HYDRO22842

• Permit No: C1981010
• IBM Index Class Name: Hydrology
• Doc Date: 4/14/1999
• Doc Name: COLO CDPS WET TEST REPORT FORM ACUTE
• Permit Index Doc Type: NPDES
• Media Type: D
• Archive: No

PERMITTEE NAME/ADDRESS (Includ¢Facilirr NamaJLocarion fD~erenr/
NAME
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ADDRESSI R A P F E h C l r!
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LOCATION
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NATIONAL POLLUTANT DI$CHAHGE EI.IMINATIONSYSPEM (NPDES}
T
RING REPORT
D
DISCHARGE MONI
O
12-161 (
Mq~
07- 9)

PERMIT NUMBER DISCHARGE NUMBER

MONITORING PERIOD
YEAR ~ MO DAY YEAR MO DAY
FRGM 00 C1 OS To OC G3 .1
/20~2D /22-231 lY4~151 f26-211 !26"29) f3p-JI)
Forrit Approved. '
OMB No. 2040-0004
C I M C A Approval expires 05.31-98
(SUPF Ni)
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NOTE: Read Instructions befo! c mpleting this form.
(3 Card Only) QUANTITY OR LOADING (<Cerd On/y) QUANTITY OR CONCENTRATION NO. FrtEOUENC SAMPLE
PARAMETER (<s-5s) (Sash (OS-as) (as-s3) (5e-s I) EX of TYPE
(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
(6&6T1 aIJALYSts
(94-68)
(69-70J
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FL'JEN" GRi ~: VhLLf R ~UIFiEI(AENT -" C##:~ ,~ G I
NAMERITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
IAR WITH THE INFORM
M FAMI LAW THAT I HAVE PERSONALLY EXAMINED AND
AND BASED ON MV
ATION SU
MITTED HEREIN TELEPHONE DATE
;
A
L
B
INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING _./

W• Gordon Peter$ THE INFORMATION. I BELIEVE THE SUBMITTED INFORMATION IS TRUE,
ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT
N
THE Jr~~C ~-~
~! 970-824-4401 00 U4 Z]
President/General Manager PENALTIES FOR SUBMITTING FALSE INFORMATION. INCLUDI
G
POSSIBILITY OF FINE AND IMPRISONMEM. SEE 18 U.S.C. § 1001 AND 33 U.S.C. $IGNATURE OF PRINCIPAL EXECUTIVE

TYPED OR PRINTED 4 131 R. (Penetties under these slerures may include lines up ro 510,000 end or
maximum impnsonmerrt of belweenBmonNS entl Syoers.) OFFICER OR AUTHORIZED AGENT A
NUMBER
YEAR
MO
DAY
f.
CDMMENI S AND EXPLANAI IUN OF ANY VIULATIUNS (HBIBIBOCB 9119R9COIrlenr5 ^e/6/
1;5 S~TCTAL IriCR 1IP115 DILL BE SiAIYEU, ANG SETTIEABlE SCLIGS LIC11 AFf-lIfO FCA <=1CYF,<4NF. FbEC1F EVEN1-
_~L dUADEN CF FACCE FfQIAEE:EhTS UbDEh I.A.3. TCS CCNITCFIN6 - I.E.3. CII E GEE>F~E - SEE I.f.l.(C).
E A orris 30.1 -9) Pr vious e i Ions ay n e u e` !.A R -4 IC -B~'USED.) C C C B 2/ C G C I 1 1- 1 6 1 4 PAGE 1 OF
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