Laserfiche WebLink
PERMITTEE NAME/ADDRESS (/nclude Faciliry.Nome/Gntalion JDiJferentJ NATIONAL <br />NAME SENF.CA COAL CGEfANT I <br />i'r.' .. <br />ADDRESSDBAYER D ~ ~ <br />NATDEY CO tl1E34 :' .' PE <br />FACILITY <br />LOCATION~AYDtA CO b16lU <br />FROM <br />ATTYS G. bUD E3ii0YN, 6ENCRAL 71ANAGER f. <br />.ELIMINATION SYSTEM (NPDES) Form Approved4!'~~~' <br />IING REPORT {OIUR; OMe No. 2040-0004 <br />Yr7 91 IS I IiQ R Approval expires 05.31-98 <br />(SUEA YY) <br />DISCHARGENUMBER p- F I A 11 hL L I T <br />ING, P.,~R40D CI SC HA (+CE TC IEIE/CiT CiEEE <br />Y~P.~' MO DAY <br />TU ~ ! ~4a NC C1`_CNAF6E ~__~ ACS <br />r26~2r1 fee 2s1 (303n NOTE: Read Instructions before completing this form. <br /> (3 Card Onty) QUANTITY OR LO jG Cerd.Onry) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (5d-61) (38-d5) (d6-53J (54-67) EX OF TYPE <br />(32-37) <br />AVERAGE <br />MAXIMUM <br />MINIMUM <br />AVERAGE <br />MAXIMUM <br />UNITS <br /> <br />16267) ANALYSIS <br /> <br />(64-68) <br /> <br />69-70) <br /> SAMPLE _ 40'44 S ( ' S' <br /> <br />GI5SULY EU <br />MEASUREMENT <br />~ S ~/ (~ <br />Z S ~ ~\ <br /> o V <br />7U195 1 U D ~ PERMIT. ~ ~410~4>xa ~ <br />~ >cafi ~ , ~ <br />M! If1T BA@ <br />EPFLUENT GROSS 4ALGF .RE~uIC~Etdt'NT' ~ ~ '`~~ ..`, <br />' ><ec>u ; <br />- - <br />tx°3k`ff #~ x <br />r c i l <br /> SAMPLE <br /> MEASUREMENT <br /> "~,ER IT <br />f <br />~ <br />~ <br />~ <br />~ - JAY 3, ~'~". <br />~ <br />. <br />' <br /> F <br />3 <br />,f~g <br />MENT ,?~ <br />' , <br />i'T . . <br /> SAMPLE - <br /> MEASUREMENT <br /> ~~Q~IREMENT ~I i" ~x~ ~~ r°ya <br />~:. <br /> SAMPLE <br /> MEASUREMENT ~, <br /> <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> ~F`.': - <br />~ <br /> -~Q I s .~~T ~ ~' <br />~ <br /> SAMPLE <br /> MEASUREMENT <br /> kk <br />~ <br /> ELiI~IR <br />I~ENT <br /> SAMPLE <br /> MEASUREMENT <br /> ~QU(PS,rttFit` <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSO <br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HERE NALLY E%AMINED AND <br />IN <br />AND BASED ON MV TELEPHONE DATE <br /> , <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE. <br /> ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT <br /> PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUDING THE <br /> , <br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE 16 U S C. 4 1001 AND 33 U.S.C. <br />SIGNATURE OF PRJ! CIPAL EXECUTIVE O ~ O <br />TYPED OR PRINTED mexlmu ml mnnsanmen~ol beMeen6monfhs ~tl5utle lures up ro510.000 end or <br />p ~"') OFFICER ORA HORIZED AGENT <br />AODE <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND~EXPLANATION OF ANY VIOLATIONS (Reference ell attachments here) - <br />TSS L IBUN LIdIIS Ylll BE YAlYE'D AAD SETTLE:AdLE SCIIUS LI"LT AFFLIeL FCfi <=1^vYH,:YPF EiECIF fYElT; TSS 6 <br />ZHON LIALTS YAIYGD rC.F ~lUTN,Z4UR PRECIP EYEit SG E.7F.CT TO tiUfiDEli Li FnCCF IN I.A.:. CIL L GFEI~E-.EE <br />r-t,-1-"• TOS 44xiTCLINC-°o>€ 1 ° ' t <br />EPA Form 3320-1 (OB-95) Previous editions magnol be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) P C nb a'/ O a P i : ~ _ i~ t c ~ PAGE ~ OF <br />