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,:.~r.: ,... - <br />PERMITTE NAMEfADDRESS (7nc7ude Fuciliry Name/Locnnon /Different) <br />/~PRUS ERPIRF, CORp~R11fi0N <br />-OEIIGLE n[NF,' G011PLP.i <br />P. O. BOI Ibd•;, f <br />AGILITY CRIIG (~' ,?;~r,:.y. CO' 92 F26,; <br />OCATION ~ ~ <br />sT'[N: 11GEOR1;.! E. TAB , <br />PARAMETER (3~Cerd Ony) OI <br />(4653) ' <br />(32-37) '~ ~ ~ ~ AVERAGE <br />LEPPECT S?TITRE TDII'f SAMPLE 4#ai <br />~ CHk CERIODIIPRNTR MEASUREMENT ~_- .~~tt~t <br />TCPJB S D D ,' <br />sse conl~eres, RrcaN E x, <br />XEFPECT STRlRC 76XY SAMPLE. araaa <br />CtlR PIMEPR0.LZ5 `' MEASUREMENT <br />TcPSC s D • v <br />see cor.nears ,~r.Lw <br />SAMPLE .`= <br /> <br />SAMPLE <br />SAMPLE <br />MEASUREMENT ' <br />• o ,~ <br />SAMPLE <br />SAMPLE <br />MEASUREMENT <br />NAMEtTITLE PRINCIPAL l7(ECUTIVE OFFICER ~ I CERTIFY uNDEI <br />AM FAIAILIAR WI'. <br />INQUIRY OF THC <br />Richard Mills THE INFORMAT <br />ACCURATE AND <br />nvironmental Manager PENALTIES- Fo, <br />PossleluTV of <br />9 1318. (PeneN'a <br />TYPED OR PRINTED meu"mum lmpnsa <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/eienc <br />SEE I. 9.3 PJR DF.T.IIII.S. REPJ3! L¢t' <br />LONEST X EPFLDERT AT itRICB sr~-r 9 <br />EPAfiEorm~33?~o-1,R(08=95)rPravious. Ifions~m`ay no`t'lie~ se <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM MPDESJ FOmI ApprOVed. <br />DISCHARGE MONITORING REPORT (DMR; OMB NO. 2040-0004 <br />a-re) m-91 ~7MDR <br />+xn•n n'+ + ~~ nn~ ~ ~ Approval expires 05-37-98 <br />~' (SgAR tlv- <br />PE,F31v11T NUMBER'~T •^^: ~ - DISCHARGE Nl)A,1~EI) ~r ~ P T ° II I. M~FI <br />FROM <br />Tta21) <br />Y ORY OR LOAD'S <br />MAXIMUM <br />ataaaa <br />UNRS <br />1laaaaa <br />L-'.r <br />Qaa <br />aaaa <br />., '~°% , <br />.. y' <br />.. . <br />r• <br />;~ , <br />' e <br />PERIOD "!'R'1NT^ vFT TP.STTN~ IIT 001 <br />AFAR MO DAY <br />a <br />qa Or, 10 Yaa a~ !)TSCHARGE eao <br />(z6z71 fee-zvi (3oa7) NOTE: Read Instructions befo pleting this form. <br />IIy)~~~ ~ ;- QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />N<5)~_ (4653 (54-67 IX OF TYPE <br />NGM~"_, AVERAGE MAXIMUM UNITS rez33) ~ 687$ 6&70 <br />. <br />, <br />y <br /> P. R- +, <br /> sC rn rM Y "v:; <br /> Qa>kaaa j aeQae- (»~ <br /> sR- <br /> <br />IMrwsG MG71. stE le U.S.G. 41 W1 qNU 33 U.S.G. I SIGNATURE OF PRINCIPAL EXECUTIVE <br />resgl`s mey include 6naz up ro S,O,ooo end n ,OFFICER OR AUTHORQED AGENT <br />etx6en a months end Syean.) ...k, <br />...-.: <br />cSmenLS here) <br />DP,RITLTIOMS RS "wEPPGC?`, -+ROVTp/RGpROpO( <br />P DIPP BETH eE)1 TF47 G''COM1rROL vas UR4 x'R-P~ I <br />'~(PEPLACE !EPA FORFII~T~40 W~fICNIM171 NOTTBEIUSED.)' ' ' 7 " ~'~' ~ j' <br />I ~ s ~ <br />'?.~ ~. ~IIO O~ IITC-j. <br />YEAR' :-F:'IO; <br />4 ;.,~ o <br />TELEPHONE'-~~.r DATE <br />-870-272 T 28 99 <br />NUMB~F~. ~r '.YEAR MO DAY <br />e„ <br />aT cone "s", TC24 <br />v' ~rP_6E OF 1 <br />ro3.yr I . <br />