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PERMITTEE NAME/ADDRESS pMiif. FrlGry Na./f.«nlw dDld ur) <br />NAME pOMUL~kHORN CJAL COMPANY <br />ADDRESS ROADSIDE HINEe N E S PORTALS <br />p.0. 801( 143V <br />PALISADE <br />CO 61526 <br />FACILITY <br />LOCATION <br />iL`fTii: JJHN A. MCNABe PkE`iIDENT <br />NATIOXµ GOLL!!i'~IF/r OISCMMOE ELIMINI1fiON SYSTEM IAIPCE$/ <br />OI6GH~ R6 E titONITORING REPORT lOM~1 <br />000 ~ ub <br />PERMIT NUMBER DISCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAV <br />FROM TO <br />!767/1 l77-731 !74761 !7677/ lZ8-791 134311 <br />Form-Approved. <br />POMD 9 TO COLDRADtU~L-A~~°y~~°-oooa <br />(5 (I B R fr C) /CpProveLet{Pjrp~05-31-98 <br />F - FI RAL lI LL VV <br />MINOR <br />4O~ NO DISCHAkGE ~~~~ <br />NOTE: Reed Inetructiau beta i eo tMtlnp this }orm. <br />PARAMETER 13 Grd Ontyl QUANTITY OR LOADING /I Grd OnNI QUANTITY OR CONCENTRATION ND FflEOUENCV SAMPLE <br /> !46531 156611 l38-451 M653 1546/1 E of <br />137-371 X <br />µµY515 TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS Is]-63J 164-581 159-701 <br />.liL ANU GREASE SAMPLE ~ ;#Or;F## ( g4~ taoot}atl ~eoaaaa IC~gY+A#4 <br />Y I ~ U A L MEASUREMENT <br />o4J66 1 O O PERMIT, ::: .. >adai#iCi~Ql,... R.~PEIRT ES=1 argaa>a~~l #4s~4~1 : : #+0:4?0#0: #>k~ a~KiX SVA <br />.I <br />L,FFLUEN'T (:ROSS 9ALU REDUINEMEN7. : ;pgT.;i7AY N0~0 -..,: '' 0~l#4 . <br /> SAMPLE ~ .. <br /> MEASUREMENT _ - ~ - <br /> :~(?E MI" <br />:'.'s::. "r:: <br /> ~REQUIRENiENT :: ;: <br />..::.: ~ 1 - <br /> SAMPLE <br /> MEASUREMENT <br />} ~.. PERMIT <br />~ ~ ~ ~ - - <br /> . <br />~RE(lUIREMENT. ~ ~ ~ ~ .. ~ ~ - ~ ~~ <br /> SAMPLE <br />~' _~ MEASUREMENT <br /> PERMIT : :.::. ~: w...:...:"i' <br />~ ... .i;. :._ _. : ~ ~ - <br /> .REQUIRENIEN]'. : ";.'s:,. .S-,`;e~:.':,rc, (~~' ' <br /> SAMPLE ` <br />~ <br /> MEASUREMENT ~ <br />' - <br /> :. ~~PERMIT ~.:. ~: . :. ,. .. ~ <br /> <br />:. <br />.. <br />.. <br />.. <br /> <br />REQUIREMENT <br />~ <br />~ , <br />. <br />~ <br />~ <br />', : ~ ; <br />~ ~ <br />- <br /> ~L: <br /> SAMPLE <br /> MEASUREMENT ~ ~ ' <br /> PERMIT ... - ~~.. ..: .. <br /> REQUIREMENT h <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ - <br /> REQUIRENIENT~ ~ - <br />~ ~ ~+~ <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER 1 cERn <br />~ <br />F w u1+DER PENALTr of <br />N <br />N F uw THAT I NAVE PERSOxuLr EAAMINED AND <br />EI <br />1 <br />1 <br />O - TELEPHONE .DATE <br /> / <br />1 <br />E /J <br />- <br />/ <br />/ <br />(,l/1(,L r~/1't (A--1 ~ ~~ <br />,yy <br />INOUIRV OF <br />INDINDUµ5 <br />ATELV <br />THOSE <br />MM <br />ED <br />RE5PON51lLE <br />FOR <br />~6BTNNING THE INFORMATON, I BELIEVE THE SUBMITTED INFORMATION IS ( // <br />I <br />' <br />~L. TRUE. ADCUMTE ANO LOM0.ETE. I AM AWARE THAT THERE µE <br />SIGNIFCANT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INOLUDINO / <br />/ / <br />'' <br />~ <br />/ <br />P~ , <br />THE PoSSIBIUTY OF FINE µ1D IMPNSONMENT <br />SEE 18 U <br />S <br />C <br />1 1001 AND 77 ~ ~~~ O J <br />/ <br />/ <br />_ / . <br />. <br />. <br />. / SIGNATURE OF PRINCIPAL EXEC E <br /> u.s.e. f t st B. rFtlwd.. +.rA.r dl.,r mnrt., mer ~+eAd. 6... ~ ro r ro.ooa <br />TYPED OR PRINTED .nd ar muim.n MAdmrwNWMrwwn s nmdra W 6 r.va! OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANV VIOLATIONS lRe/erence s!l sttschmenfs here) <br />.iE'fTLEABLE SOLZUS LIMIT5 APPLIES ONLY IF <~LVYR,24Hk PAECIPITATION" lSYEMT I9 CLAIMED. PEAMITTP.E HAS <br />d~nUEN OF PROOF WHEN REQUESTING RELIEF FRGM SETTLEABLE SOLIDS PkIMARY LIMITATI0~5. <br />R:~ <br />fi <br />t <br />EPA Fam 3320.1 108-961 Previous editions mey ba used. (REPLACES EPA FORM T~10 WHICH MAY NOT BE U6ED.) VO 0 39 2 / 9 B C 2 2 3-125 6 PAGE 20F <br />