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PERMITTEE NAME/ADDRESS (!nclude Focilin•NnmelCorulion jDiJferrnU
<br />NAME
<br />C,LD:YO CDAL CO~IPAhY, L.[.
<br />ADDRESSCO LC.IYJ t!IKE
<br />5731 `iTPTF feIGw~'AY 13
<br />FACILITY * t }'• u'F~ CO 01 LU1
<br />LOCATION
<br />°T'1: J. ~. NAP°7`., FF.'I C.~RL St A~~F.
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOES) Form Approved.
<br />DISCHARGE MONITORING REPORT (OMR; OMB ND. 2040-0004
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<br />rnr+ru51f.1 DRG n (ggaj, y~~ Approval expires 05-31-98
<br />PERMIT NUMBER DiscHAaGE NUMBER c _ F1 ti A L ".O F A'•
<br />MONITORING PERIOD -'Er IFi "7kC :O c:000 .SFF.I NC, C4
<br />YEAR MO DAY YEAR MO DAY _
<br />FROM UC' U U1 TO Ul) U"~ .{U :: {. ~. :,- ryl r~Nt~ur-c % r;±r y;
<br />~__~
<br />rzo-zo (zazs) (z<.zs; -;~~ (zs~zrl (1B-P91 f3p91) NOTE: Read Instructions before completing Ihis loan.
<br /> (3 Cerd Onty) QUANTITY OR LOADING + card Only) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER (46-53/ (54-61/ y (3B-45) (46-53) (5461) EX OF TYPE
<br />(3237) AVERAGE MAXIMUM UNITS ~ MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS
<br />7
<br />6
<br /> rsz 537 (64-69) 9-
<br />0
<br />' ~~ SAMPLE 4::C Cc S: >} '.~''.'iY,: .': ~1.~"'
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<br /> MEASUREMENT
<br />ri .71')71 I (/ ('
<br />PERMIT TFKfi>Sa?'rY Aa1 ~ R
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<br />6.5 xz, " j
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<br />MEASUREMENT .
<br />vU~j!' I G U PERMIT u'0#AC# ###'R+P# `R ARM =APP `_-
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<br />~~ 70 C NC£/ :rAF'
<br />FF i. U F:1 T :; Y') 5 5 V A L'J 1
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<br />'~~< •~3G'~A=AYG 33AILY MX `;./L CGNT>+
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<br /> MEASUREMENT
<br />UIIy45 1 U U PERMIT i~nCC4;,t pCnetL'a t :•I::•_ yl+.lr '"`* "' B$?Q&!!' ~.c C h'CF.J 'F.A[:
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<br />(P. ;. F $) MEASUREMENT '
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<br />V:L 5:76 .-T(.`:ASi[ SAMPLE ,qrA -e;r: ~-n¢t e:a~•[; riKT4#Csk qe ~"~I>7 ('tfi ( tQ)
<br /> MEASUREMENT
<br />U{~'7L 1 C' () PERMIT #n.^.4t:i: :nt::„e34o r, rn., #RBCfIf~! ., tt-~#+~OCiY I^ "' ~ QM?IM igA"P
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<br />IRS
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<br />:~ j ;SOLY ~:^ MEASUREMENT '
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIAR WITH THE INFORM LAW THAT I HAVE PERSONALLY E%AMINED AND
<br />ON SUBMITTED
<br />AT
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<br />~l f TELEPHONE DATE
<br /> INQUIRY OF THOSE INDIVIDUAL I
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<br />EIN; AND BASED ON MY
<br />S IMMEDIATELY RESPONSIBLE FOR OBTAINING I
<br /> THE INFORMATION, I BELIEV
<br />ACCURATE AND COMP
<br />ETE E THE SUBMITTED INFORMATION IS TRUE,
<br />AWAR ~
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<br />PENALTIES FOR SUBMITTIN
<br />I AM
<br />E THAT THERE ARE SIGNIFICANT
<br />G FALSE INFORMATION
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<br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE le U.SC 4 1001 AND 33 U.S.G SIGNATURE OF PRINCIPAL EXECUTIVE I /. i ~' ~4~ I([W C' •' 1 .: ~ ~.
<br />
<br />TYPED OR PRINTED g 1319 (Penalties antler these statutes may include lines up ro E10.000 antl a
<br />maximum imprisonment of benreen6monlns end5
<br />ears
<br />) (.OFFICER OR AUTHORIZED AGENT AEA
<br />NUMBER
<br />YEAR
<br />MO DAY
<br /> y
<br />. CODE
<br />OOMMENTS AND F,(PLANATION OF ANY VIOLATIONS (Relerence all attachments here)
<br />:~L'TTlF.duLf. CGLIDG LI°IT 6!'PLIE.= ;?t;LY _TF <=lilYk,24H? Q "P F.L'';:F'T I:i CLAI14=('. Ir CLAI° APPROft$0 NY AI;tCD,
<br />,'-i .i i; (rO+i LI !".ITS JILL '(n" '3 AFPLI 3C• TO REPO F.T ED ;1 ~;,A$aTtEC tNTS - $EF: I.A.2, PG. 5 FOR FUf?CEN OF PP.COF
<br />"EPA Form 3320-1 (0'8.95) Previous editions may not be used ~ - y ~(REPIJICES EPA FORM~T•40 WHICH MAV NOT BErUSED:)~ ^ Y V •• ^ ` ~ ` ~ V r ~ J ~ u ~ PAGE OF
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