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PERMITTEE NAME)ADDRES$ //ncfude Fnc~hq~N^me/LOrmlan ifDifferenr) <br />NAME S~MECA CCAL CCCPANI <br />ADDRESSD A A W F: k D <br />HACflElY CO 41639 <br />FAClllri <br />LOCATIOI~AYDEN CO 81630 FROM <br />ATTty: i;. fiUll ,!,U;+1;, GEMEAAL I'ANAi;FA <br />POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDESJ Form Approved. <br />IISCMAR GE MONITORING REPORT (DMA;9f f I NG k OMB No. 2040-0004 <br />Approval expires 05-31-98 <br />0 ~ 0 _ (SCbR 6i) . <br />RMIT NUMBEFI' ~~ DISCHARGE NUMBER E~ F I I /1 ~ h C L~ 1 <br />MONR~ ING PERIOD CISC dA [4E YC TbIF/SAGE CIrFEY <br />R MO DAY YEAR MO DAY '~~ ~ ' - I i 0 0 <br />To ~~ ~~ ~~ o• -~txAbcE <br />(zz-13J (2a. (16-21) Ise-zvl Po-30 . ead Instructions belo Eompleting this form. <br />£< <br /> {3 Card Onty) QUANTITY OR LOAD Card Only) QUANTITY OR CON ~ TION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-61) ~ (38-45f (46-53) (`.,4'671 EX OF TYPE <br />(327) AVERAGE MAXIMUM MINIMUM AVERAGE MAXIMUM UNITS <br />(6P-G)) ANALYSIS <br />(64-68) <br />68-70 <br />~ SAMPLE '~ O JI+~ 0 9A0 ( I i ) <br /> MEASUREMENT <br />IUgUU 1 U I °s~JEH 4728 ,~ ~ :.~. i0# , : T " C Q~P/' i- ~[~`~'. <br />EFFLUEkT Gfl055 Y[LOE ~~ $Y~,~ENT, ~^~,- ~ 6n~3 ~ 5U Y~>I <br />OL 5, TU A SAMPLE v ''"'" "` 000 a' AIb07;4 ( 19 ) <br />USPl:NG"r'U tIQEASUREMENT o <br />~~ <br /> • <br />u~>3u 1 o c ,~ i43 <br />~ <br />EEfLUEFT GkUSS VALUE '~ "~' ~ ;;< 1000 <br />` ° <br />3~~ ~ ~ ~ <br />. <br />Alit Q lG/L ~ ~ 6~•'1>B -. <br />~ <br />"' <br /> , <br />, ;~ ~ ~~, . <br />; . < <br />,. <br />UL , .~ L A6L SAMPLE 0 <br />3X° <br />~ 'G0+0.0 00 ( ~S) <br /> MEASUREMENT <br />o5v5 t o o ~~ ~ SiM1T ~r s+- oa z4>+ a - .~„ G[i,.' ~ .` <br />EFFLJE~IT Gk0$S YALI+E ` ~ J~IREMEN7 ~ ?~:~~-' ~. ~ zi+'fi ~ '-~~~~ . `< 1!L/L ~ ~` i ~~i= .,; <br /> L , , <br />kON, TC' AL SAMPLE #008#P 000400 :%'4400 ( 1S) <br />(AS F'E) MEASUREMENT <br />U1U45 1 0 0 ~' ~BFAIT' <br />' ~;1-., <br />~ " `~ <br />~ ixo oWOOq>a w~ r.F,. <br />`~ <br />~a C1R/fir <br />~ <br />~i31 [ <br />EFFLUo++T CAOS5 9ALUF i~@lA~M~r)r <br />,1 ~ zi4;~ 3~,~~ : <br />~. iLl EI C.G/l . <br />~ <br />IL ANG CdEA$'E SAMPLE #t4>tr 000000 OY~.t.'!tX~ 4a440'i ( 19) <br /> MEASUREMENT <br />35tlL 1 0 0 ~~(~: Aq i00 020 00 000f00 1 .' ~ ;~, ~,. , ~,'~ >1. "' <br />~~ <br />"PYLUdNT GHDSS VALUE ~, <br />1~~i~1H1:~1~NT ~ ~%~ ~ ~">;;; i04^ ~~$~ g' fIG/I <br />FLOr, LN COa It C SAMPLE F U3) xz~enz-: 4~~zx=: 0tiiia <br />ftSU THEA'SMEiF4 PLAY1 MEASUREMENT <br />~UUSIi 1 U 1 ~"' 11EiF - <br />~ ~!. .;. 00'0490 4a8aa$ ~ afar >~ ".:O OOi f, t;(-.. •5~..~, <br />tFF'LUE.tT Gk~SS rALUE ~;lfl ~MFNT 3flDi t, ~ -`1 200 <br />,UL1GS, TOY/lL SAMPLE x043 0 0000#0 ~..~+~% 1 19) <br />I SS OLYEU MEASUREMENT <br />7019` 1 U 0 <br />' PERtaIT IYMI ,- i0# a000 b1ICY1L EiEF*ES'1 ~r ; - ~~.C;-: <br />cFfLUENT GkOSS YALOE ' ~4UIRLMliNi ~'~ r <br />«~ ~`,-, i00# (SSE [VG Q[ELI 2[: l1G/L <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AMINED AND TELEPHONE DATE <br /> AM FAMILIAR WITH THE INFORM ATION SUBMITTED HEREIN; AND BASED ON MY <br /> INQUIRY OF THOSE INDIVIDUAL S IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> THE INFORMATION, 1 BELIEV E THE SUBMITTED INFORMATION IS TRUE. <br /> ACCURATE ANO COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT <br />~ <br /> PENALTIES FOR SUBMITTIN G FALSE INFORMATION, INCLUDING THE <br />~ / O <br /> POSSIBILRY OF FINE AND IMPR ISONMENT. SEE 1B U.S.C. § 1001 AND 33 U.S.G. SIGNATURE OF INCIPAL EXECUTIVE v ~+ <br /> ~rs/es up to Elp,WO end or <br />~ <br />6m <br />ns~ <br />lu <br />mea <br />umPm <br />o <br />eb <br />an OFFICER OR UTHORIZED AGENT NUMBER YEAR MO DA <br />TYPED OR PRINTED menr <br />M <br />n <br />onr <br />S <br />pds^ <br />f <br />l <br />l' <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference e/I attachments here) <br />TSS 6 iYOH LIRITS Ylil H~ kAIYEU AHD SETTIEAFlLE 5(LLDS LIRIT AIFCIEC FCF <=lUYfi,iyFF fBECIF EYfi7; T'_5 G <br />IAOY LIriITS rAZYEO ECF >lUYA,27LNk PRECIP EYFNT SUFJBCT TC NUiiGEN CF CkCCF IT I.).i. 011 E GbEA_9E-SEE <br />Y T n +n r r r <br />EPA Form 3320-T (08=95) Previous edi ions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NO7 BE USED.) 0 0 09 9/ 99 G F 27 -16 5I PAGE I OF <br />