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PERMI~E NAME/ADDRESS (Jnclude Facility Namr/LOCerian iJDifferrnQ <br />DAME CYP4Ur I, •e: p.. r~Fa`u'A; TO': <br />ADDRESS s'p, ii. f. "I '~° "~N~LT'~' <br />Y.O. °1y 6° <br />FACILITY L. k 4 I_ '^~ n l °, 2°; <br />LOCATION <br />4'~T h'e Ar: G'rlo~P _ tll ~^.1 tr-U_ <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISC~A6 GE MONITORING REPORT (OMR~9j <br />~~n~TnT ~ n+r <br />PERMIT NUMBER :. DlsCriARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM 9 9, !1 q 9 1 TO ~ C ~ r ' ~' <br />(40.411 2-231 /74-251 8671) (7879) (3631) <br />Form Approved. <br />OMB No. 2040-0004 <br />" T " ` ~ Approval expires 0531-98 <br />(r"` ;) <br />.-... v.., n. cruLNrr .:. .. <br />NOTE: Read Instructions belo~ [pleting this form. <br /> (3 Card Ony) QUANTITY OR LOADINO (4 Certl Ony) QUANTITY OR CONCENTRATION NO. REOUENC SAMPLE <br />PARAMETER (46-53) (54.61) (3b-45) 46-53) (54-61) EX OF TYPE <br />C3137J AVERAGE MAXIMUM Ur5 S MINIMUM AVERAGE MAXIMUM UNITS <br />(a-d{ AIYALYS/5 <br />(64-68) <br />69-70 <br />P H SAMPLE . ': i..: ,. .; n ....•: ': ( r ?I <br /> MEASUREMENT <br />l~Ul!'JO 1 't 7 PERMIT 4H{k+~RP Cm'~¢pAt. .~ ^,.~x„ lQKtSr#~A ~~ l»~t •.)t~~-:, <br />i Fr'LU~. h,T ':F7.5 Y` f.%'• REQUIREMENT ~~""~ y. r,~tY :r TA <br />.i ..1:IU5~ ~ .'. T.1 S '! SAMPLE .. -:r-r< r. .... w•Y .}t1 ( ~r,1 <br /> MEASUREMENT <br /> <br />70;u5 I U <br />'T PERMIT'-'-~ °^'~~~4!¢04RR 3aQ~RQ <br />r.--: R9 ' <br />r ~ <br />..:: pt~R .S E7C~'/ . ~RIiEt~:.~ <br />~- P r r "- ° `" I. •' ° EOUIREMENY'' ~ . ~ - y - •• I ! t M k 4 <br />JIL (: ~{>AqF SAMPLE 4ftr:~Rp I: z: .y r. r: •: Rd........ ( t^1 <br /> MEASUREMENT <br />00i5F. 1 p 0 ~ _ PERMIT p41Ff1~A~ ;,:, RO C "'°r 4Crtra4s¢ !% {~;, f;- ' C DlI1INI RlIB~: <br />f: P F 1- ii ? K T G ° 15 5 'J A !, ~! ~HEOUIREMENT X. r -: r ,; r r; T <br />FLD7r T'~ .^.7YD0TT ~^ SAMPLE ( ^3( ,~r,t:r.~ ;~aR:1^-'w 7fieteyr,:;: <br />;:fFli Tier:'".I.^ r.1Ati'r MEASUREMENT <br />`; l!';I `,U ! ,~ '~ PERMIT R.°P!!R; •.,. ~ LNrtrt.«# l:r,-L4 #!s ^t MI#4#~11 K: ~. ~ D!°r 1'~" <br />t.FFLUF!7T GP7~ VA'.,'{F REQUIREMENT 3QD>t ~ ~- ~ ~t^~ I <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT "'"J' <br /> <br />gEOUIREMEN7 <br />~r <br />~n ~~; -, -- <br />- _ <br />- <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - • ~t *'~` - - <br /> REOUIREMENT ~ _-~:= i <br /> SAMPLE <br /> MEASUREMENT <br /> <br />PERMIT ' <br />AEOUIREMENT - - ~ '_ ` `'~ <br />NAME(TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSO TELEPHONE <br />NALLY F](AMINED AND DATE <br />AM FAMIUAA WITH THE INFORMATION SUBMITTED HER <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPON <br />I BELIEVE THE SUBMITTED IN <br />TION <br />E I <br />FORM _ <br />EIN; AND BASED ON MY ^ <br />~~ <br />SIBLE FOR OBTAINING , •~ ~ r `I <br />/ <br />FORMATION IS TRUE <br />/ <br />, <br />N <br />A <br />Richard (v1iII5 TH , ~ ~ <br />FlCANT <br />E S <br />~ <br />l <br />ACCURATE AND COMPLETE. I AM AWARE THAT TH L. <br />~ // ~ <br />ERE AR <br />IGNI <br />i <br />// <br />THE 970-870-2772 <br />D <br />7 28 99 <br />EnvironlRentnf 1.lanager PENALTIES FOR SUBMITTING FALSE INFORMATIO N. INCLU <br />MG <br />POSSIBILRV OF FINE AND IMPRISONMENT. SEE IB U.S. C. 5 7001 AND 33 U.S.C. SIGNATURE OF PRINCIPAL EXECUTIVE <br /> g 1319. (PoroNm antler these rneAas mey IncNtle tines up ro 510,000 entl a OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY <br />TYPED OR PRINTED msYimum rmpnsonment of beMeenBmonCrs entl5ymrs.) <br />COMMENTS AND EXPLANATION OF ANY VIULA I ILJN~ (Hererence all aaacnmens nereJ <br />?E"TLh:AC:. t: 'P''[...,r LI'•TT usj4vD r~,c •sr)7c.?qqa p'rF'Cr rYcN .r4... Tr1e~r nr' rn, r~•: rr..r....-yr.al"5. rTT c <br />:~4- ,-R vp• ] `ln ?F'i r o C I rT•;,I r•- ^r pyr r,•rT -nmrLe ^A ~•'T T, ': r. TT'r.T D•1('TIr1 ET !'~T~..•.nA <br />!. i..; ., i,RAP iA. Lr Ati..LY ;IS Fr. ,.T T VT ;T. L t D 1 <br />EPA Form 3320.7 (OR-95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) PAGE OF <br />(111'17Fi/R~(1 Lit 2-1 `J? ] <br />