|
PERMITTEE NAME/ADDRESS l/weN4 Fr,HryNr~Eornlw dD,Dr..p
<br />NAME TNA/HF.R `IMING, T9C.
<br />ADDRESS TRp PPER '!IYF
<br />P.O. Pa( t~7
<br />Ci!AIL CO Nj5~2A
<br />FAaLm
<br />LOCATION
<br />3ITT!+i i. G080Uk CLT'R5, PReS/Gk:N PIGR
<br />NATONAL POLLUTMT OIBCHMOE ELMINAl10N SYSTEM [NPDESI
<br />DISCHARGE MONITORING REPORT DMRI
<br />1IJ 61 77-191
<br />p ~
<br />PERMIT NUMBER DISCMMOE NUMBER -
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FAOM TO
<br />!161!1 l12-131 I14151~ - /16-17/ E19-191 /3631/
<br />Forrn Approved.
<br />y T y C R OMB No. 2010-0004
<br />(S U !' R R Y) APProvd expires OS-31-BB
<br />P - PZ M AI. - Tl ;lr a
<br />°Ot(C e'A+ Tt" PAST 8g2<A~'+ f:pLCH
<br />644• Y'1~4[SCNARFE~~ ###
<br />NOTE: }MAd Nrtructlorle bef compNtlnp Ulie }am.
<br />PARAMETER l3 brd OnlYl QUANTITY OR LOADING !/ Gld OnNI QUANTTY OR CONCENTRATNNI ND FREQUENCY SAMPLE
<br /> ~ 116-531 /54511 138-~51 !16531 /5F5I OF
<br />131-371 EX MALrsls TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !Pies _ 154681. 169-701
<br />r'11 SAMPLE ###P Ra
<br />` aaba¢1< ¢4Rtd^ { 12j
<br /> MEASUREMENT
<br />UU4p0 L U U .PERMIT . Rs+l#$aa aakra4s 46G ~¢>zF#>k>;+
<br />~^
<br />~
<br />~
<br />~~
<br />~
<br />x'
<br />E.FPLOF.kP C:POSi -A1.U, :REQUIREMENT. 44# ".~"`
<br />.. .
<br />.
<br />.. y
<br />.t.
<br />T [ :.
<br /> . .
<br />.
<br />.
<br />.
<br />.
<br />5[)LLDS, ,i:Tt'L611PLF. SAMPLE ~:#t44¢# 520445'Y ###uaa ~ ~K1
<br /> MEASUREMENT
<br /> l
<br />UD541 I } 9 .PERMIT :. ¢dLC[l-d1.
<br />... : dlaaa.+f.¢: ..
<br />.. .. #¢R
<br />/.. ~
<br />~
<br />~ :
<br />:.
<br />LfPT TO>pX :0,~i .:
<br />~ :.
<br />~::
<br />-
<br />:'LIC:F~y:
<br />.
<br />~~AtB!
<br />
<br />e;FPLU£M? Ca7iS YALU :REQU.IREMENT
<br />~..::
<br />#
<br />.
<br />lr
<br />
<br />A
<br />3
<br />~''
<br />
<br />
<br />
<br />QA ~''~iT~:~~: :
<br />
<br />
<br />M
<br />
<br />, ..
<br />
<br />.....:;:.
<br />
<br />.
<br />
<br />:: ~ :.~: .,
<br />,
<br />
<br />
<br />:;;:;::;:~:.
<br />,~1
<br />U AMU ::F ,.~jF. ~ SAMPLE ¢##'iQ d h C¢YA *zAR ~~fLTlr¢#t" { ~ 9'
<br /> MEASUREMENT '
<br />
<br />U 3'iH 2 1 'D f] PERMIT. b#'OY,E
<br />.. #¢R#a# t:?6 O OgrB#3T~ j.Q • '..:. tS,~'~~':~ .RA..P . :
<br />,.
<br />itFFLU£4T 'HESS VILU REQUIREMENT.
<br />.. .
<br />.. . .- ~ .T!~ i"^'~~ .lt h~]F %::,
<br />1
<br />:i:
<br />~.,~..~,;:
<br />:::';:
<br />F'LUM, IH C7 >71': ',' '?? SAMPLE ( p3) ¢#s<,t;t ~- xts fr r. r.t :ttrt ~yf:
<br />THI[U TAf.'AT"!EF* !'L.l t, MEASUREMENT _-
<br />`.UUSO I ii `~ (I PERMIT .1.: ~ R?,P~QRI~ ~: ~ BP.4Jp! ':OIR##O{+ r: tti¢$C .hdr~da!R#¢:.. ¢'S!' .
<br />'~.~` g.4a ,
<br />~
<br />E;FF'LU£Y'P (;?].>; YnL:! .REl1UIRENI 3A131E.A.itG. :DALLT RT M!;D ##r# .
<br />
<br />:: ..
<br />.
<br />,.:
<br />SOLIDS, TDT~L SAMPLE #ESa4aa asab¢,t a-nh:x^ ( 141 'f
<br />.
<br />CISSOLYFa MEASUREMENT
<br />70195 I. D ~~ ;..;.eERM(;i4;°;
<br />~ :::a##;1-0.t::
<br />~ ; :~tge~#1I~~s
<br />~ ~ eaR R#1b~lk*!a 097Lt)NIIL : .: R~(+Q!1"':. EE
<br />LP?LUENT GPU55 YALq `REtYkpREMEA}T .: ~~ ~ ~~~~
<br />:':..T ..
<br />
<br />;
<br />'
<br />°
<br />OIL ARD .:RF.AS`. SAMPLE a !MaMtr. I S 9!~ IRaaa#t '={:4tYfi^: er;,-lA,~ ;-. ~
<br />.
<br />~
<br />
<br />VIi,UAL ;~ MEASUREMENT
<br />~.`r
<br />~ ~" ~ ~
<br />. '~ ~ ~:
<br />li+l.ii66 1 0 8 PERMIT. doll a. - ~p, ~ ~ti. .v #'~f
<br />,:::v :y'':>`s}{rr< ^~?a~a:}a t:'xIR ~BfiLT T4~f/L
<br />EFFLUElr1' C:R~S~ YpLq .REOIlIREMENT IKSf lPAI Y0=0 .
<br />,.; •1'~:,
<br />#44d .
<br /> SAMPLE ;.~:
<br /> MEASUREMENT
<br /> PERMIT
<br /> REQUIREMENT
<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF I
<br />AM fAMILIM WITH THE INFO .AW THAT I NAVE PERSONALLY E%AMINED AND
<br />RMATION SUBMITTED HEREIN
<br />AND BASED'ON TELEPHONE DATE
<br />- ;
<br />MY INOl11RY OF THOSE INOIWDUALS IMMEDIATELY RESPONSIBLE FOR
<br />OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS ./
<br />~ / -
<br />
<br />W. GOrdOD Peters
<br />SIONIFICMT PENALT~S FOP SUBMITTING FALSE iNFORMATON,TINCIUpNG ~
<br />.
<br />L
<br />970-824-4401
<br />99
<br />U7
<br />I4
<br />President GBnQ ti8 r THE PGSSTBILITY OF FINE MD IMPWSONMENT. SEE 18 U.B.C. 1 1001 MD 3]
<br />SIGNATUR
<br />
<br />TYPED OR PRINTED ~ u.s.C f t 710. IfYnN>. uWr eT.r .or.1,s nrr ~>~. n/11) w ro S IO,000
<br />.naa.mA.in,~.„vnr7.omrnr of brwwn 6mondra Md6vFrAl E OF PRINCIPAL EXECUTIVE
<br />OFFICER OR AUTHORIZED AGENT
<br />AREA
<br />NUMBER
<br />YEAR
<br />MO
<br />DAV
<br />~_-.--_-.__ --... ~......... ~~...~ ..r ..~., .....~ .~~.....- ,... ~_.. .. _.-_ _. CODE
<br />I.UMMCN I J ANU rnrr.nnn, wrv ~r n,v, vl~~n ~ ivrvo Inwe/nnCe an arrscnmen rs nB/e/
<br />iiEfTL£lRLE SpLIp5 LIPIi hpT 9c, uATY^.D FO!i >1pf9,24N? Pn"F^.7n cV°"I* - r;c~ tr,,•c;.•-.•I~: LT°TTA'^i`1M5 7NDFR
<br />I. A. 1. D, AND 1L4D 80PDF.N 6F X47?~ R`'OUIRF."iF5T5 ')RDRR T. p. 3. "T1. ~ rTC~cr _ -~~ T, ,, T.,1n1. TPS
<br />riLTk (70Rt Yr= - T F- (_ ~.'2.._D6Y. ~," .-~ - w r •r -n n^~nv+~: •,
<br />r,PA Form '13: D-1 IOB-751 PreV10US edninn- Inav nn u«d. IREPLAC - EPA FORM T40 WHICH AV NOT BE USED.) ~,Iq ..~ , / ~,I ~ 1 ,~ ~ _ I /• T PAGE ~ OF }
<br />1
<br />
|