|
PERMITTEE NAME/ADORE55 (Iw 44 FsWryNaW Lxanaw UDI>)fvwq
<br />NAME TAArFER "i~I'-~F I`-'~.
<br />ADDRESS TArI t''t'tB P.i'
<br />P.O. c'.'7S i'-,7
<br />Ckd.C, CO !'lo2v
<br />FaauTr
<br />LocanoN
<br />NATIONK POLLUTµT dSCNMOE ELIMINATION SYSTEM /rVPDE$l
<br />DISCHARGE MONITORWO REPORT lDMR1
<br />(2-I51 l77-191
<br />000032115 CO] A
<br />PERMIT NUMBER DISCNNiGE NUMBER
<br />MONITOAINO PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM ~ . TO
<br />110.1!/ 121-131 III-151 l16-171 /IB-191 136311
<br />Form Approved.
<br />F(lt:[ r10 TO JOHN~'as''19N4'.I~~!ocoooa
<br />(S U c R t' V) APProvdleltplrPq-05-31-98
<br />F - FTFAL
<br />vrlCf-
<br />... Nr. GiSClA3~F. ~--~ .. .
<br />NOTE: Reed instruetione before completing thu form.
<br />PARAMETER !3 Ard ontyl QUANTRV OR LOADING (I GM Dnryl QUANTITY OR CONCENTRATION NO, fREOUENCV SAMPLE
<br /> lI6-53/ I5I-6!/ 1385 115-53 /51-57 Of
<br />131-371 EX ANALYSIB TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS le1.e.Tl 151-551 /es7o~
<br />-'.- 1' - + ! ~ SAMPLE . • •. r,. o:v,cGKc$ X+t'ddd.^ 19
<br />( )
<br />~, U ; i' E N D F:v MEASUREMENT .? Z a 2 0 /3v ~'/F6
<br />lJUSiU 1 U CI PERMIT d+=Y.::•Z,F ~u"#{r5'St di7' rk4dYdtl14 i5 .
<br />~c
<br />~e~/
<br />:&AII
<br />~E':,,UE.+T ~F.GSS VA! !;, REQUIREMENT
<br />:. rJr,YII
<br />...
<br />~~
<br />:
<br />~ }aLF. Y~ CAI]Y: tl$ t`;/L N'3YTN
<br />.
<br />.~ SAMPLE :: r: .: :, :OAt4RY,: Qa
<br />ti C
<br />d ( LS) '
<br /> MEASUREMENT
<br />
<br />~ii`,ItS 1 0 0 PERMIT ::e+:`%:; Yr•~Crd: aa# ; .7x:0.. :a.II E If.~A2.' `: AE
<br />-i`t3F+!`; 1N~F</ 'BAR
<br />c FFLL EMT L, ROSS PALL' :REQUIREMENT ~ ~~ .~:-
<br />~ Q); If d' ~~"~ ~~ .
<br />:: 3a~E ~, A~qG. .
<br />..`~A TIY ~rLx !'L/L ~~~ - Pl t7li'('.y
<br />11. '+ SAMPLE ': ter: ~•,0 Y_:ACc4t:? •'.+ddd:d ']g
<br />( ) ~
<br />/
<br />(AS FE:) MEASUREMENT /.O /,!~ V f
<br />/~D G.e' YNd
<br />~1J4S 1 U J PERMIT '~-''+c~u~ ~IIdurs.# -'.1~~:~ ^tcddAd _~,L` fi.0 4Cf.:/ .AAB
<br />_iiLUEY'[ i,R05.5 V!IL'J REQUIREMENT 4A~ 3Q[A,bYU -CAI.tT F]X M~)/L !]D!i^NI
<br />:~ Lr rf .. SAMPLE .. ~_%=,. fi-i Y:fi~ ~: :7fid=)^' r„fi><fiL ( 19)
<br /> MEASUREMENT /Vf/ y/~ yN /1/i9
<br />
<br />L35t;1 1 0 () ~ PERMIT .,,.. ;tir.yi7ik..+ .. ~ {:dL'dd>` dIIdIIAr>t 1~? ~ 'JHn,I`1 ~I~~;AH
<br />YFLUENT ~,it0:i5 YAL'J. REQUIREMENT ;:fir.; I83T.:SA$ M,/L Gd'7T '.
<br />., ~:)wF C h.'JI Oi! SAMPLE ( U3) ddar)$C ~,fidr}:3 :" ..^..tCc,y r:::: ,
<br />;It?3U 2deA~[flh tiT PLA\ MEASUREMENT O, /'f9 d.19S O ~ 7rJT.Tw
<br />~JU3U 1 0 0 PERMIT Ae}tU.:'3T ftE:POAT . 04fi~'-tit.. : O.Tl~b:#II . .. :.?QK4br7r: :,-YC,: o .. L
<br />.~, Y
<br />rxsrA:
<br />c'FLUtiWT GA03S YALO REQUIREMENT ..3JDA AY3 .IfAILY ax. nGD `. .`.. . :. .:.
<br />~. ~. u~~rr
<br />.:' L J + SAMPLE :y ~: ,^. Y=5 t: ~:+~~~'~: ;: dOA+CfiC ( 19) i
<br />L L ::i J L Y, U MEASUREMENT /y/po /t'!.O O /9G („~3u,)+
<br />7U1')7 1 U `) PERMIT IIYA=tihG ~ ~ Yk#=."-A+% ' d+' ~ dATdIIrL? ..L.FTICRAL .~. ~A.F,FORT '*F.I.Y '~yAF
<br />::FFLUENIvA055 'J.ILLI REQUIREMENT :d;`•:`- CATF AYG C.AT1Y Mx. hG/L
<br />U h SAMPLE ,. •. c: .;,;cam ( 4l{) YsL L Odfifi"0 ,fil; r,: i
<br />V L s i, A L MEASUREMENT V D ~ v/J++A[
<br />., +l Jvb 1 4 0 PERMIT ~-"` - ZE. CR E5=1 "dd>sdN ~Y"IId:: ~ #fi ddl!Yd~ cA. '~L'
<br />FLY q
<br />'i_ UAi
<br />:.F?'LUE%T GRO55 'JALO ''REQUIREMENT ~ ~~INS1' 'SAx~. NC=U ~ ~ ~ ~ ,=%;:Gr
<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I cfRTlfr uNOER PENALTY of L Aw THAT I NAVE PERSONULV ExAMwED AND TELEPHONE DATE
<br /> AM FAMILIM wITN THE INFO RMATION SUBMITTED HEREIN; µD BASFD ON
<br />
<br />I~. Gordon Peters MY INQUIRY OF TNOSf INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR
<br />OBTNNINC THE INF011MATION, I BELIEVE THE SUBMITTED INFORMATION IS '/
<br />r / /! _ /S ~~
<br />-~~
<br />970-824-4401
<br />98
<br />7
<br />Z.7
<br />er
<br />identlGenoral Mana
<br />P TRUE. ACCUMTE µD COMRETE. I AM AWME THAT THERE ARE
<br />SIONIRCANT PENALTIES FOP SUBMITTING FALSE INFORMATION
<br />INCLWING 7~C~./ L I'~~~
<br />g
<br />res ,
<br /> THE POSSIBILITY OF RNE µD IMPNSONMENT. SEE 10 U.S.C. 1 1001 µD 33 jIONATURE OF HRINCKAL E%ECUTME
<br /> U.S.C. E 131e. lPMWM+,+dM ebw NNN+mrY hcAll+ r+w+W m 110,000
<br />TYPED OR PRINTED +nd er morn.+nhwlonrr,.nrwMw..nemu+m+.nds wra/ OFRCER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IReler~nee s// eftschmsnts hers/
<br />~~~ .. T•1'fl•L Ix`>s LI"•I2S FILL dF. YFiVG, A:IU iiETTL°AC,L~ SO i.7~° II'"TT AIFLis^ FCF ~=10-+P,?4i(F PP,f;::7v YF.?:':-
<br />.,.' bUliJL:4 CF<'40JF k°,UIhiit:G11T3 "iNQEii Z.A.3. PF,RLITT:c". ".UST TAFF P[L FP'A:CKAPIF KE.ASUf?`".S TO h(iUih';.
<br />. ~ ~~ r
<br />EPA Form 3920.1 108.961 Previous editions meY be used. (REPLACES EPA FORM T40 WHI H MAY NOT USED.1 ~ U ~ U ~ / q 7 ] 211-164 6 PAGE ~ OF '
<br />
<br />,
<br />
|