Laserfiche WebLink
<br />PERMITTEE NAME/ADDRESS pxlude Facilrp•Namellxarian ifD~ermrJ <br />NAME <br />CO LL+Y't0 C0~1L C„hPF.4Y, L.1'. <br />ADDRESSCOLOWYO MIKE <br />S/.il STATE HIGRMAY lj <br />FACILITY ro E F R ~ .u. C'0 81641 <br />- -f.i~~.~'` <br />LOCATION - - <br />1TTN: J. D. HARRON. GENERAL RRwAGF.R <br /> <br />PERMIT <br />FROM <br />(NPDES) Form Approved. ' <br />MI ti 0 R oMe No. 2Dao-oooa <br />Approval expires OS-31-98 <br />1 (SD9R NW) ~ <br />+urAeER F- _ ^ f •; a L QtOF'AT :~ <br />e!.?IF4 ;OSE SF.DI TO TAYLOR CREEK <br />DAY <br />rso-sl) NOTE: Read Instructions before completing this form. <br /> (3 Card Only) pUANTITY:OR LOADING (4 Cerd Onty) ~.;';(OOANTITY OR CONCENTRATION NO. FREquENC SAMPLE <br />PARAMETER (46-53).:'x,-.,.;., ~. ~. (54.61):;' (3845) ~.~`.::.. (4653) (x-67) EX OF TYPE <br />(32~7J <br />AVERAGE ~ •- ~ - ~ <br />~'~ .MAXIMUM ! <br />UNITS T ~ <br />MINIMUM;)', Y~ AVERAGE <br />MAXIMUM <br />UNITS ANALYSIS <br /> <br />UIL AmD f=REASF. SAMPLE '~##'~~' ti.~':.",' ( 'T4) +F#4 ####fi'r '.`•'~.'i#Y'= <br />Y .I S U A L MEASUREMENT %,jy~ <br />b11Ubh 1 U 0 '-PERMIT ° - <br />~ RS=1 `~ <br />- ~ ~~~. ~' <br />~ fi; ~,.;:R <br />~ X![~,~ f.~541di <br />::FFLUENT ::ROSS VALUk REQUIREMENT "' 't.,- <br />, . #O <br />D ~ <br />; %^f# °~ ; <br />u <br />~ ^' <br /> , . <br />? . T <br />. n <br /> SAMPLE "> ~:~ .;. .. ,Kys -. <br />~!~' <br /> MEASUREMENT ~~';`_ .;. .~ <br /> PERMIT <br />O °"-'~'~ <br />i++~ ~ r.. `- T~' <br />I <br />: ~P.R '!"~Yl,f ~ T ~ <br />~ <br />I ~,~J <br />~ }}~~t i3~+~; <br />~ <br />q„rs' °~3 a;, ~. <br />:-. <br /> R <br />UIREMENT~ <br />.°, <br />n~ ~, . C~ <br />>~ <br />~~ ,,~~ <br />*~ <br />'t c <br />~2 ~< <br /> SAMPLE ~ -:~u": ~ ~ :7t• .. <br /> MEASUREMENT `~~ `~~r' <br />~_ . <br />~k: <br /> w <br />.~ PERMIT` r . <br />T!~s-3y', -`'~". <br />~ <br />5 ~p <br />k ~t t:,. exi ` <br />` i ~'' Tk yr' <br />,s~ r <br />~.,~~ 4 <br />T <br /> REQUIREMENT ty <br />f~ ~ ~ ~ - . e <br />.~'' ~r. dt <br /> . <br />a .~< _ ~ <br /> SAMPLE 4 <br />1 <br /> MEASUREMENT ~~ .,1~ <br /> k <br />`-f~"FERMIT <br />~ <br />r -,•-sx <br />z b ~. t z <br />_ <br />w3;'r <br />r rs _ r';t` <br />~', :. <br />~ <br /> TRE <br />UIRE <br />MENT: <br />O -'- ~ <br />x i ~*~ <br />a }~+ "~ ~." <br />•t c3 ~;. <br /> ~ <br />~ <br />a ~ , a- <br />. T 4 v. 'm=-~. G <br />i J <br /> <br />SAMPLE A •....~. <br />~ <br />. <br />, <br />~ ~. <br /> <br />MEASUREMENT , <br />~ <br />A <br />,. <br />kir .. <br /> }}~y~~yy~pERMIT.C''+ <br />}M~J/.5 k r •~ a F zyjY <br />4 <br />- f <br />~}` L, r c~, <br />'SR A+i ~'; n.}F sXX, .. <br />(y <br />*$ F Fy 3.i}~ t <br />1 t•`9 <br /> T <br />REOUIREMEN - <br />l' <br />.," 4 <br />N. <br />4 <br />~~ <br />- ~ y ` r, X~ <br />J <br />wt 1 ~~1,_. <br />'YM1YKiFSI IC <br /> SAMPLE .,'~~~,. . <br /> MEASUREMENT ~3 <br />,. <br /> , <br />s. . <br /> "~,'-P,~~ERMIT `~ <br />`~ <br />r _ r. ~ `r ``'~. ..t•" fi'r' ~'~~,t y~~ "; ~ <br />~ '?` T s'I ~ 3~ <br />; f'e ' <br />G ' ~e~ ~+ R <br /> RE <br />QUIREMENT `a^'° <br />' <br />J <br />" T * ~ ~ ~ <br />' •~ <br />3~ r` '{ <br />; a~` a "` <br />' <br />°~; <br /> ~ ~ <br />.. <br />, s <br />3r,3.; ~; ~ <br />_ - ~~ <br />. <br /> SAMPLE ~ ~ ~~'.1 <br />•i: <br /> MEASUREMENT ~. ~,?: -~'" <br /> _ <br /> '°~RuER..M.~T` +. ~.. cc's ~ x` ~~; <br />~~ „ $ e~" ' £ , ' ~~~'' ,~' r r ` , ~r > ~ ( <br /> ?R <br />FOU <br />yREMENT i '~ " <br />'~ ~ <br />°,.~ <br />` <br />' . <br />° <br />~ <br />• ~ # <br />"~ x <br />k <br /> a <br />j, <br />„ ;} <br />, ~ <br />,~y,~ls <br />y , <br />.#ti iF. y <br />_'~i+; <br />, .i$ n . <br />§ .; <br />. <br />,$ <br />MAME/T17LE PRINCIPAL EXECUTIVE OFFICER I CERTI <br />AM FAM FY UNDER PENALTY OF <br />ILIAR WRH THE INFORM LAW THAT I HAVE PERSO <br />ATION 6UBMITTED HERE NALLY EXAMINED AND <br />IN <br />ANO BASED ON MV ly'.. <br />/ TELEPHONE ' "7 DATE <br /> INQUIRY OF THOSE INDIVIDUAL <br />THE INFORMATION <br />I BELIEV S IMMEDIATELY RESPON <br />E THE SUBMITTED IN ; <br />SIBLE FOR OBTAINING <br />FORMATION IS TRUE ~ <br />ry/f <br />,T <br />~/ <br />A <br />_ <br />/ <br />3 i <br /> , <br />ACCURATE AND COMPLETE. <br />PENALTIES FOR SUBMITTIN <br />I AM AWARE THAT. TH <br />G FALSE INFORMATIO ; <br />ERE ARE SIGNIFICANT <br />N <br />IN <br />L <br />DIN <br />THE ~ <br />V <br />_ <br />~ <br />` <br />" <br />, <br /> <br />' <br />~I\ ~ <br />J h r n+DrY POSSIBIUTV OF FINE AND IMPRI , <br />C <br />U <br />G <br />SONMEM. SEE 10 U S.C. 4 1001 AND 37 U.S.G1F <br />' <br />' <br />' ~'~ SIGNATURE OF PRINCIPAL EXECUf1VE q <br />1 ~(/ p <br />L ~V~ /~ /~r~ ~) / G r~ O La <br /> <br />TYPED OR PRINTED 4 13t0 IPenetties under Ihase sleMas may include line <br />s up to E10,000 en <br />due <br />manmum imprisonmem of betwean6mrnfhs end S.yesrs.) OFFICER OR AUTHORIZED AGENT <br />~....... _ <br />CO E <br />NUMBER <br />YEAR <br />MO <br />DAY <br />/I <br />J <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/arence all attachments here) ~ ' ;"~,'i; <br />SETTLEA9LE SOLIDS LIY.TT AFPLL<:S :)>iLY iF <=IOYFi,24HR P;15CIP 'Ei[S~' I5 CLAI*IuU• IF CLAIM APPROVED BY YQCD, . <br />SSS G IfiON LIl1IT5 YELL ROi BE APPLIED TO R.FPORTF:D !MIASU6$MEIF`~ .3lE I. A. 2, PG. 5 FOR FiUADEN OF fy ~~,?~' <br />e_ .. _ •~~ ~~I <br />.. .... <br />