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PERMITTEE NAME/ADDRESS Qnc(ude Facihrv Name/Incarion ijD~erenq
<br />NAME CCPE'US YA!SPA VALLEY CDAL COFP.
<br />ADDRESSiIt1ES 1,2t;J SOUTh, t'Cf("AN PH
<br />ylUU LAST MIIIt:RAL CIkCLE
<br />`'~GLf'4f000 CO ;U1S~
<br />FACILITY
<br />LOCATION
<br />- .1T';N: .'Ut'3I5 w. ttcGL"r Y, I;F:t::nhL ATt.Y
<br />I COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rete2nce all attachments here)
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<br />CLAT"J. SF5 I. A. 2, P, 1H, FJ* 6UC'SN '7? :•FC'uI fsr_ ;ilcri:k';. Cy,, G ',7",--_
<br />EPA Form9320.1 (OB-95) Previous editions may not be used.
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOES) Form Approved.
<br />DISCHARGE MONITORING REPORT (OMRJ A J D R OMB No. 2040-0004
<br />(216) (I]~ 9) M
<br />CCOJ77 5!1 DDS ~ (SCSa t1 {1) Approval expires 05-31-98
<br />PERMIT NUMBER DISCHARGE NUMBER c• _ F' I N A L flC U T'7
<br />MONITORING PERIOD zli+E L'r rOVL' n 'TC F~~ICEL CRt::K
<br />YEAR MO DAY YEAR MO DAY
<br />FROM uv u~ III TO VU UD JU '`~`~ vC OLSCNF.dGF (_I :>t ~.
<br />rzo-z0 (zaz31 (za~zs) (2s~z~1 (ze~zel !3031) NOTE: Read Instructions before completing this form.
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<br />PARAMETER (as-53) (54-6 rJ (35-as) (4653) (54-6a) EX OF TYPE
<br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS (sz~) A(64LBB)S (6970
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<br />NAME(TITLE PRINCIPAL IXECUTIVE OFFICEfl Y CERTIFY UNOER PENALTY OF IAW THAT I HAVE PERSONALLY E%AMINEO AND
<br />AM FAMILIAR WITH THE INFORMATION SUDMITIED HEREIN; AND BASED ON MY TELEPHONE DATE
<br />
<br />Richard Mills INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />THE INFORMATION, 1 BELIEVE THE SUBMITTED INFORMATION IS TRUE, '
<br /> ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE BIGNIFICAN7
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<br />970-670-27
<br />Environmental Manager ING FALBE INFORMATION, I
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<br />(REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) F U , ~ c 5 / 1. ,• ` 14 - r~ _ 1 - ~ ~ I PAGE 1 OF
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