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PERMITTEE NAME/ADDRESS pndW FsYIryNr/Grcenm rfOrpnwN <br />NAME TkAPYEA ";Ii.Ih~r I!.:;. <br />ADDRESS '1' F1 A P d f .: >1 I 5 is <br />N.O. 6D}: I,.-J <br />CitAI~ <br />l0 vl( ~., <br />fncam <br />LOCATION <br />d'.:^r: Y, i.GitD;l:t Pt.T1:F._;r rtii':'~/~:t~: '~:, <br />NATIONAL POLLUTANT OIBCNARGE EUMIMATION BYSILM Irrr'/wr <br />DISCHARGE MONITORING REPORT (OMRI <br />1-161 77-f9) <br />~;0r,32115 CO? A <br />PERMIT NUMBER - DIBCNMGE NUMeen <br />MONITORING PERIOD <br />YEAR MO DAV ~ YEAR MO DAY <br />FROM ~ t TO .. ~ . - <br />!?6111 111-?31 /11-151 !16171 118-191 !3631/ <br />Fortm Approve i. <br />FORS( t: TO EAST 1;~1N4St7i4~'CN <br />(S U P F ~ N) APProvellagp~rs~ -3t-9s <br />F - FT~AL <br />.I1,~~ <br />NOTE: Reed ImwEtlorr bslps eomplstMp thb twm. <br />PARAMETER !3 Grd On/Yl QUANTITY OR LOADING !1 C+rd OnlYl QUANTITY OR CONCENTRATION Np, FREOUENCr SAMPLE <br /> 11653) (5461 !38-15 !1653 151-67 <br />EX OF <br />T <br />131.371 ANAlrsls YPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS K=.eal !br_5g) /5y1o1 <br /> SAMPLE .. . , t>:::;:t:s:::: #L{':~.# { 12) <br /> MEASUREMENT <br />J (IJVU 1 0 0 PERMIT .. ~'e:f:}:;: to S:'eyc t}-x .. F~.S La>Y icara 9.0 ~ ~ :EB%Zr rusIT <br />,.Ft'LJC:;'C •~P~S~ YALI} REQUIREMENT t:-::n `tIMl!".Or MA7tI!^UR SU . <br />~tl..i v:T~ v:: 7I,EA'.;LF SAMPLE .::: r,: t:::: :: {n}.^<~ ^•#Y~.)C~L ( [~J) •. <br /> MEASUREMENT <br />.:V54j 1 0 0 PERMIT ,c;:c.','fr:C: cL':':':#•'.= .. Y,c'a$4a8~. ..C~F ,I~.~:A1:~:. ~.Qi~ ~.:M~$.~~ :RA~9 <br />c.P}LUBh'I .;ROSS YAL11 REQUIREMENT »#"~x `g~:LA:'A.tlf,: .. $.ATTt..l4lE f!L/L ` :.iMOt1rM <br />~, t..i .Y. SAMPLE .•,.::.n:t.;~;: t: ': :'::::x ': -'.r ~.a*ae aYgaYC .? ~ ( 1Q) <br /> MEASUREMENT <br />J3~i2 1 0 :0 PERMIT ..si;.; ~=% ':4`r•-+`-c%• S: a>raAar: I,O: OYTIN =?AN <br />c.FFLU'e:N:' iaR055 YALU 'REQt11REMENT p-,:::x .jRSZ tSAX h/'/L CE'I.T <br />0NF U '" ('E SAMPLE ( n3 * <br />., <br />»c»#0 +;a #L .'K:': ;: <br />'i ~ Ii0 T K i.~ qT l! Z }I T F' L A N MEASUREMENT ~ ~ <br />/ <br />SG`/7/'>'/e _ <br />~pOSO 1 . 0; 0 PERMIr Rif' RT 4E?Op: Y,:acp»ar aap>a» »a~c»r.:x :#::r:r P,RYLY IMSTA! <br />:FFLUEnT G OSS YA1,U :REQUIREMENT .30llA. AY i fl;~r" <br />.~• T ~ L SAMPLE , 'x-: ': r:;::x c ^. a»a#»» ( i9) <br />..i~~OLYEU MEASUREMENT <br />70205 1 U C PERMIT. [:r,a-:::^ ;<:;':#C+a r: G: '++L;'94r} CETIC2AL HYbCRT "'RLY .;RAP <br />:.t"r'LUtiNI L.ROS; ~ALU .REQUIREMENT o;t:a GRTF A.V; ~AII.Y 'i* "!G/L <br />r .. L vt SAMPLE •• ~'.:` ( r74) a»::»a% #Laar~:/ »t#b;: ;: <br />ti i [:0 A L MEASUREMENT <br />^JJD+~ 1 0 0 ~~ PERMIT ~ '~.::%' ~~'•: Rr:POR~T ~ (':3=1 >ra~eo» aae r•.a ~. aa>sa~A~x~ ~»e: .~YLY ISGAI <br />;:F:'L'JL:VI' (:8f. i5 7ALp- REQUIREMENT I~ST !1kX !~C=O C'rf°'x <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> ftEQUIRENIENT~ <br />~ <br />NAME/TITLE PRINCIPAL EXECVTNE OFFICER r EERnFV uNDEn PENALTY of <br />M WITH THE INF01 <br />F <br />MI <br />A EAW THAT I NAYS PERSONAUr EzAMwI:D MD <br />1MATION BUeM1T7ED HEREIN; AND BASEp ON TELEPHONE DATE <br /> <br />Gordon Patera <br />w M <br />A <br />U <br />MY INOUIRr OF TNOBE INOINDUALB IMMEDIATELY RESPON4BLE FOR <br />OBTNNING iNE INFORMATION, I eE1.1EVE THE SUBMITTED INFORMATION IS <br />T ~ A/1 L/__th. ~ <br />t C. 7/_f 970-824-4401 98 7 27 <br />. TRUE. ACCUMTE MD COMRETE. 1 AM AWME THAT <br />REAE ME <br />TIEB FOR SLRMItTING FALSE INFORMATION <br />INCLUDING <br />T <br />ENA <br />A <br />PreaideDt/Gan~ral Mane E!L <br />g , <br />SIONIFC <br />N <br />P <br />L <br />THE POBBIeIL17Y OF RNE AND IMPNSONMENT. BEE 18 U.S.C. ] 1001 AND 37 tiIONATURE OF PIIINCIPAI EXECIRIVE <br /> <br />TypEp OR pRryYTEp U.B.C. ] 1]10. IMWtl.. uMw tlN~ mem. rery MrrA.oN Miw. W ro S70,OgD <br />.,,sw,,,..ww„hwlrn..taanv.nemw:m. r"esY.val <br />ofFlCER OR AUTHOR11E0 A0ENT <br />~E <br />NUMSER <br />YEAR <br />MO <br />DAV <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRdsrsncs sll sttechmsnts here! <br />.,i~:'FLEAt:I,t 5JLID5 LICIT "AT i.'E JAjYED FOR >1)Y1:,244iI 'ri":'i F F7=pI - °fF 4ErFI+hE9F. LI"CTbTTi:N~ J>7L-": <br />I.,;.l.l?r AtG6 d.L°Il yUAA:.2! OF pROUE' Bi~IIIYENE4C`. UhPefi T.A.3. CII E ~FFIS? - $F5 I.N.1.(I'). ]'PS <br />1 !) 4! P (1 :- r n.": T.} t.~~_ 711 ] y e Y F L M r• C T c N T A o :: T' M/ V. TAI Y s V r E E f f T A~ J .• [ L F C 1 P P E E[ f~ O T C P <br />EPA Form 3320.1 108.96) Previous editions may be usetl. (REPLACES EPA FORM T-40 WHICH MAV NOT BE USED.1 0 0 ~ Z ~ / q i 1211- t E. 4 t. PAGE loF <br />/ <br />