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PERMITTEE NAME/ADDRESS?+rYLSrWryNw/locala dor8,,.,n <br />NAME Tkf. e'r'~.fl i~'; \'n, Ib ,. <br />ADDRESS INS~r cr 4T!•"~ <br />P.V. ;~;;~ 1 7 <br />cr,Alc, cu 41526 <br />FACarrv <br />LocnnoN <br />r.'PC\: .. :SO!iU~`: F?TEP.S, i•itES/G7.i MGR <br />NATIONAL POLLUTIW T dSCHMOE ELMINATId1 SYSTEM (NPDE$) <br />DISCHARGE MONITORING REPORT /DMRI <br />7.161 17-19, <br />000032115 CCS A <br />PERMIT NUMBER DISCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />1261/1 117-131 /74751 176771 118-291 !36311 <br />Form Approves. <br />~cRC ~: Ta ~sinnteD"'lsV~~!?G-~t.cr. <br />~ S U F R N H) Approvalle~pyra&05-31-98 <br />F - FI*AL ~ <br />"IfICF. <br />NOTE: Rssd Imwcrlorr before complsNnp tfNs form. <br />PARAMETER l3 Grd Onlyl QUANTITY OR LOADING !1 Grd Ontyl QUANTITY OR CONCENTRA710N NO. FREODENCV SAMPLE <br /> !16531 !5661 /38-151 11653 !546/1 OF <br />/31-371 E% MALY313 TvPE <br /> AVERAGE MA%IMUM UNITS MINIMUM AVERAGE MA%IMUM UNITS aesi !64681 169701 <br />+nJ vt{ k-r SAMPLE :t;: ~k ;f 6-X 9y <br />t ' fiiCOt: {'; :fi4+~ +. ~: <br />0 .~ ^ ;s-. <br />~ <br />Y I _: A L L MEASUREMENT Q ~ /7 v/J/*~! <br /> <br />Y,U _ ~.~ 0 0 ~~PERMIT~~; ~.~ .. h#t`>x q:Cl ~ TIE~PQ~HT :~ 85=1 ~ Gfl:gIYO.C 0>a#>D.0?~ ~~ . ~yL~#tF.4%i ~ >(:~:# ~ L <br />86l: YjillA <br />t' ~ ..J;,R7 GFtr~g` '~ d LU REOUIREhiENT. <br />~~~~ .: `INS'. ltAX. NC=O gY,rt,#P ; <br /> SAMPLE <br /> MEASUREMENT <br />- <br /> <br />.. <br />.'...PERMIT ~ ::~ ~ ~~~ ~:..~ :: <br />.. , . <br />~ <br />~ ~ <br />~ ~ <br />~ ~ <br />~ ~ <br /> <br />~ <br />~ <br /> <br />~ <br /> <br />, .: ~y. <br /> ;REQUIRE <br />MENT : <br />.. <br />. <br />.~ .-: <br />:. , <br />:,: <br />~ . <br />~ <br />. <br />~ .. <br /> . <br /> SAMPLE <br /> MEASUREMENT <br />., .... .. <br /> .a::.:.:: ,... <br />„ <br /> S'AMP <br />- MEASUREMENT ~ <br /> <br /> <br /> REQUIREMENT ~ ; .,: <br />~ <br />,~ <br /> F., <br />. <br /> SAMPLE <br /> <br />~ MEASUREMENT - <br />~ :a':.~..PERMIT.~:~;.~ ~ ~ ~ .. :~ ... <br /> ~.. , <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT. <br /> :REQUIREMEHT~ ~ ~ ~ : <br /> SAMPLE <br /> MEASUREMENT <br /> ~. PERMIT <br /> REQUIREMENT: :. <br />NAMERITLE PRINCIPAL E%ECUTNE OFFICER 1 CERTI <br />AM FA FY uNOfR PENALTY oFUw THAT I HAVE PERSO <br />MIUM WITH THE INFORMATION SUBMITTED H NaLr ExAMINED ANp <br />EREIN <br />MD BASED ON TELEPHONE DATE <br /> ; <br />My INQUIRY OF THOSE INDIVIDUALS IMMEOIATELy RESPONSIBLE FOR <br />W, Gordon Peters IEVE TAMS WMEEOFI <br />NIACCTUnATE MDACIO <br />ETE <br />TRVE <br />M <br />~T <br />O 970-824-4401 98 ~ 27 <br /> . <br />I <br />R <br />. <br />A <br />HE E <br />M/ <br />SIGNIFICMT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING <br />President Ganaral Mane •r , <br />THE POSSIeILITV OF FINE MD IMPRISONMENT <br />SEE 1• U <br />C <br />S <br />1 1001 MD 9J <br /> . <br />. <br />. <br />. BIONATUIIE OF M11NCgAl EJ(ECUTNE <br />TYPED OR PRINTED e~o-~ilRnr l~+Erno.e.er~ aial.w~ ~a,:w ~ ~• "' ro t ro.pop <br />Y.A'+1 <br />OFFICER OR AUTNORU'EO AGENT <br />CODE <br />NUMBER <br />YEAR <br />MO <br />pqY <br />COMMENTS AND E%PLANA710N OF ANY VIOLAT Ions lNaerones Ni sttscnmsnts nsrsl <br />'I:i~ P, TU l'AL IiJI' LIB"Ii.l nIi,L Nf' YfiI VE'D. ANu GET; LF.3RL:•' S7L IC` II"I7 AiF1.I°D iCf <=70Y=:r 27!ih P~:~Cir -~7~; j.;_ <br />_;dt isUdU~ti 'Ir I.OgF ilf..'.1;:'.c;:E!;'.'3 JaDL'.R I.A.S. :DS t:ONLTDi?Ii.G - I.F.=. CTL F F:fF4°.£ - Si,E I. h. 1.(7). <br />~Q 'TAY xLr'~~A-'~' pTr.~.,..r +n~r!~IV Lyvatrc nncTNr. ucDrr.n Orcr•c~cr_ <br />EPA form 3320.1 108-951 Provroue sdrnons msy be used. (REPLACES EPA FORM T.LO WHICH MAY NOT BE USED.1 D D C 7 ` / V ~ I ~ I 1-1 f. II 5 PAGE _OF ~ <br />