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PERMITTEE NAME/ADDRES$ (1nNude fbciliry NamelLocation i/DijlerenQ <br />NAME rY; or- •.•., rnoa~l.;AT7~'~ <br />'k~.U. Pny F n <br />FACILITY C F. 1: ~ r n ,+ t c 7 r, <br />LOCATION <br />ATTR: RG4CP"O VR.?f`A_ :%.s~. <br />NATIONAL POLLUTAtff DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR~ <br />f2451 (1]- 9) <br />rnnn vn R, n+) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM 99 Qy 7] TO ~' ^T ~" <br />(P0.111 7 '- 31 (Z4-P51 (26-Z]) (2B-29) (3631) <br />Form Approved. <br />OMB No. 2040-0004 <br />'% ^ ~ Approval expires 0&31-98 <br />.,. _ -,rr-,,, ._,. I I .-t~~ <br />~ ,NOTE: Read Instructions before leting this form. <br /> (3 Card Ony) QUANTITY OR LOADING '+° (4 Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (5461) °1 _ (3845) (46-53 (54-81) FCC OF TYPE <br />(32-37J AVERAGE MAXIMUM U ~ MINIMUM AVERAGE MAXIMUM UNITS <br />(bz831 ANALYSIS <br />(64-66) <br />69-70 <br />JZL hNJ :; r.re ;. SAMPLE r>;t •: (. rc r,: ~ 41j) ^'f,: :4 F.RtR ..-.. ~. /_^r N:.-. ~, •. <br />Y Z S!7.R L MEASUREMENT <br />p4~)t,t, 1 P I' PERMIT OcrAe44b D ~';=1 Q9?'~~_ .~AX17#64R it.Agt##O i~'-' N4 k'/ LStlpl <br />F FPL 7P!I"' i:F 7•rc 7a L1•a REQUIREMENT tR$~ rt~A •.~=n , <br />`5-;}~ ~"`- - ~ +~ g <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />~ <br /> REQUIREMENT ~ : <br />- j <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - - - - - =„d <br /> <br />REQUIREMENT <br />- . <br />§~')'+~x <br />- <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT `~`i`< '' - ~~ <br /> REQUIREMENT ''' <br /> SAMPLE <br /> MEASUREMENT <br /> ' PERMIY ~' , <br /> REQUIREMENT ' <br /> SAMPLE <br /> MEASUREMENT <br /> { <br /> REQUIREMENT 'E.r'~?S "+ <br /> SAMPLE <br /> MEASUREMENT <br /> - PERMIT ' - - <br /> REQUIREMENT - s , - <br />. - ~ ~ +,t,~,r . .. <br />NAME/TITLE PRINCIPAL E%ECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY ExAMINED AND <br />AND BASED ON MV <br />N <br />MITTED HEREIN <br />- TELEPHONE DATE <br /> AM FAMILIAR WITH THE INFORM : <br />ATIO <br />SUB •I <br /> <br />Richard Mills INQUIRY OF THOSE INDIVIDUAL <br />THE INFORMATION <br />I BELIEV S IMMEDIATELY RESPONSIBLE FOR OBTAINING <br />E THE SUBMITTED INFORMATION IS TRUE <br />~ <br />~ <br />~ <br /> , <br />ACCURATE AND COMPIFTE , <br />I AM AWARE THAT THERE ARE SIGNIFICAM r <br />~~ <br />` <br />/ <br />1"j <br /> <br />Environmental hilanager . <br />PENALTIES FOR SUBMITTIN <br />G FALSE INFORMATION, INCLUDING THE ~ <br />y, <br />~ ~ <br />/ <br />... <br />970-870-2712 <br />7 <br />28 <br />99 <br /> POSSIBILnY OF FINE AND IMPR ISONMENT. SEE 18 U.S.C. 41001 AND 33 U.S.C. 'SIGNATURE OF PRINCIPAL IXECUTIVE <br />TYPED OR PRINTED rrlarimumlPmp~wunenf ol0etween6nwnt/u entl5lu~~RSUproE10.000 endw OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Helerence ell ettacnmenrs here) <br />.'. 'r.C*Li.A,1 i. r' ::~L~ '.T°ri ~AiY~n F-nS )Ift'(Fr?yl{v oa c.^rp .. ~r-.., n•_q: . r~)~ ~,r .~/r r'~9 oc!~/tiRa'xrr•n.e~ r,T• r <br />~;cASF. ,.,+. I'. c9r^;.r F!,:LY':TS v;'l11IAF7 Ic VZ'Itl,r ~I{Try I, nr^nyc• :moTv ge..nl• T`;iTP "'I <br />EPA Form 3320.7 (OS-95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) PAGE OF <br />