Laserfiche WebLink
PERMI 1AME/ADDRESS (/nc(ude Faciliry Name/Lxalian i~DiQerenq <br />NAME (n.trq r.; .p.. ,-~•,,J~,R ~'.I '1h <br />ADDR'cSS: F. ;:. :: ....t, -.fir.. 1, ;.y <br />?. p. Pn7: r-l <br />CRAIG C'7 ,ttA~q <br />FACILITY <br />LOCATION <br />NATIONAL POLLUTAM DISCHARGE EUMINATON SYSTEM (NPDES) <br />DISCHAR GE MONITORING REPORT (DMR~a( <br />nnTnt~ ~ nit <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING P RIOD <br />FROM <br />(N}21) <br />Form Approved. '~ <br />• ~ OMB No. 2040-0004 <br />Approval expires 05-31-98 i <br />/ r.^9 . r) <br />_ aTVrIT °~+c <br />'-': {,' TQ Fy_^151 Tr1 •l.v D! :: T~r^ <br />NOTE; Read Instructions beto plating this form. <br /> (3 Card Ony) QUANTITY OR LOADING (4 Card Ony) QUANTITY OR CONCEN~ TION NO. FREOUEN SAMPLE <br />PARAMETER (46-53) (54-61 xa. (38.45) 46.53) 54-61) EX OF TYPE <br />(~-31) AVERAGE MAXIMUM UNIT MINIMUM AVERAGE MAXIMUM UNITS <br />ratpl aNa-YS(s <br />base) <br />69-70 <br />S t7LI75•°J°4L SAMPLE ^[a4ph t;eC~~.. .,L..y ..:... ( ~'71 <br />6 I `' •; it L Y F. p MEASUREMENT <br />10Z7ti 1 D C PERMIT=. a*i+saRR yep ~c~. ~~. pF. k^fl°P OFt7lR YKti'~' k<~` `'~'~~°~+~' ~~:=. <br />i~FY~li;:rrT ~rnz~ :;E{q REQUIREMENT _ <br />~ ~ >a4R0 z~~" " ~"~ <br /> SAMPLE u <br /> MEASUREMENT <br /> PERMIT. '~F~ <br />- '~` <br />L ('- <br /> REQUIREMENT ;.~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT -` ~f. <br /> REQUIREMENT - -- ;~ ~,:,__"`-` - <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT- f.'~~ "` I <br /> REQUIREMENT { <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~ <br /> SAMPLE <br /> MEASUREMENT <br /> PEAMIr <br />~ <br /> REQUIREMENT . ~;_, :. , <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT- - - _ ~~~ <br />- <br /> REQUIREMENT - F; ,1s<",+, ( <br />~- ' <br />NAME/TITLE PRINCIPAL IXECUTIVE OFFICER 1 CERTIFY UNDER PENALTY OF LAW THAI l HAVE PERSO NALLY ENAMINED AND TELEPHONE DATE <br /> AM FAMILIAR WITH THE INFORMATION SUBMITTED HERE IN: AND BASED ON MV <br /> <br />Richard Milis INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPON <br />1 BELIEVE THE SUBMITTEO IN <br />THE INFORMATION SIBLE FOR OBTNNING <br />FORMATION G TRUE, <br />~1 <br />~ <br />~ <br /> , <br />AWARE THAT TH <br />T <br />I A ERE ARE SIGNIFICANT r - <br />1 <br />ntal '~tana pr <br />E <br />viron ACCURA <br />E AND COMPLETE. <br />M ~~ /. 970-870-2712 7 28 99 <br />n <br />me PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE <br /> PQSSIBIUTY OF FINE AND IMPRISONMENT. SEE 18 U.S C. 4 1001 AND 33 U.S.C. SIGNATURE OF PRINCIPAL IXECUTIVE <br /> g 1st a. (PerelNaf antler these statures may Include 8rres up ro E/0.000 entl w OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY <br />TYPED OR PRINTED mevmum impdsarunent of beMaen Bnpneu entl5years.) <br />GGMMENTS ANU EXPLANA I IUN UY ANY VIULA I IUN3 (neTe/aDCa au BRBCnmenr5 natal <br />rt:iLF.F r~r ~~~r~. ',1 "T'• .;:iUc~ c1u >In~^~~q~rq o~FTrTn cyr,.lT_^.r^ T•~~v~ ^^ Tq~ r~r ,rnrrrgjq ~T* .. <br />cerAye ;6A° ra wpt °,A'. AL. '!.^Tr rn. ^~tll ec•1 Ic 7l r,r'1Lr ''4=cr; IS 'iot Fngt•n• On.. r.(Y rr vn. TVr I~.^-nttf"~Tn y•~-I. .•Is <br />EPA Form 3320.1 (OS-95) Previous editions may not be used. (REPLACES EPA FORM Td0 WHICH MAY NOT BE USED.) PAGE OF <br />~~131/~~041?-157' l <br />