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PERMITTEE NAME/ADDRESS pM:bFa10ryNe./Laum IJD~smp <br />NAME :idNtCA CDhL CCh1FA:iY <br />ADDRESS D Fi A ~ F. Fi e <br />NA7D6R <br />CO b1639 <br />FACILITY <br />LocAnoNNAgDlI: CO B1b30 <br />ATTk: G. DUD FiNUYN, G£.+LIiAL .",A\A1;5.2 <br />NATIONAL POLLUTANT OISCNMGE ELIMINATION SYSTEM (/VPA/'$) <br />DISCN=R61E MONITORING REPORT (DMR1 <br />l77-f91 <br />COOJGOiZl 604 A <br />PERMIT NUMBER DISCNMOE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAV <br />FROM ~ L TO y [ < D <br />Il l22-231 !1L?51 126-771 !PB-291 /36311 <br />Form Approved. ~ <br />C I S C Y. A F C =. T O T F' I L{9M8IND;12o4el0oop <br />(~ U F x S a) ApproveL e~p~ryleq~05-31-9.~ <br />F - F7DAL L <br />NINCA <br />NOTE: Rasd Imtructions before completing thin corm. <br />PARAMETER l3 Grd On/y/ QUANTITY OR G /I Grd On/y! QUANTITY OR CONCENTRATION Np, FREOUENDY SAMPLE <br /> 146531 !5457. 13845/ 14653 15451/ <br />EX OF <br />TYPE <br />l31-371 MKYSIS <br /> AVERAGE MAXIMUM ITS MINIMUM AVERAGE MAXIMUM UNITS !sZ-sal 15L5BI 169-70/ <br />N SAMPLE <br />MEASUREMENT .~. 5:: r.::: #4t•v ~:: ~: , ! <br />~, + ~ is y~„y ,. (~ <br />~ - v ~ ( 1) <br />LI ) <br />/3 O <br />~ v, 5 <br />U04ilU 1 1 0 PERMIT S3.'~10133 -:=#=t#t<4 ., 6','S >OCBd'r+ O,G iBCF,/ LgSITL- <br />tF'FLUc:9T GRDSS YALU REQ0IREMENT' r; C;+;: KAXI"LIC; SU '1..%:iT'i <br />LD.J, iN CON UIT Uh SAMPLE <br />ME <br />ME ^^` <br />D <br />'~7 <br />~ G <br />D <br />C <br />~ ( D3) >aQ4~00 Ct9t4;r ~.Je~z-.~ <br />~~ <br />j <br />L <br />s <br />TNl{LI THtAI'$NT PLA': ASURE <br />NT , <br />-l.+ , <br />O 3~ j <br />~ <br />501)50 1 1 U PERMIT R6 03~T ~ OP~~ IOt~ ~:~:: rc±e~~+ae ~ oas o~la retL•;`~ : :;y is^. 1vCE./ HST A': <br />cFfLUtNT GRDSS YALU REQUIREMENT 3CDA hYt; OAIL4 0X. [7GD ;~°`~%°~ ".~'<:' <br />' 'uK 5 SAMPLE •~ ~~r• J~ ~ 94) ~Q'7 ~>tO <br />~ ~LO~J R:i :1%: ;<:~f: <br />(/' <br />~ <br />Y I:i ii A L MEASUREMENT V j Q l S <br />N4liUU 1 1 G PERMIT ~1X L-4zLO nI:PO;;T ~i=1 CO~fl09 4A~t~'Q 4T?>Cd#~ I •'~:~°:. <br />' <br />11tCF./ .~ t <br />._CAL <br />EPFLUeWT GRDSS YALU 'REQUIREMENT ZN_iT CtAX tJC=O ~'^°`°'~` ~:JI'T;5 <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~~~~~ <br /> REQUIREMENT <br /> <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 />NAMElTRLE PRINCIPAL EXECVTNE OFFICER OF LAW THAT I HAVE PERSONALLY EXAMINED MD <br />1 CERTIFY UNDER PENALTY <br />S <br />BM <br />TTED HEREIN <br />MD BASED ON <br />M F <br />T <br />NFOR <br />T <br />W ,` TELEPHONE DATE <br />p ~ <br />{,JQV NHS O~"pS ; <br />A <br />AMILIM <br />I <br />H THE I <br />MA <br />ION <br />U <br />I <br />MY INDUIRY OF THOSE INDINDUN.S IMMEDIATELY RESPONSIBLE FOR <br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS 'i <br />^ <br />1 <br />/ TRUE. ACCUMTE MD COMPLETE. 1 AM AWME THAT THERE ME <br />SIGNIFICMT PENN <br />TIES FOR SUBMITTING FN <br />SE INFORMATION <br />INCLUDING <br />~ <br />~~ u ~ <br />C <br />Y , <br />. <br />. <br />THE POSSIBILITY OF RNE MD IMPAISONMENT. SEE 18 U.S.C. 1 1001 MD J7 <br />UTNE ~ fi651o <br /> U.S.C. f 1 Jla. lMWOY. uM.r ewr. memo m.Y kchKS r.wa .q ra J 10,000 SIGNATURE OF PRI PAL EXEC AREA <br />TYP OR PRINTED .rMams.F.R.n hlpd.NnNnr ortwnrwn anlmNa rMFy.r..l OFFICER ORA ORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reterenee ell sffechments here/ <br />ZCiS LIiiIT 4I LL n° GAIV.:U AK9 SETTLEABLE SOLIDS LII^IT A?PLIFC FCF <=1CYF.,~4NP FR!CIP 2V''ST: TSS 8 <br />SETILEARLt: SOLIiiS LIY.IT rAIYtiD FUif >lOCk.244k PRECIP F,YctiT SUFJfC1 TC E11F.C?.Y 6F PROOF Iu I.A. 2. OIL r; <br />('HCA tiF' S F' T Fl 1 I' TOC •7 f1N TTfIRiN^ SPP T R T y <br />EPA Fam 3320-1 (08.951 Previous editions mey be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.) C 0 0 3 3 / 9 7 ] 0 31-1513 PAGE lOF <br />