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PERMITTEE NAME/ADDRESS pM,drFanllryNs./(sellen ~/D~fmmq <br />NAME pi.\t!.A CJ;L CCt<FP.vY <br />ADDRESS D K A s L F. D <br />HAYDLN <br />CO 81639 <br />FACILITY <br />LOCATION f1AYDP.b CO dlt 3C FR( <br />ATTN: G. L'UU E1F.Oi1N, GENERAL MANAGoA <br />"ISCNPF2F. T!' if. <br />(SUPR Al:) <br />F - FI1'AL <br />'1~HCP. <br />Form Approved. <br />I i3~INO: 2040; OQOg <br />Approvele~pirLee~05-31-98~ <br />T <br />•' tir DISCHARGE: (__( %l+0 <br />NOTE: Rasd instruetlons bsfors complstinp this lorm. <br />PARAMETER lJ Grd Ontyl QUANTTY OR LOADING (~ 4 Ontyl QUANTITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br />l3I-J71 146531 (54611 +-=.TJH-451 !46531 /54511 <br /> EX MALY515 TYPE <br /> AVERAGE MAXIMUM UNITS ~ ~ INIMUM AVERAGE MAXIMUM UNITS lei-s~~ 1545e1 l5&701 <br />PM SAMPLE .. .. <br />.- I~ kv:}I?C'k <br />~ b{YLYa9 ( 12 <br />) <br />I <br /> MEASUREMENT 5 / ~ T, <br /> <br />1 <br />1 ~ <br />UUvUU 1 0 0 PERMIT YA,cop ;Y~:$ ::O #.r TS;F :: ;c: . ... .: <br />e.s. .. . <br />>ss,oa-: <br />.o « <br />e~K~Y ,. <br />tN,rr <br />EFFLUENT GNOSS YALU REQUIREMENT :^;~: YI.x~1~;pM... MASIriDti SU <br /> SAMPLE <br /> MEASUREMENT <br /> ~~ :PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~ 1 <br />NAME/T1TLE PRINCIPAL EXECUTNE OFFICER I cERnFr UNDER PENAITr of uw THwr I HAVE PERSONALLr EXAMIN <br />AM FAMILIM WITH THE INFORMATION SUBMITTED HEREI <br />A <br />D ED MD <br />SED TELEPHONE DATE <br /> N; M <br />B <br />MY INQUIRY OF THOSE INDINDUALS IMMEDIATELY RESPONSIB ON <br />LE FOR / I <br />/ <br /> OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMA TION IS / <br /> TRUE, ACCURATE MD COMPLETE. I AM AWARE THAT THE RE ME / <br /> SIGNINCMT PENALTIES FOR SUBMITTING FALBE INFORMATION <br />INC LUDING E <br /> . <br />THE POSSIBILITY OF FINE MO IMPRISONMENT. SEE 18 U.B.C. ! 1001 MD 73 BIONATURE OF P <br />L E <br /> <br />. eD ro llo,soQ <br />~ A.1/ <br />l <br />~ AIN A <br />XECUTNE <br />R A <br />TYPED OR PRINTED Yr~1 <br />rM Ormuhx.n <br />ela .«~ ~d <br />M OFFICER OR ALIT ORIZEO AGENT A <br />CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANV VIOLATIONS lRefrrsncs sll sttbchments hsrel <br />i=~ LI'911 -'ILI. H`; rAIYhD AhU :,ETTLR.IBLE SJLIDS LIMP. A'lPLIFD FCF <=1(!YF,2u:'S FAFCIP F.VF.hT: TS_`• „ <br />ScIILEA3Ld SOLI US LII7IT aAIYED FOR ~lUY}i,24Hii PRECIP EVSVT ~CPJECT TC eaxr.z% CF FF.OOF IN I. A. 2. GI1, & <br />si 11 +:ASF'-:iEd I.F;.7. D. TJS 11f1NTTElRTN~.-C.F T-q.l-P. <br />EPA Form 3320.1 LOB-951 Prevloue adlOOns may be used. (REPLACES EPA FORM T40 WNICN MAY NOT BE UBED.) Q 0 D R 6/ 9 7 ] D 31"1S ] 3 PAGE lOF <br />