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PERMITTEE NAME/ADDRESS (1neYb frmryN~dLoc.nm ynd6,.,n1 <br />NAME TEtLRUk :.'. ",? ~U'1'~iVY <br />ADDRISSTERROR ~kEEK LOADOUT <br />1840 HIGHYAY 133. <br />PAOhIA CD 81428 <br />FACILITY <br />LOCATION <br />-lTNS EELLY PkITZL~:R, 3~'::;ArI0V5 !1;9 <br />NATIONAL POLLUTANT DISCHMOE ELMINATION SYSTEM /NPOESI <br />DISCHARGE MONITORING REPORT IOMRI <br />!7-161 I17-191 <br />~~;esouza uo ' <br />PERMIT NUMBER DI~CNMGE NUMBER <br />MONITORING PERIOD <br />.'YEAR MO DA ~ YEAR MO DAY <br />FROM ~ 'TO li <br />110-Z Il IZ 91 /Zt151 116-I71 128-191 1363/1 <br />JG~.i71 FOND <br />(suck ac) <br />f' - FINAL <br />tiINOR <br />Form Approved. <br />T'~ t: gM~}yr,~.2oag-ooogOx <br />Approvd e~~1~~65-31.98 <br />#'~»'~ 1~ISCdARGE ~ ~o~` <br />N,~eed Inetructiarr t»fon(Ke mPlHinp this form. <br />PARAMETER !3 Grd Ontyl QUANTITY OR LOADIN !I Grd On/y) QUANTITY OR CON ION <br />~ tjD, FREauENCY SAMPLE <br /> <br />137-371 I46-531 I5a6/l 138-a51 106531 !54611 <br />EX OF <br />MALYSIS <br />TYPE <br /> AVERAGE MAXIMUM U 5 MINIMUM AVERAGE MAXIMUM x1NlT3!~' ~1-esl !5458/ 169-70I <br /> SAMPLE YQ:»»C ~'~Q?::~ YkCI #: {-.1» <br /> MEASUREMENT <br />~ <br />04UU 1 U 0 PERMIT 'r`iti"<Y'?» :t~QQ»,~ ##,» <br />:.: <br />~ sFR;..': # <br />4.0 ,... <br />a., r <br />~' <br />::.: ;;: <br />.$'B.KLY <br />'.N5Ir~1 <br />EFFLUENT GROSS YALUE REDUIREMENT. #~;:a-. <br />IFIgU~..'. <br />:. <br />ilAYI?lU14 " <br />3U ~: <br />OL S, TOTAL SAMPLE C=Q}rXQ ..`?:-': ' piR»R#,'F ( 19) <br />USPGNUEp MEASUREMENT <br />, <br />. <br /> <br /> <br />S~ 1 0 0 <br /> <br />:...~~PERMII' <br /> <br /># 'b 34 R' <br />~:a##~s . <br />t~~» <br />¢~.?~?~#x...::. <br />:35 '': <br />7d .... <br />, <br />, ... . <br /> <br />....r;~~ <br /> <br />:R-B <br />FPLUENT GkD55 YALUE ;REQUIREMEN7 - . ###p " <;:.;::."'..,;: F:'3aDE-` YG DAILY Mp hG/L ` ~IP7H <br />L , Sd LEA LE SAMPLE ;:3»Q.•:t RRRRRR Ri#i1~0 #Q# fir. ( .~5) <br /> MEASUREMENT ~ - <br />0505 1 0 0 PERMIT #acaa» a#gr.:OFti.:: »#;k 1:a1~#:";- ~:' ##oa` # 4~e5 t NCF./ .aAB <br />PPLUEN'1' GkO55 YALUP. Ii2nulliEMENT <br />~ <br />~~ R <br />~ ~~ <br />~~ <br />F AIL/ KY ML/L t!'OHYH <br />R Y, TO AL SAMPLE ??»C`-k+ »R4:» <br />~ «#»iF## ~' , ( 14) <br />(A.i FEI MEASUREMENT . <br />.I <br />1D45 1 D ) PERMIT ##QR3'R "Gtx1r# #'.`.• >k:` "~y.p. be;a NCF/ ~RAR <br />'FFLOENT GROSS YAL'JE 'REnUIREMENT :as `"~'?• t:' <br />~~-~~~~ <br />~ :.:.'O~l, YG <br />~ pAILI "IY riG/L tlDHTH <br />AN RRA E SAMPLE Q»»»»» rRRO#;+ #V : ~## O# ( 19) <br /> MEASUREMENT <br />3Sy2 1 D J PERMIT aR. a.cF'R. sYL~OC3t?ti tr#:+ ;-A;x:RtP~:::: #: ~+Y ~' i0 f OR1'IN :SAA <br />FFLU6N2uRD$S YALUE :REOUIREMENT: pp#g. <br />~~ ~~ ~ 11AILY !tY MG/L GEI11' <br />, J LT UR SAMPLE ~ 03) 4»r»## ###~ ## G##; ~= <br />HRJ rREarhtHr PLANr MEASUREMENT <br />0050 1 O D PERMIT P2I: II.At '8EPt7&T ~ .. RE~t#+k .ioclCo4t:+R LI#ykysLe# ' v4Q EBl~LY :li~TAH <br />FPLUENT G3O53 YALUE REnU)REMENT. ;pD6: AiPr: .:OA~'~I,~,.;lll : MGD <br />~~ ~'GQ <br />U J SAMPLE ~R »»? R ROR# ; ;Y:+#4+r #Q <br />#f- - ( 19~ <br />ISSDLYEU MEASUREMENT <br />0295 1 U U PERMIT +r r YF•'.~ #Ri'. , . '~ # #')j'.' RERORT 3R.(,Y RA9 <br />FPLUENT GROSS VALUE :AEQUI.REMENT +>. 'v Y: DAI.w.X AY MC/L <br />NAMElTITLE PRINCIPAL EXECUTR/E OFFICER I CERTIFY UNDER PENALTY OF l <br />AM FAMI <br />IM WITH THE INFO A1W THAT I HAVE PEg50NALLY E%AMINED MD <br />RM <br />TON SUBMITTED HEREIN <br />MD BASED ON ~ I TELEPHONE DATE <br /> ; <br />L <br />A <br />MY INQUIRY OF TNOSE INDINDUAlS IMMEDIATELY gESPON5IBLE FOq <br />OBTAINING THE INFORMATION, I eEUEVE THE SUBMITTED INFOIIMATION IS . <br />' <br /> TRUE, ACLUMTE MO COMRETE. I AM AWME THAT THERE ME <br />SIONIHCMT PEHKTIE9 FOR SUBMITTING FALSE INFORMATION <br />INLLWIMG ,~ <br /> , <br />' <br />~ n <br />7n C <br />2 -~ <br />~~ <br />CZ <br />O~ C <br />KFI I V FD 1771 F0 ~?DFq AI!`O THE POSSIBILITY <br />OF RNE MDIMPNSONMENT. SEE to U.S.C.I 1001 MD39 <br />UTNE <br />E <br />~ l . <br />.J J <br /> <br />TYPED PRINTED U.S.C. f 1 ste. IPNWtlrF uWr ewr FYNna Avr McAM. rMNF W ro S 10.000 <br />AM>nr.im.n NYYIAYYIIYIr PIbfw.An emmdlaAMSyPVAI L <br />XEC <br />SIONA E OF q-1 <br />OFFlCER OR AUT~IOflRED AOENi AREA <br />CODE <br />NUMBER <br />YEAR <br />MO <br />OAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Rel~rance e// sttechmen4 hale! <br />$ErlLEAHLE SOLI9$ L[!1If APPLIES ONLY If C~ iD-YR, i0-HR PRE;:IP nYCti'r i5 C1.AINED. IF CLAIC APPROYED BY <br />YQ:DA TSS E IP.OV LI!lIri PILL NUT Rd -PPLIED rO RP.PORrED )IEASuka't:LIJl'S--$ E I•B.1.A, PG 5 AND I•R.1D, PG 6. <br />ST!1AMYITL'B t1etlE :Pe1RV 'LpLBY 171jE'T~~-Oi. <br />EPA Form 3320-1 (08-961 Previous editionB may be used. IREPL.ACES EPA FORM TAO WHICH MAY NOT BE USED.1 PAGE OF <br />0 1 <br />yy .,n lU8 G- 254 <br />_ -.~r.r_~.i -~ . _. _._ ..a _: ~~...utw. _ .Y' _ .. ._a Jl.Yd -, l i.s r .. - r Nn,Kw..r I-.- i. - -.. <br />