br />iIL S11U ~RE14E SAMPLE =k .`-3;`.-.• .-,.~¢:- ,..ri:,7.;; ~4:# ,., ( ly~
<br /> MEASUREMENT
<br />J3St}1 1 Q D PERMIT 't,'k:~:.~: n:,aaa~ # +::: D,',+k t:L+r :k.:;:91 # 1D { ONTII+ :RAB
<br />,FF'LUSbC C~(~S$ Y.aL'JE .REQUIREMENT Or,,,:^, DAILY fIX dG/L GPNT
<br />'i,Jli, IN D~JIC ')k SAMPLE ( DJ) .~++".'f"' ~.. !~~ ,;.~:-.,
<br />"rt t2ll TH::AlM F.N^ L0.'iT MEASUREMENT
<br />TUD~D 1 D J PERMIT PTIDBAL :2EPJr7t k7Qar3iA +::i=1r`'Ti # ~rR`#04# ., ( N: f/ i1S;'h`I
<br />~Fi'L!+ENT iaR~55 'lALJ": REQUIREMENT 3OQA:~A~Ia QAI LT MX 11 GD ~ (,pN'f [I .
<br />IL ANU Gfi6ASF, SAMPLE aa~laaa ( ~;) ...r,-„ i:Na c3a;:;:;:
<br />i 51J A L MEASUREMENT
<br />,•1 J1.0 1 ~D J PERMIT r-aaa~ itEP~RT Y E=1 ;;K~,:C# ~r~# O :k#?Rrt~-r } #.'~~ ( NC;'/ 'ISU4;,
<br />}'F'LUdY'!' GRJS$ 1'0.LU~ ~REQUIREMENT j.N$p MAi( NC=D ##+k>r ~ MBGT!!
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIT
<br /> REQUIREMENT
<br /> SAMPLE
<br /> MEASUREMENT
<br /> PERMIT
<br /> REQUIREMENT
<br />NAME(TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENMTY OF uW THAT I HAVE PERSONALLY E%AMINED MD
<br />AM FAMILIM WITH THE INFORMATION SUBMITTED HEREIN; MID BASED ONE ~ TELEPHONE DATE
<br /> MY INQUIIIY OF THOSE INDINDUMS IMMEDIATELY RESPONSIBLE FOR
<br />`--'
<br />~j-C14LLU ~1• M~6CD OBTNNING THE INFORMATION, I BELIEVE THE BUBMITTED INFORMATION IC
<br />~ _
<br />'-- ~I
<br />Vice President TRUE, ACCUMTE Mp COMRETE. 1 AM AWME THAT THDIE ME
<br />SIGNIFCANT PENMTIEB FOR SUBMITTING FALSE INFORMATION, INCLUDING .'/,^"-"e'~~ 970 723-4721 Dl ~l D6
<br /> THE POSSIBILITY OF RNE AND IMPNSONMENT. SEE 18 U.S.C. 1 1001 MD 7] /BIONATURE OF PRINCIPAL EXECUTIVE
<br />
<br />TYPED OR PRINTED U.S.C. E 1 ]t P. /{Nr1Mai, MM« aeY eerlun, rneY NCp,lI rnee :y b ! IO,OW
<br />«a«m.,erNenl.wl.a+nrAVr el e.ween en.A,m,waTe.rAl /,
<br />OFFIOER OR AUTHORIZED AGENT AREA
<br />CODE
<br />NUMBER
<br />YEAR
<br />MO
<br />DAV
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRe7erence e// etfecnments nerel
<br />J;E:'fL1:nJLi SDLrUS LI"III WAIVED F2R 1D-Y:i, 24-H3
<br />HAlii I. H. 1. D, P. 5. 1'JRMNAI'2i M0.NA~E9EN'i P[. .4N
<br />PAh'~IP ?YEdL ::u:.Jt::'f i0 EaURDES OF PR~6F Rc.~,"7rN;:1E'dP: Iv
<br />DU° 1-1-x'1.
<br />EPA Form 3320-1 108-95) Previous editions may be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.1 J _} 5 4 /'~ ] 7 8 1 ~1-12 i U PAGE E OF
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