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PERMITTEE NAME/ADDRESS (1Mib FrWryNaWlaulm l/D/QGnnn <br />NAME :iEti:.l:A CnAL C0t7FANY <br />ADDRESS U R A a t P ~ <br />tiAYDcA <br />CO 81639 <br />FACILITY <br />LOCATION H A Y D N C O b 16 3 t) <br />A'CTbs G. 6UD PFG'a: (',F\oItAL HANAGH <br />NATIONAL POLLUTANT DISCNMGE ELIMINATION SYSTEM (NPDESI <br />DISCHARGE MONITORING REPORT IOMRI <br />ra f 6~ nas~ <br />CoG~OG721 C07 u <br />PERMIT NUMBER DIBCHMDE NUMBER <br />MONITORING PERIOD <br />YEAq MO DAV YEAR MO DAY <br />FROM L TO <br />1 1 /I2-231 114251 /26-27/ 118-191 /3o-3// <br />Form Approved. ~ <br />C Il T F L F'" T E ST I N GOAlle~lo. 2-pyo-eooa <br />(S U P P ~ {,') APProvelLe~ptSesj05-31 X98 <br />F - FZNAL l t <br />MIl+Cfl <br />NOTE: Raed inetlveNane before completlnp this form. <br />PARAMETER 13 Grd Ontyl QUANTFFY OR L /e Grd Only) QUANTITY OR CONCENTRATION NQ FREQUENCY SAMPLE <br />r32-37/ 146-53 /54671 l38-~51 116-53/ 164611 EX DF TYPE <br /> AVERAGE MAXIMUM MINIMUM AVERAGE MAXIMUM UNITS <br />16363! ANALYSIB <br />/64661 <br />/6¢70) <br />lJU ~ A .. A C SAMPLE :}{::::~{: .:`.}C~~'~.`. 4'J~;•.^,. ;}{: :};{:;::}:} ( ~3) <br />CcnluDAi'HNIA MEASUREMENT ~- - <br />CAt13B L G C PERMIT -~~r #tS~ r`•: =1 L'FV ..... <br />' . ~ 100 8-0t5A41F ~ri~a#r., ;v{;_ <br />- <br />:TREY <br />:9A <br />I:FF• -tF 'REQUIREMENT ~ . <br /> 1 SAMPLE <br /> Q V ME SUREMENT <br /> RMIT <br />Q L/. ~ (/ Q REQ IREMENT <br /> S MPLE <br />^ <br />~ <br />4 4 Q LA O k C L MEA UREMENT a <br />: <br />. ~' <br />cc J <br />J ~ <br />~ 0l <br />~ RE UIREMENT ~ F~,~zvg <br />, <br />' <br />% <br />' <br />, <br />R ' <br />. <br />"3~, <br />T <br /> SAMPLE <br /> MEASUREMENT ~ <br /> PERMIT .:.~ i„ <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 />~ <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF <br />UW THAT I HAVE PERBONAlIY E%AMINED AND <br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN <br />AND EASED ON ,~ TELEPHONE DATE <br />_ <br />1 <br />' aY 'r` ` .~.~ ~{ Ca MA S : <br />MY. INQUIRY OF THOSE INDINDUN.S IMMEDIATELY RESPONSIBLE FOR <br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATON IS <br />~ <br />E <br />11 <br />L ~ ~i5.3 ~ <br />7 " <br />V <br />~ TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT TNERE AIIE <br />SIGNIFICANT PENALTIES FOR SUBMIITHO FNSE INFORMATION, INCLUDING <br />~ <br />G~7~ ( C'v0 <br />UC( <br />~ <br />rr <br />lt <br />fr C/t <br />` THE PO551&IJTY OF RNE NiD'IMP1115pNMENT. BEE 1 B U.B.C. 1 1001 AND 30 <br />10NATURE OF CIPA <br />EXE <br />NE ` I EJ .7 1 <br /> U.S.C. f t3te. //1eWeY+Mrlr N+w mAn++m.P AcAd+ rxw+w ro f Io,000 8 <br />L <br />CUT AREA <br />V <br />TYPED OR PRINTED rMwnurbwnYlp+ionrtl Pl bn.++n 6monel+W6rrra/ OFFlCER ORA ORIZED AOENT CODE NUMBER YEAR MO DAV <br />COMMENTS AND EXPLANATION OF ANV VIOLATIONS lRe/rrence s//ettechments here) <br />SEA: PAhT Z.A.4 FUR DETAILS OF TtST PkOCEDUk~. :7EPC3T LJNIS'. CZIU'lICA (~ EFE'LUEF'!') MHI':P ZS LETHAL 2J <br />SJ,: OF TEST ORGANISMS (iC5D) AND ATTACH ACU'CE YOXICITY TES? F'FCP7 FCFr °C CNF. Ct12IE5 OF ALL <br />[4F:7RIEATi(1N RUST i+F CENT Tn FDB. <br />EPA Form 3320-t 108-951 Previous editions mey be used. 1 IREPLACFS EPA FORM TAO WHICN MAY NOT BE USED.) C 0 011 / 9 7 ] 0 31-1 S 13 PAGE IOF <br />