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PERMITTEE NAME/ADDRESS Qnclude Facdin'NamelLoeauon i/D~ercnO <br />NAME <br />TkiFF;,E ."INING, IhC. <br />ADDRESSI h A F F F. ~ f! 1 }+ e <br />F.C. iJOX I87 <br />PACILITYCRAI., /_O dlt~6 <br />LOCATION <br />a :'i'9: ~. GO dLG[. FETkF_. 4F.: `_/i;~~ nr.a <br /> <br />NATIONA DISCHARGE WONROHFINGI gEPORf (~~~/ <br />f2•T61 ~{n- 91 <br />S <br />PERMIT N MBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAV YEAR MO DAY <br />FROM D Cj TO GC G3 .;1 <br />(2041) (224]7 (2e.25) (26~1I) I2B49) WO-311 <br /> <br />~~~ FoTmApproved. - <br /> OMB No. 20a0-0004 <br />t' I NO F Approval expires OS-31-96 <br />~sus>i NY) <br />F - FItt11 tCFAT <br />EU5CEf/~It~F f7E TC CAR Gl1CB ~ <br />L#a NC CI~CEiAFFF ttt ' <br />i <br />m <br />pleting this form. <br />NOTE: Read Instructions befo <br />c <br /> (3 CeN Ony) QUANTITY OR LOADING Id Card Gny) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-61) (38~d5) (d6-531 (54.61) EX OF TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />(62~G7) ANN-vsls <br />(6468) <br />69-70 <br />ail SAMPLE +~#IC### #i###a #t Lx#: ~ li) <br /> MEASUREMENT <br />ODUU 1 0 U ~ n[~RN1LT~ '~t ~ Iti y,-. .. LAi1 yl~ ~ ei,'~ y ;~ <br />~ yT p;e" ~ <br />. <br />L <br />} F <br />tr ~Y.I <br />~~~'~. <br />c <br />LFFLUE 'T GNOS_ YALLE RR~IREMENT -"';i <br />~ -'? _' +>b+PO S = <br />x~ <br />~'„.. .,_~-' ~ <br />1,= <br />; 00 , <br />-:,s - <br />.'i,LIDS, TCTAL SAMPLE O4~AAO IOAIOO~C OOa000 ( jg) <br />:, li 5 P E N 0 B D MEASUREMENT <br />C u 5 30 1 0 0 PERMIT >~!##I'- ` <br />L F F U E O ~ Y E fiF,Q(11REMENT r' ,~ ~ <br />- ~ `~' ` ''-r', q OOri - <br />Y <br />y '~~~- ( wl. . <br />SGLIUS, SE:x2LPAEIIP SAMPLE # <br />00'vA# ,ly #C <br />AOCG ( i~) _ t <br /> MEASUREMENT <br />UG545 1 U U PERMIT 0#ti~113 4411# '~ , ~1 : 6$IGi'>t . Cd/" ~ <br /> <br />eFFLUEN G6055 YALU?• <br />RE{,~UIREMENT <br />p4T~ "~ <br />>D>•~r,. <br /> <br />~ <br /> <br />` Y r . <br /> <br />t' <br /> <br />K .. . <br />1 nON, TCTAL SAMPLE r, r, 4t~ ~v 0>S4##>p A#qD#:~ I 15) <br />(A5 Fi:) MEASUREMENT <br />11045 1 0 G ""p~RMIF O>p4#+IL1b y " <br />zr LS# ">aA##44 (} ~ "".. rQ; <br />.~.,:.). 6CE/ [/E- <br />'"~"" <br />r.'FE'LUEA? GRUSL YFLUE H~~iE{IR@MENT . <br />~:' ~ ;,;X# °' # <br />;~" ~f .. YC L , <br />, <br />;Ii ANU GflEASF SAMPLE #%'+##O OAO#4Y 4#~90# i##~O~C ~ 15) <br /> MEASUREMENT <br />(;35e1 1 U 0 PEArn1T 4rYj1&Of~4 ' b - a+o# 4-tF#~a+- #„+Il~gl I,~^`: <br />' ; t435 FIE: <br />c F F L .1 E ', T C.., O 5 ~ Y A L (: E RCr4UlRE6lENT ='i„ `:' Y Y ## `•' .' „ ', t' G ; <br />, <br />"' E# T. <br />FL.i:, IN CCNDLIT CF SAMPLE ( 03) #>Ct### 4C~6##d A>Of;t9 <br />I' n h U TEE.° T R E N 1 F L n h'i MEASUREMENT <br />~~cUSV 1 U C aERMIT ~ <br />O8~-Ct~~ 'a8111~DF1~ .` ~ i~FYiO~i~P ~~`~#~ ~4ee ~#~ ~ p6[Y FSTi! <br />EFFLUk,A'T GROSS >. ^Lhi REQUIREMENT , <br />3G ~ -i I.GD ~ #0>Ct~ <br />_.,LIDS, ^.GTAL SAMPLE atu#Y# #L#C%'~ ##A##4 ~ jc) <br />:~i55CLVPL MEASUREMENT <br />Jue~iS I u C P@81JnT eo~e+ollc>tlt. <br />~ <br />. +14#*tPA <br />` Boa ~aCa~~FaRm ~'4~C;E4~i: .g~I'Q.I~'x... iiL9 IA E" <br />~FLIIENT GROSS VALCE REQFlfgT1MHNT ~ <br />' - <br />., ~. Cip# . Z X3-~ ~ CG I <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMILIAR WITH THE INFORM LAW THAT 1 HAVE PERSO <br />ATION SUBMITTED HERE NALLY EXAMINED AND <br />IN; AND BASED ON MY TELEPHONE DATE <br /> INQUIRY OF THOSE INDIVIDUAL <br />THE INFORMATION, I REDEY <br />ACCURATE AND COMP <br />TE S IMMEDIATELY RESPON <br />E THE SUBMITTED IN <br />I AM AWARE THAT SIBLE FOR OBTNNING <br />FORMATION'IS TRUE, <br />ER <br />AR <br />S <br />CANT <br /> <br />~ ~ <br />W. Gordon Peters . <br />LE <br />PENALTIES FOP SUBMITTING TH <br />FALSE INFORMATIO IGNIFI <br />E <br />E <br />N <br />INCLUpNG THE 970-824-4401 00 04 Z7 <br />President General Hann eI POSSIBILITY OF FINE AND IMPRI , <br />SONMENT. SEE IO U.S.C.51001 AND 33 U.B.C. SIGNATURE OF PRINCIPAL EXECUTIVE <br /> <br />TYPED OR PRINTED § 1319. (Penakies antler Nese srelutes may include lines up ro 510,000 antl or <br />maximum lmpnsonment of banreen6montfW end5yeeis.) OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference alf ettaohmenr5 heFe) <br />.~~ L TOTAL IEiCN CI(!ITS WILL dE I.AIVED, AIYC SETTLEABLE SC1IL5 L.ECI1 AFFLIEC FC6 (=1CIF,d""LFfi FFFCIF :YFNq- I <br />~~k uURDEN OP PECGF 6EGUINEMeNTS UNCEN I.A.3. TC° NGNITCFING - I.E.3. CII v GFFASE - 5EF I.E.I.)C). <br />A F rrm 3 0.T Y 8- Pr vibus i ions may no a used. E OR -4 IC SED.) C C C 9 4/ C C C I 11-1 t i 4 PAGE I OF <br />Z.,. <br />