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PERMITTEE NAME/ADDRESS //nrTudeFacilip•A'omv/Lxuiinni/DAerem) <br />NAME SgNECA CUAL CClSFA6fY <br />ADDRESSD N A Y 6& G <br />HACDEN CU 81139 <br />NATIONAL <br />FACILITY <br />LOCATION(AlUEN CC 61t3U FROM <br />ATTN: G, pUD UHOirA, C1NEhAL t1ANAGEH <br />DISCHARGE MONITORING <br />(P r61 <br />ooaal~zl _. <br />PERMIT NUMBER ° <br />' MONITORING <br />YEAR ; MO DAYS <br />(2PP]) ~~''{zZ231 . (24~Y$) <br />PION SYSTEM /NPOfS) Fofm AppfOVetl. <br />ORT (OMB; , OMB No. 2040-000°4! <br />f1z el rI bG C Approval expires 05-3198 <br />011 ~ (SUBN !Ir) <br />DISCHARGE NUMBEH F_ F I y A I :FC L 1.1 <br />Roo SED.,:1~IE CStGE 7C G>lASS1t CFN. <br />1R MO DAY ~."`~~ ~" <br />y u ~u ~"Ilr'~ 'EISCU~GF ( ( OaA <br />?TI (za z91 (3o-3r) ~,NO,,TE: Read Instructions befor~mpleting thls form. <br /> (3 Card Ony) QUANTITY OR LOADING <br />~~ (4 CeN Ony) QUANTITY OR CONCENTRATION ~ NO. FREOUENC SAMPLE <br />PARAMETER (4G53) (5461) (38-45) (4B-53J (54-61) EX OF TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM <br />~ UNITS <br />!sz-Gil ANALYSIS <br />(64-681 <br />69-70) <br /> ~ <br />, a.. <br />~UL1U~, 'l U7AL SAMPLE >ru~o°~" ~s+vaaA a ~v>os '~ ~: I9~ <br />UiSSOLYEll MEASUREMENT <br />70195 1 0 G PERMIT ~ >RA 9 iR Sa0 ' ~ <br />IT~€~' ~ <br />~ '- ~36F(~~1 ~~~.~ ~~~~:'t <br />t FPLUENT t;hUSS VALUE REQUIREMENT - , <br />u . L594 ~ <br />,:; " , <br />, <br />,~ <br />(i3'~1 ~~r(rF?~. )iNl~t~~l ~~Rx~ RG/I A<-}y <br /> SAMPLE <br /> MEASUREMENT ~ <br /> <br />- 'PERMIT' <br /> <br />~ <br />" 'r- <br />-~ <br />~.~„ <br />~ i ~- r ~ v <br /> -REQUIREMENT- ~ - ~~ ~ i"?" `.y~ ~ - ' ~ ~~)' ''~` x - <br /> . <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> .,'.. -PERMITr' ~.. ~ ~ <br />.~ <br />. - ~~ ~" ",y" T ~ ~ ~ s F r ~''~, rl: <br /> R_EOUIREMENT ' <br />~ - ' <_Ja t - " ( <br /> SAMPLE <br /> MEASUREMENT <br /> <br />-PERMIT -~ <br />_ ~ <br /> <br />~"- <br />- <br />. A^F <br />`" -r - <br />x .. <br />~- <br />p <br />z*7 ~" <br /> REQUIREMENT - ,; - - ~ <br />tC~ ," a ~ :~-, ., <br /> SAMPLE <br /> MEASUREMENT <br /> -' PERMIT ,•. <br /> <br />- ' - ~ ~ - <br /> <br />~ r <br /> <br />~ ` <br />Y ' <br /> <br />' <br /> REQUIREMENT '.'~ ~ i~ %~y ~ + t s.yr <br /> SAMPLE <br /> MEASUREMENT <br /> `PERMIT' ~ . <br />~ .. - <br />~ ~ I° * .~:' `. a.. - ' <br /> ~REQUIR,EMENT ~, I. ; - .. .: s,f <br /> SAMPLE <br /> MEASUREMENT <br /> ''PERMIT: -• • <br />. { <br />' "" 2 x'k <br /> ~ ~ - ~ <br /> REOUIREMENT- ^ <br />~ } ' ~ r,` <br />NAM[/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER <br />PENALTY OF <br />M <br />TH <br />F LAW THAT I HAVE PERSONALLY EXAMINED AND <br />D <br />N <br />ED O TELEPHONE DATE <br /> AM FA <br />ILIAR WI <br />THEIIN <br />ORMATION SUBMrRE <br />HEREIN: A <br />D BAS <br />N MV <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br />' THE INFORMATION, I I BELIEVE THE SUBMITTED INFORMATION IS TRUE, <br /> ACCURATE AND COMPLE-fE. I AM AWARE THAT THERE ARE SIGNIFICANT <br /> PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE <br />POSSIBILITY OF FINE AND IMPRISONMENT SEE le U.S.C. § 1001 AND 33 U.S.C. <br />SIGNATURE O~ PRINCIPAL EXECUTIVE ' /~ <br />( I <br />TYPED OR PRINTED mazlmuni~mpnsonmenl of benrse ~B monm~a sold 6u~9irres upro E~0,0o0 and or OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY <br /> DE <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference ell attachments here) <br />T55 S IAUN LIDITS Mlil P,i iiAIYEL AKD SETTLF.AELE S(LIDS LIlfIT AFPLIFC FCA <=10l9,i4flfi FBFCIP FYEIT; I`_`_ L <br />IRON LIMITS YAIYED EGf >l0YB,14NR FBFCIP EVENT SULJFCT TC BUBCEN GF PBCCP IN L 4..]. CII i GiFA~E-SFF <br />EPA Form 3320-1 (08-95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY•NOT BE USED.) ,~ 6# H PAGE I OF <br />