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~ERMITTEE NAME)ADDRESS /include Facility Namr/Gocarian ~Difjeremy <br />NAME C v A P L E :: '~ ' •. t~ ;• , <br />ADDRESS I'aAPF CFI iI'~;~ <br />.O. ,i't~ L7 <br />'':AI:< ~J dl~2:r <br />FACILITY <br />LOCATION <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDESJ FOrtn AppIOVEd. <br />DISCHARGE MONITORING REPORT (DMRJ OMB No. 2040-0004 <br /> 'LaJ'. <br /> <br />PERMIT NUMBER DISCHARGE NUMBER _ .; ; (, , L `S:J F' ~) T <br />MONITORING PERIOD y=UT'. .-rT TESTING F-?N 011 ~,1 <br />YEAR MO DAY YEAR MO DAY <br />FROM I TO I '~ 3 31 ~+~~ :+~ DCSCHI.KGF: ~~~ _~_`~: ,_-_ <br /> <br /> QUANTITY OR LOADING QUANTITY OR CONCENTRATION NO. FREDUENC SAMPLE <br />PARAMETER EX of TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANa't5~ <br />L~S.i ,:'AC; [' I-t.ti( :i:' SAMPLE ..:fGX0::1 #-^•#### ##:t'<.:: ~'.=#tt#:Y ( Z3) <br />:: E ~~.: ~ .~ A i :, ? I ? MEASUREMENT <br /> ~ ~ ~ : <br />r.~E'L~I: •T 1;° YA J f~,4 M ~` k ,•fil <br />~ as## ,~ $f <br />,'~`"'~ ~ :~~ k= .~,~ <br />.. <br />L ::7'J .,' .^:, .i •,i"' A~ SAMPLE #3!#9t# A# <br />4#QO #OXt fFd Oi ~~ Ot+k.##)?R ~` Z3}~ . <br />~ I . :`.. ) L . MEASUREMENT <br />,' ifi' II ..... <br />" Rat>oi <br />. g,. ti <br /> <br /> <br />~ .. <br />F.. , <br />F <br />r <br /> <br />~ <br /> SAMPLE~ i <br /> <br />MEASUREM~cNT / / } <br /> " ' ~ i is ~: ' k ?}~ ~ti ,tEtr F <br /> <br />• <br />" <br />~~ x <br />. 'w <br /> ~ <br />~ ~ <br />~ ~ ~ . <br />,; <br />." " ~ ^ <br /> SAMPLE ~ <br />~ <br /> MEASUREMENT ~~ . ; <br /> <br />~Av <br />ERMIT " - <br />.iY <br />UPI: <br />~ 4 L <br />~ ~ <br />~ l~ ~ <br />Y .3'Yt <br />'~ 9'I <br />' <br />" IREM~NIii ~` r''~? 1 1 <br />, <br />({=p .s :Ye"ar <br />. <br /> * <br /> SAMPLE <br />' MEASUREMENT <br /> <br /> <br /> SAMPLE <br />.. ., PEEiMI'i~''~~ v"' ";k.- it ~`p~,,_ 'h+~~,.,'§. ;: '°° .w-; ~' .. ~, t ~ y'"` ~ <br />~AE4U1REId~N~`, u; ."' " '` ~ ~ ~ ~ ~~. ~, M a a <br />SAMPLE <br />MEASUREMENT <br />RE`QUIR~MENT r - ~,-F «s ,~ ~: ..~ i <br />AMERITLE PRINCIPAL EXECUTIVE OFFICER ICaniry uMer penalty of law that this document and all attachments were TELEPHONE DATE <br />prepared under my Onection or supertision in accortlance with a system tlesignetl <br />' to assure that quatiGed personnel operly pelher end evaluate the inlormalion <br />W ~ <br />GOrd C''1 PeterS subminetl. Basetl on myinquiry of the person or persons who rtunnga the system. ~'-* /" 970-824-4401 01 0J1 Z~J <br />or those persons dlrecay responsible for gathering the inlormalion, the inbrmetlon <br />I~reaide :c/General Manager submittetlis,lothebestolmyknowledgeardbaliel,tilue,Eacurate,andcomplela. SIGNATURE OF PRINCIPALEXECUTIYE <br />I am aware that Nere are sign?cant penalties for submining )else inlormalion, OFFICER OR AUTHORIZED AGENT <br />f TYPED OR PRINTED InaWho llx oossfVA'M Of tine and imprisonmentfor knowino molations. rnnc NUMBER .YEAR MO DAY <br />COMMFNTC AND EXPLANATIDN OF ANV VIOLATIONS /Reference all attachments here) <br />SI:C I. n. L, ?P /-'7, FOi: Lz^hIL': Ot' TST PgDC°DUIIE. B5P05'L LC50 - STATISTIEAL FD'INT ESTI9AT4 PNICH I5 <br />LNTHAL ?'~ SUS 'F r55:' U3~?H1~~:3, AN9 ATTACII ACUTP °DXZCIiY TEST nEPOR~' FDA. "1 TO D!13. COPIES OF ALL <br />r A orm 332 -1 (REV 9/99) Previous editions may be used. •' ~~ ~ _ _ _ . ~ „: _ _ G c - ^ ~' ^ <br />