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PERMITTEE NAME/ADDRESS (/nclude FauGry Name2oontmn iJDifferen0 <br />NAME 51syFCA CCAL CCI!FANY <br />ADDRESSU h A Y E l3 U <br />NAYLEN CO 81639 <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR; <br />(2.16) (/]- 9) <br />PERMIT NUMBER DISCHARGE NUMBER <br />FACILITY ~q-[~~-~` <br />'v~ MON. ~~ ING PERIOD <br />LOCATIO <br />~ ~ <br />~ YEAR MO <br />, ~ ~~~ EAR MO DAY <br />i71YD8N CC 81630 ROM p ~ <br />A T T N: l:. BUG E e 0 i R, G E K E R A L tl A N A G E R (zazl) (zz z3) (z+ zs} .~ "' (zb 2i) (28 29J (00.31) <br />Firm Approvetl. <br />h I Y G N OMB No. 2040-000 <br />Approval expires 031-98 <br />(SUSh 11) ~CoUTT <br />f - FII1/i <br />L:.:C;iAEF! iC T#IE/!I'-tl CEFEA <br />cYy NG tI_CM~66E ~__~ ~~~ <br />NOTE: Read Inst[q+clions before Completing this form. <br /> (3 Cero Only) QUANTITY OR LOADING (<Card Only) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-61) (38-45) (4653) (54-61) EX OF TYPE <br />(3237) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />(6263) ANALYSIS <br />(64-6a) <br />69-70 <br />FLUw, Ib CO1cUUIt CF <br />TNFtU TNEATMP,h7 pLAl11 SAMPLE <br />MEASUREMENT <br />O•C'6~ ~ <br />Q.QYjZ l I U3) ~~~ a t.t„>r: /~ <br />(,~ U <br />7 <br />Cf ~ <br />~$ <br />iUUSU I 0 I PESMIF,. -' -i Iii! p©7iT +1 o a as>; 1 # <br />LFFLUE1iT GKOS°_ YALUE 'A'EOU(RECNENT " 3Git# i'~6' - BAT.L3'!QI fG^. t42t ~Z~. <br /> SAMPLE <br /> MEASUREMENT <br /> ~gEOILIgT <br />lv1ENT i _ •*: <br /> > <br />, i~e~CSM <br />W (k aYrt <br /> SAMPLE <br />~ <br /> MEASUREMENT ~ ~ ~ N (k <br /> PER }T <br /> 4(7iR~f~tENt ;-,; <br /> SAMPLE <br /> MEASUREMENT <br /> P~Aff~~JJT' <br /> ~~dUH6Ad,ENT ~ . <br /> SAMPLE <br /> MEASUREMENT <br /> e~(iM~' > .~. <br /> AEOUIfi~fiQEEtT ' ,., <br /> SAMPLE <br /> MEASUREMENT <br /> - :PER l~ :. " <br />~ <br />~ - <br /> i~EQUIR <br />MENT= " ` ° <br />fe <br /> SAMPLE <br /> MEASUREMENT <br /> I <br />~' PERM1f"- <br />AEGUJW~M~t1T <br /> <br />- ~ ' <br />"' <br /> <br />~>v <br /> ~ <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTI <br />AM FAM FY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AMINED AND <br />ILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND BASED ON MY TELEPHONE . DATE <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br />THE INFORMATION. 1 BELIEVE THE SUBMITTED INFORMATION IS TRUE, <br />ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICAM <br />PENALTIES FOR SUBMITTING FALSE 'INFORMATION <br />INCLUDING THE <br />. <br />POSSIBILITY OF FINE AND IMPR <br />SO <br />MENT <br />SEE <br />S <br />C <br />I <br />N <br />. <br />18 U. <br />. <br />. 4 1001 AND 33 U.5 C. <br />5 t3t9 <br />i <br />P <br />d <br />u SIGNATURE OF PRINCJ AL EXECUTIVE <br />. ( <br />enett <br />as un <br />er rnase sralules may include l <br />res up ro $16,OLtl end w <br />TYPED OR PRINTED maximum rmpnsrnmenr of beMgenbmonlhs ends years) OFFICER OR ALIT ORIZED AGENT <br />~ A <br />E <br />NUMBER <br />YEAR <br />MO <br />DA <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerence ell attachments here) . <br />:~~ Li..".IT PILL BE iIAIIEG AND SESTLEAEYLE SOLIGS LIlIT APFLIEC PCN <=IOYfi,24N9 PRECIF EYE17; T55 E <br />SL1'TLEAdLE SOLI US L1l7T iiAI9EG foil ~lUTR,l4N# P6CCIP EYENS SUEJECT 70 EUfiGBM OF FFCCP 31 I.A. i. CIL G <br />~'1 iJ C4-CVO T e t T 7~S' !i~`i M.IT^F{;;/~-~~~ ~ ~ 1 p <br />EPA Form 332o-1 (08A5) Prewous edRlons may not be used. 1 ~,: , (REPI:ACES3EPAifORM T-40 WHICH~MAY NOT BE USED.) ~ ~ ;PAGE OF <br />...- 9aQT-2l99Cf:7-1653 1 <br />