|
it111N7iiEE F1AA~lAdDR~S~p•eYiFSWryN••/farnlaldDUbwQ ~. .k~_ -I ,'NAjIQI/AEPO[[~~AN7'DISCH~~ptOE E~~l~yIN LOR 9YSjEM /NPOfS1 ~ ~ ~ ~ ~ FOM4~APPFOVed.
<br />NAMG _ 81~5Cjt~n6f MOAIITORMTO-~ORT (OMR~ _ O No. 2040-0004
<br />BOYI~ RY~~III!?CFti I.LriL'fF0 PARKIN;: AREA iO $,~~b(~Ilb>?pirea'bk-17198
<br />ADDRESS BOGI Nn 1 +. Nr! 1 Y£ST MLHF.S ER DI E eEn ~_ (4URR IIC~ 123u`•
<br />r P.O. BOY. 1'; tID ~-
<br />F ~ FI11AL
<br />FACM.ITY PAONIA ~ CO 81423 MONITORINGP RIOD f1IYDR
<br />BOYI~ 'iF.'~(?!,';!!'1; i LI`IITQD YEAR MO DAV VEA MO DAY
<br />LOCATION _ +~¢ y -~ r~ T ~ ~-1E L e `
<br />f t F t FROM !141/1 !1Z 131 (14161 TO !16171 B-391 f363!/ ^O~:'ltYSd'llrtFOGU~tlYiCr~ulrplsth+p~tEtia 1otm.
<br />PARAMETER !3 Grd only! QUAN 1TY OR LOADING !I Grd Onhl OUANflTY OR CONCENTRATION NO, FREQUENCY SAMPLE
<br />l31J71 /16531 !5I-b'7 ~ %38-15 !1653 ~ ~ 6L6'1 EX OF TYPE
<br />ANKrss
<br />AVERAGE ,~ ., YdAXIMUM ~ UNITS NfiINIMt)M AVERAG~~ MAXIMUM UNITS a-e] 151-651 Ib'3701
<br />i1IL AND GREASE sAMPLE C4RSi#al
<br />MEASUREMENT ., ~ 9Y) ~ OPtd## O#4## #fYY4#
<br />. ,.
<br />,~.::; :;~ ...::.::::.::.:. ..:: ::...........:.::....... .;,.:...:.....; .: r;; .
<br />1±uD66 1 0 0 ••::.~.... ,.. .!9~~~fiID1..:.::.:::..R tS- ,`:.:' ::....::..........
<br />~.
<br />SUA
<br />En811R ~ ~.::>:>. ..:..:~::. •~;:..:..:~ .::: ~~::..:.~~~„!. ~. -1 ...;..,.. :..,..I.;'Q!:fE1E:".11?1?!~~: R4~#
<br />.~.
<br />',
<br />,~..
<br />~EASTUREMSFiT L} R „ ;: i + ~ »
<br />.,
<br />M
<br />h ~ ,y ;,
<br />~,> ~
<br />~~~SAMPLE ~ ~ t"
<br />~ MEASUREMENT ~ ~,
<br />n
<br />,. .~
<br />.:..:.........
<br />... ..,..
<br />..... RMIT': ::. :.. .,,,.....
<br />,.,. , .;.
<br />_~;:
<br />>:
<br />~..:.:.. ... .......,. , : , ..a : -: . ~., .. ..
<br />... ':.
<br />.,. MPLE ~: ~ v ~~ ~.; ~~
<br />MEASURINI~`
<br />..
<br />~~.~: ~.., ~~ PER ,n`.r:;: ,,:.. ~ ;:./":• ~:. :.:::m:. :::xa ,
<br />,. ~t ~ ~~- REtlURE ENT' .. .:~~.:.:::.i::`?:r:.>.. .~ ..:~..... ... ..
<br />....... .: 'i . .
<br />.>:..
<br />.. _~... :. ~ °.::3:.. . :.. ~ ~.:.....
<br />~gy~~ SAMPIIE
<br />~ ,i7:' ~"`I V, MEASUREMENT 1;•~
<br />... ,...
<br />u~. .,
<br />I;':. .
<br />.::.;:: ....M. ...::.
<br />i7..
<br />~g ;.:
<br />,. '. .., ..:f
<br />. ... .':.'...1:.
<br />etl I ENI ...:. ;,.::
<br />.. .,. ...R ,. ..... .. ...: ~ ~ ~n ...
<br />~>... .. ... r.....Y:
<br />.ix.:..:.f:n ... ::ee,. -c.:" :.. .. ... ... .. .
<br />MEASUREMEN .` ~.
<br />~.
<br />• -
<br />... ,.. .
<br />;,::..:
<br />~~H,Etl~IR ~r~1~ .. .:. ,..... .....~ ,:~.: ..;~ ... ..... .:.
<br />...,::..r;.::.....:.~..... .....:
<br />SAMPLE
<br />' MEASUREMENT
<br />::REQUIREMEN'f:.:;:~.;:: .. ::-:.:::.:.:~.: ~,;<,: ~::~~.. .: ..~.:. :..:: ~~~ ~ ;. .. ;~~~
<br />....: .. A..:'. ...:..
<br />NAMERTTLE PRINCIPAL EXECUTIVE OFFICER I cERnFY uMOER PP/KTY OF LAW THAT 1 HAVE PEASONKLY EXMIINED AND ?ELEPHONE DATE
<br />,A AM FAMIIIM WITH THE INFOflMAT10N SllaMITTEO HEREIN; AND aMED ON ~
<br />W 1 ) I\ {~ 711 ' ~ !,,t! ~ ~~ OSTNN MG THE NFORMATONDIIna EEIEVE 17NE aUlMITTED EMFORMAnON~S /
<br />TNUE, ACCUMTE AND COMRETE. I AM AWARE THAI THERE ME /
<br />SIGNIRCMT PENKTIES FOR 9UBMITTNO JJKSE INFORMAnON, INCEUDING
<br />p ~lP I /I THE POSSIa1lITY OF FINE MD IMPIRSONMENT. SEE fa U.S.C. 1 1001 MD 3] BIONATUIIE OF PRINCMAL EXECUTIVE ~71 'Z ~~~
<br />U.S.C. 1 131 P. /narRY• uqi aMM mNh• arY Mt11N• rMi 10 ro t IO,q?0
<br />TYPED OR PRINTED rwnnr.:n1•n irWlanrn WSrnr••namenNa ••I aY•ra/ OFFICER OR AUTHORQED AGENT CODE R YE R MO 0 V
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRshnncs sN sttschmsnts hsrel '
<br />SETTLEABLE: SOLI%~ LI9IT .VPPLI:.S 09LY IF <=l0YR,2uRR PR£CIP 2V ENT IS CLAI!IP.D. IF. CLAIM ,~PPROPED RY u?.^.D,
<br />TSS E IRON LI,",ITi aIf.L !i0T c.: 4PPLIF.D TO RF,PORTSD 11EASURF.MENTS-Sev I.A.2, PG 4, f0R riURDSA OF PROF
<br />1 Pra~lolfa atlitioYii y s u5etl: ' • 1 • `- F RIE C Y T 8E ~ - • • ~
<br />PAGE OF
<br />09090/9711606-1'_'i41. 2
<br />
|