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PERMITTEE NAMElADDRESS (include Fauliry Namdllocafion i/Diperenq
<br />NAME
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<br />P. D. :-1? ] ~ I
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)
<br />DISCHARGE MON170RING REPORT (OMRJ
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />Form Approved.
<br />Y I N J R OMB No. 2040-0004
<br />(SJ'lk NM)
<br />F - FI'tAL
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<br />ACUi% `; E° TESTItiG FOR 9191
<br />FACILITY `• ` -' " ` MONITORING PERIOD
<br />LOCATION YEAR MO DAY YEAR MO DAY
<br />FROM 1 t.l Ol TO J1 03 31 •• ~ @~ Di SCHARG F: ) 6:~#
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<br /> QUANTITY OR LOADING QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER ~ EX oP TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER ICediry under panairy of law that this tlocument and all atWChment5 were
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<br />W, GOLdOR Peters submitted. Based on myinquiry Mthe person or persons who menage the system,
<br />or those persons directly responsible for gathering Na IMOrmation, tfre inbrmatlon _ _ _
<br />~-~ 970-824-4401 91 D4 26
<br />President/General Manager submined is
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<br />rncludin the ossibili o! line and im risonment far knowin violations. OFFICER OR AUTHORIZED AGENT
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<br />COMMtN I S ANU EXHLANA I IUN Vr ANY VIULA I IVNA (He/Q!@OCB all eRaCnmen(5 NBIB/
<br />~~E I. A. 1, PP 1-9, FON D°TAILS OP PEST PROC?DURP.. R3PDkT LC 50 - STATISTICAL POINT ESTIHA'pl~ FIHICH IS
<br />L::THAL TJ SD; OP TEST UR:;ANIS:^.5, AtiD ATTACH ACDTE T01(ICITY TEST 3EPDRT FOR!1 TO D!1R. COPIES OF ALL
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