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PERMITTEE NAME/ADDRESS pMib FsWryxdL«anen l/DIEb..p <br />NAME iitAPPF-R !+INI'+G, I:JC. <br />ADDRESS T n A r i' t '? ~ I N F <br />P.U. BOX 1?7 <br />CRAIG <br />CO 81626 <br />FAaLm <br />LOCATION <br />:I T;Ii: w. GOY GO'i PEITF~ASF pdLS/'o E'i r!.;k <br />NAT10r(N. PdLLUTANT DISCHMOf ELIMINATION 3YSTELI (NPDESI <br />DISCHARGE MENIITORMIO REPORT (OMR) <br />2.15! l17-19/ <br />000032115 C A <br />PERMIT NUMBER DISCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAV YEAR MO DAY <br />FROM TO <br />(2621) 112-131 (2a-251 (2627) (28-291 /30-31) <br />form APProvsd. <br />C I S C EI F G T O F L U E! E ~Lh.°HZOao-oooa <br />($ U E F A Y~ PProveLe~P~rs¢OS•31-98 <br />F - FIAAL 1 ~' <br />!?MICA <br />~'•'fi NC DISChANCE 1~~ r'"~i°= <br />NOTE: Reed Inswetlane belore eomplednf thle form. <br />PARAMETER l3 Grd only! QUANTITY OR LOADING II Grd onlrl QUANTITY OR CONCENTRATION NO- FREDUErcr SAMPLE <br /> 125-53/ 15s-5I1 13B-I51 14G53 I5r-s/ EX~ of TY <br />E <br />132-371 MN.Yyts P <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 63!]1 !51691 159-701 <br />~, HD (;k A f.: SAMPLE ~fi4~^O ( 94) LtAfiC4 Of Ad~ID, Oi:}r}Cb <br />Y I r U A L MEASUREMENT - - <br />o40bb 1 0 D PERMIT'.. antra-fi R$P:30kT. 65=1 ~t+,@A.riig4 d9L0>izti p:bCblss!Et... P'Y# ~1C~i~` .I3lIAI <br />cFrLUE4T GA~JSS YALU .IiEnuiREN1EN7 .. <br />;x?iST ~?AX? FYO=0 ~.:.: <br />... :: :.,, alaoa .:.E;'>::r . <br />,~ <br /> SAMPLE ~ ~ ~ ~ ' <br /> MEASUREMENT <br /> ,. <br />~ <br />~~ <br />' <br />. <br />.. <br /> '~~IEQUIREMENT .. <br />~ ~~ <br />. ~, :. ., <br />ii~.;:. ~ <br /> Y:: <br /> SAMPLE <br /> MEASUREMENT ~~ /l ~~X <br /> ' :PERMIT :. , <br /> ~~;REOUIREMENT ~ ~ ~ - ~. <br /> SAMPLE <br /> MEASUREMENT <br />~ .: PERMIT .~ .. <br />_ ~~REOUIREMENT ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~, <br /> SAMPLE <br />- MEASUREMENT <br />: <br /> P.ERMLT :'~. .. .. , ~ :..... . , <br /> :REQUIREMENT' .. ~. <br /> SAMPLE ~ ~ ' <br /> MEASUREMENT ~ ~ ' <br /> PERMIT ~... <br /> :(iEQUIREMEHT' ~ .. ~ ~ - <br /> SAMPLE <br /> MEASUREMENT <br /> . PERMIT ~: _ ~ <br />"~ .. <br /> ::REQUIR.EM.~NT ~~:::. :' . ~ ,.. , <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I cERn <br />AM FA Fr uNDeR PENKTY of LAw TNAT I NAVE PERSONNLr EXAMINED MD <br />MILIM WITN THE INFORMATION SUBMITTED NEREIN; MD BASED ON TEI F01.1r1uF DATE <br />' MV INQUIRY OF THOSE INgNDUN.S IMMEDIATELY RESPONSIBLE FOR <br />I BELIEVE THE SUBMITTED INFORMATION 19 <br />OBTNNINO THE INF011MATION <br />~ J ` <br />~~.~ "'~~ <br />W. GOrdoTl Peters , <br />TRUE. ACCUMTE -MD COMPLETE. - r AM AWME THAT THERE ME ~~ <br />President b General Meng er <br />B SIGNIFICMT PENN.TIES FOR SU6MITTING FALSE INFOMIATION, NICLUOING <br />THE POSSIBILITY OF FINE MD IMPRI90NMENT. SEE iB U.S.C. E 1001 MD 37 <br /> <br />f10NATU1IE OF PRINCN'AL EXECUTIVE <br />97 C! <br />824-4401 <br />99 <br />I <br />25 <br /> u.9.t. f Isle. (PMWW/ uiW/ dMM IYNh. n.r MIC.Y.dF rw• w ro i 10,000 <br />TYPED OR PRINTED rldwnr..inun beP'laonnrlt el MfwwlsmomnaWSPw+I OFFICER OR AVTNORIIED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IRe/orence N/ fttechmsnts here) <br />;:i5 E TOTAL IRON LIMITS GILL BE YAIYEDE AND SETTLF.ARLE 5~LIC~ II"IR AFEIIED FCF <=1DYRF24HA P5ECIp E:YEAT- <br />.iEt: :fUifU°-N OF PROOE' AEIUIREMEYTS UNUER I.A.3. TDS NONITORIEIG - I.E.3. OTL 6 GFF-1SE - SEE I.fi.l.(D). <br />fu ~-r t.vPaBCe 15-xT_e~-~ <br />EPq Form 3320-1 108-951 Previous editions mey be used. IREPIACES EPA FORM Td0 WHICH MAY NOT eE USED.1 D D 191 / 9 71 Z 1 I " 1 64 ri PAGE iOF <br />