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PERMITTEE NAME/ADDRESS 9.~L~b FSWpNuWG«nlwr lloMirnq <br />NAME tj;,Ir:,I:A (;UAL CQY,i~AdY <br />ADDRESS ~~:t A e ~ R D <br />I1AYDh'N <br />Co 81639 <br />FACILITY <br />LocAnoNHAYDnN CO 91630 <br />AT'PN: G. UUD o4u4N, GENERAL tlARA~'c:R <br />NATIONAL POLLUTMT DISCNMGE EUMINADON SYSTEM INPOESI <br />DISCHARGE MONITORING REPORT IDMR) <br />(1.161 17-191 <br />CG70GG221 CO A <br />PERMIT NUMBER DISCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAV YEAR MO DAY <br />FROM ~ L U TO ~ <br />I Il 171-131 114151 116171 l15-191 /3P31) <br />Forth Approved. ~ <br />f I ~ C N A F' C T O T N I S~BINoR2o4pL-UOEO~ <br />(SUER ! M) Approvelle~p~r~~05-31-98 <br />F - PI1AL ~ <br />rlntA <br />'fir' 9C ^ISCHAkCE ~__~ ~f'r <br />NOTE: Rssd ins[ruetions before completing this form. <br />PARAMETER 13 Grd OnlYl QUANTTY OR L G 14 Grd Only) QUANTITY OR CONCENTRATION ND. FREQUENCY SAMPLE <br /> <br />I31-371 106531 I5a-511 I3B-451 !0653/ 154511 <br />EX of <br />TYPE <br /> AVERAGE MAXIMUM ~ ITS MINIMUM AVERAGE MAXIMUM UNITS u-ssl <br />l µALY51S <br />/54 <br />5 <br />81 /6970) <br /> SAMPLE <br />MEASUREMENT .: ~.`-:A'k?Ek %S .. ~ <br />~ ~ Ctt': ;: ~; ~. ~~ ( IL' / <br />U /- <br />1 <br />' 5 <br />~ <br /> • I E . . <br />UU4JU 1 U C PEAMIT it:;L;xO~;;. ::'+L'.F~s1IRY <br />' 6A5 >altCb;L 9:C '?'•:Y.LY I:~SZT <br />EFFLUENT ~,:kOSS YA LG' , REQUIREMENT •'•::k <br />'r ~F ~LB~XIF~Y! ~rAxIr.U14 $il <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 /> 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 PENN.TY OF LAW THAT 1 HAVE PERSO <br />MIUM <br />TH T <br />FOR <br />N S <br />TTED N <br />AM <br />T <br />B NN.LY E%AMINEO MD <br />ERFIN <br />MD BASED O ~ / TELEPHONE DATE <br /> ; <br />FA <br />WI <br />HE IN <br />MA <br />IO <br />U <br />MI <br />N <br />MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br /> OBTNNING THE INFORMATION, I BEUFVE 'THE SUBMITTED INFORMATION IB ) <br />'' <br /> <br />TRUE, ACCURATE µD COMPLETE. I AM AWME iNAT THERE ME <br />R SUBMITTING FALSE INFORMATION <br />INCLUDING <br />SIGNIFICMT PENALTIES F ~ <br />~ J <br />i~~_ <br /> , <br />O <br />THE POSSIBILITY OF RNE MD IMPNSONMENT. SEE iB U.B.C. 1 1001 MD 73 10N <br />RE OF P <br />IN PA <br />EXECUTNE <br />T <br /> U.S.C. f 1318. 1PNNIIMF YII./ flwAr mNhF TrY h[N.d/ rn,a W ro S 10,000 6 <br />A <br />U <br />R <br />L AREA <br />TYPED OR PRINTED .nemnrA:m.n irlFriaslrlr ortwrwwn smalu.wsy.vAl OFFICER OR AUf ORRED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Rel`ersnce el/ sttschmenfs here/ <br />'S'~:i LI:'IT MILL 6E iIAI'~cU AND SETTLEABLE' SOLIDS LIMIT Ai'PLIPL FCF <=1CIF,2LLY.R pRECIp F.VF.ItT; TSS 6 <br />~ETTLEABLc SOLIDS LItlIT MAZVcD FOR >lOYR,2LLdR pRECIP EV£!iT SUPJEC7 TC FURDER CF PROOF ZN I.A.2. OIL t. <br />I:d>:0 +t1-`iEF. T. R_1D. Tilti Mr]N iTf19 Tq^.-SPP T-R_TC- <br />EPA Form 3320-1 108-951 Previous editions may be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USEO.I C 0 0 3 u / 9 7 ] 0 31-1513 PAGE IOF <br />