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PERMITTEE NAME/ADDRESS 9MN. Frmry Ner/LxnIe. QDIDGnm) <br />NAME IL:;HR OJ4L ~JyPA!If ! <br />ADDRESS ~ A'; SL ~ D I N ~~ <br />P. O. d'JX 773157 <br />srsaeaJAr s~~IVS-> ~0 5D177 <br />FACnm <br />LOGTIONMALJGS ;J dDi jJ <br />~rr:+: :;eJ:tc= Y. aArr~~ss~n, ,1:.;. t; a. <br />NATIONAL POLLUTANT DISCNMOE EUMINATON SY4rEM'~A/f ~F$~ <br />DISCHARGE MONITORING REPORT lOMR! <br />r7-!el n-rsl <br />CJ.;BSOD37 U06 <br />PERMIT NUMBER DIUNARDE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAV YEAR MO DAV <br />FROM ~ TO Ul `J 3 V <br />!7671/ l11-13I IZi75! !7617/ /IB-79/ (30-37! <br />~r~l; <br />- - - ~ Four{-Approved, t'' ' <br />POND P/TRIB TO CA91iA~°A?A~t~R . <br />(SUER NN) ApwDY°y.°1`~'uSos-3l-sa :j.. <br />F - PINAL ?~ <br />l1INOR <br />~~$ NO DISCBARP. ~X_~ .~# <br />NOTE: Rud Inewctlone bdore completing this form. <br />PARAMETER l3 Grd Onlyl QUANTRY OR LOADING !1 GN OnIYI QUANTETY OR CONCENTRATION NC FREQUENCY SAMPLE <br /> !46531 151-b El l38-~51 !4653 15b5/1 EX DF TYPE <br />r37-371 ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS lei-e]1 (5q-551 159-701 <br />~J SAMPLE rr C;xS: #+~3=# rRY ## ( 12) -' ~- <br /> MEASUREMENT <br />JU..1 i) 1 J PERMIT r.#fi$$:#' -".-°~f''1."¢'~'v <br />' w-=>:X ja.i~ r~#ik..:R.. 9.0 :.. ~ .&~E ri..Ti'~' :>yS II« <br />:.t t'i.U F'N uS~ii iAL:•: REQUIREMENT ~ :. :: :~.' Y"~'.t <br />t~.$ItIO'21: <br />lSltx:2lll7N. <br />$D 'p. .. <br />JJL VSr 3t. L:'~ .LE' SAMPLE ;'+'t USCG F##4C;.- 1E#:<."-v: :-~'ac #$ ( 2rj) <br /> <br />MEASUREMENT J <br />~ <br />~ <br />' <br />.10 $ a 5 1 U ) - PERMIT '...~ ~ .. .:~:. ..: ~ ~'aL;+1~;r ~ :=##~[: ~~ ~ ~ <br />>.,.:': <br />~~:'S ~' :; .~~:$/,' j . ~f(A H <br />:F'F'L 11 G.~i .;kJSS VALJ' REQUIREMENT. ::.. ' ::: :,. .. ~.' ~ .~` ~~~ <br />.. ; <br />'"~~~ - <br /> <br />.:. <br />~ <br /> <br />.. DAIGI '.Cl.k <br /> <br />AL/L <br />, w <br />.. <br />T,~i <br />!!8H r <br /> <br />.. <br />J L U atlt: o S SAMPLE 'F.trCG# -.-: SR: ,'`. : G,'K#v3 ##: .- ( 19) <br /> MEASUREMENT ' <br />J3581 1 U ) PERMIT v+-~r -xCi~.i# -.-.• :±-#Ltir# #:k ;:$ ~ 10 DNTIN. rRAB <br />„F'r'LUENT J81_,$ VAL17 ~ . REQUIREMENT a#gr <br />DLT4..T t7% <br />:1^,/L <br />GL'NT <br />l.' ^ • Y .. N U Jn SAMPLE ( U3) r#.•:=r# err . r##.'~#:• <br />l~L:l rBEATtl."t9T i'L4Rr MEASUREMENT <br />~UJ~U 1 U J PERMIT 3!'TIJYAL .. REP:DRT r*xxYm -rrrY ~ «~~r:.~ ...- NC£/. 'U$tAii <br />.iYr`LUZNT ,;iI7S$ V,>.L7` REQUIREMENT ~ 30DA AYS~:. 'DAILI flX CGD ~ ~ ~ r:## ?lONTH <br />J1L A: ud'Ai-. SAMPLE ri``-+`''+`• ( 9'{~ C:v~'=+Y## +`-:4.k ;=F 'v-:='-kr=~:= <br />~ L~ U A L MEASUREMENT <br />~~1 .I f)U 1 U U ~ PERMIT' •.-.... # :-REkT7RT ~. $=1 'r lfYfk .Yx m~~v' r ~ =r.v.-"i.'~..$%r~~ r~- ~i. Pi/ 'I.r7 (fr~ <br />..i .•-L'JEN~r uri05$ V4L'J:: REQUIREMENT ~ ~:I~p$'~-~CAJC NO=J ~ !IONTR <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT - ~ - ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - <br /> REQUIREMENT <br />NAMERITLE PRINCIPAL EXECUTNE OFFICER I CERTI <br />AM FA FY UNDER PENILLTY OF <br />MILIAR WITH THE INFO UW THAT I HAVE PDiSONALLY E%AMINED AND <br />RMATION SUBMITTED HEREIN; AND BASED ON ~ TELEPHONE DATE <br />Richard A. Munson MY INQUIRY OF THOSE INDINDUALS IMMEDIATELY RESPONSIBLE FOR <br /> OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS <br />Vi C@ President TRUE, ACCURATE AND COMRETE. I AM AWARE THAT THERE ARE <br />SIGNIRCNIT PD/ALTIES FOR SUBMITTING FALSE INFORMATION, INCLUOWQ <br />970 723-4338 <br />of <br />09 <br />I8 <br /> THE POSSIBILITY OF RNE AND IMFWSONMENT. SEE 1B U.S.C. ! 1001 AND ]] b NATURE OF M11NdPA EXEdrTNE <br /> U.9.C. f 191 P. /hrWelr. lud/ e5.r .I.em. mry YNANA A,.• w ro i ro,aoD <br />TYPED OR PRINTED .nY wnrrhe.lr EnFd.Nwwlr or ar...lsnlma,.lwsY.A'Al OFFICER OR AUTHORIZ AGENT CODE NUMBER YEAR MO DAY <br />+• n: <br />,y- I <br /> <br />COMMENTS AND EXPLANATION OF ANY V1oLA norvs I/+etsnnce ui sttscnmsnrs Hers! / <br />;, Y.-r1L1;A9Ld 3JLID$ LI"IiC 11AIYED F03~10-YR, 24-9R PRECIP EVENP $UdJECT PO 80RDEN OF PRDOF RE~OIRRRENTS IN <br />.'7RC I. d. L.DF P. 5. SPOR±9iiACER SAYA;E!fENT PL-N DUE 1-1-33. <br />EPA Form 3320.1 (09.961 Prevloue edltione mey be used. IREPLACE6 EPA FORM T~0 WHICH MAY NOT BE USED.) 0337 / 97 0819-1254 PAGE LOF <br />