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PERMITTEE NAME/ADDRESS (Include Faciliry NamdGoconon /ORerenr) <br />NAME SiiNECA CCAL CCCEANI' <br />ADDRESSD It A Si E F D <br />HxfDEh <br />CC blb3`~ <br />FACiurY ~jy_ p-,_ e ~ <br />LOCATIONd A Y D E N `:4 CO 816 30 <br />1't'fN: t:. RUD BAOY11~ GENERAL RA~AGEfi <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOES) <br />DISCHARGE MONITORING REPORT (OMR; <br /> <br />}~ PERMIT NUMBER 41SCHARGE NUMBt A <br />/~ MONITO ING PERIOD <br />y YEAR MO DA Y,. YEAR MO DAV <br />FROM .TO `J U , J <br />(2P21) R2 2JJ. ( (26 2]J (2829) (JO-31J <br />Form Approved. <br />H I NO h OMB No. 2040-0008, <br />A?proval expires 05-3 <br />~suBN -~~ <br />f - fIFIL FCUTT <br />GISCNAF6E TC TAlE/El~h CFEEX <br />NOTE: Read Instructions before completing this form. <br /> (3Cerd Ony) QUANTITY OR LOADING 4Cerd Only) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53J (54 61J (3B-45J (46-53) (54-61J EX OF TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />r68CJ, ANALYSIS <br />r64-66J <br />ssao <br />P H SAMPLE <br />MEASUREMENT ~, 0 4a ,~ o ~„~ a o <br />~. ~j ~ 94 Y1fi,l <br />l! - a, ( 1 ~ J <br />v <br />I ~ <br />lye <br /> <br />LUVVU 1 U 1 AfiBMIT aaa ~..'~W ><ia . ~~~. ?•. ~~, <br />. ICE/ 19jT <br />6EFLUE:fT GA055 VALUE ~EOUIREMENT ''~ ~.'. ~~ - IfIM1kUd `~ .,. <br />- <br />~ _~~~` EU !!C[IfA <br /> SAMPLE , <br /> MEASUREMENT <br /> '~# yY4 <br /> <br /> SAMPLE <br />MEASUREMENT IA~ <br />' <br />~ <br />~ <br /> r"l0 yt 4 C 4 ~ e e e <br /> P~RMir ~ ~ ~ ~ ~ <br />• <br /> U EME. <br />:. r <br /> <br />„` $ .Y , <br />x + <br />x,~s.. <br /> <br />=~~ <br /> SAMPLE ~ ~ ~ ~~ <br /> MEASUREMENT .. <br /> <br /> r: <br /> SAMPLE <br />.~ MEASUREMENT <br /> pp~~~~IY' <br />" L, <br />~ <br />, <br />~`~' <br />~ <br /> ~T;4UT~MEN7 <br />. e Jt, §a <br />, <br />yx <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> ~" <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> 7 <br />~ ~ <br />x~ .•i <br />~ YY <br /> ~ <br />Ep <br />A1ENT. ~ y <br />- <br />! T <br />. <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF L <br />AM FAMILIAR WRH7HE INFORM AW THAT I HAVE PERSO <br />ATION SUBMITTED HERE NALLY E%AMINED ANO <br />IN <br />AND BA <br />ED <br />N ~ TELEPHONE DATE <br /> : <br />S <br />O <br />MY , <br /> INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE, J <br /> ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT <br />PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING THE n <br /> . <br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE 1B U.S.C. § 100t AND 33 U S C. SIGNATURE OF RINCIPAL EXECUTIVE <br /> 4 1319. (Peretties urrtler lhnse sleMes may rnclutle lures up to 510,000 antl or <br />TYPED OR PRINTED menmum impnsonmerrt a/DSnreenBmpnths entl5yeers.J OFFICERO AUTHORIZED AGENT ARSE NUMBER YEAR MO DAY <br />UUMMtN I S ANU EXPLANATION OF ANY VIOLATIONS (Relerence all attachments here) <br />I:i~ LIHIT MILL BE GA1SE0 AND SETTLEABLE SOLIDS LIt1T AP FLIED P.OA <=IOYA,2UHFi L'RECIF EYEItI j.. t <br />ScTTLEA5IE SOLIDS LIt'.1T dAIYED FUA >IO1R~24dB PAECIP EYEYT SU°dEC2 YO PURDEN OF EFCCT 11 ',It~.i. CIL E <br />acv r ~ <br />EPq Form 3320.1 {OfiAS) Previous editions r02y not.be used ._ , _ ;,. ~~( .LACES EPQ:FORM T~0 WHICH MAY~.NOTBE USED.) ., ,.., ~.t . ~e ., . -+ . ,.:...,,.- ~ PAGE OF <br />