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PERMITTEE NAME/ADDRESS p..We. rPney N.w.: c,•r,..„:,:pu!tl•~.~e, <br />NAME TRAPPPR ?!IRTMGe UsC. <br />ADDaESS TRAPPER !+TIIE' <br />P.O. b0I 197 <br />C:?F.IG CJ 91b2fi <br />FACILITY - ' <br />LOCATION <br />ATTNE Ir. Gf)RO'IB PP1 FA5_ PRPS/GE! A&R <br />HAIIOHDISCHARGE MONTTORINO RTIEPORT ~OMRIPDESI <br />11-151 117-191 <br />r <br />PERMIT NUMBER DIBCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO D V YEAR MO DAV <br />FROM OI TO qg p5 31) <br />l16Z71 !11.231 121.251 lZ6271 Iz5-191 !30.311 <br />Form Approved. <br />~ r n0!+ OMB No. 2040-000< <br />Approval expires OS-31-98 <br />(Sl1BR N1i) <br />o - FrrAl. M~rp* <br />:,{'(ITP MF,T. T°STINC, FOR O1 `A <br />a1>,1s. R'1 DISCRA4bIt 3~) tliao <br />NOTE: Reed inetructlarw etor Ietinp Ehie form. <br />PARAMETER 13 Grd On/YI QUANTITY OR LOADING N Grd On1Y/ OUANTITV OR CONCENTRATION - Np, FREODENCr SAMPLE <br /> !»653i !°,.:-611 l3B-151 !06531 151.511 EX OF TYPE <br />!31.311 <br />AVERAGE MAXIMUM. UNITS <br />MINIMUM AVERAGE MAXIMUM UNITS <br />!et-esl MALY515 <br />151-581 <br />169-701 <br />I.CSO STA TH P. Q9YR ~C SAMPLE a44aaa asaRa? at#aaa a?+t+t :rrr ( Zj) <br />CBL+IODAPNRCA MEASUREMENT <br />~ <br /> <br />TAR36 1 D D PERMIT <br />auaelrAs <br />aassaa <br />asa .~~~.. ~ ~ <br />as#>s!~P.. ~ <br />. .. <br />; e~ia.~i#a! <br />BR- <br />1'ltLt ~. <br />.3li18 <br /> <br />CFPLUP.IIT FRO$5 <br />VF~1 REQUIREMENT <br />~ <br />fiRQO <br />~ ~ ~~ . <br />__ <br />LCiO STA"F:F' 9588 Ac __ <br />~ SAMPLE a>taeaa aaaaa44 aaeaae as#*otr ~ 23) <br />PIC!EPRALES MEASUREMENT <br />TAHt,C 1 0~ p ~ fERnalr aa:raa(i as ofilR;:- y~• ~ IJQ aaa - a ~ -~.alklxana.. ERA TRLT RAA.'~ <br /> <br />F'FFLUE T GRD35 1ALlI Rf-OUIREMEN7 <br />Ir <br /> _ <br />SAMPLE- - <br /> MEASUREMENT ~ ~- r'1 I <br />f <br />/ <br /> PERMIT _ ~ <br />~ ~.- :,a. ;; ~>.~~,'f -~ <br />`I„~ <br />... j <br />,! <br />~.^.F;:. ;: <br />~:7. `~s: <br />;.~. <br /> pt]IREMENT . <br />; <br />r <br />: <br />•~ ' <br />~ <br />J'~~ SAMPLE <br />F ~ ~ ~' <br />~ <br />~ <br />~~~ ~ <br />~ <br />'~ ' <br />' NIEA:iUREMENT ..^x ~ f. <br />.~ <br />.. •. <br /> PERMIT f .. ..:: i:1:.:..:•. ,: <br />::. <br />.`~ •~,I,... ,. <br />. .~:Ft .. <br />~ <br /> <br />~ <br /> `REQUIREMENT - ~ ~- ~~ <br />~ ~ ~ ~ F j ~1,~...:. ~ <br />~ ~ <br /> SAMPLE `` <br />' ~+•'' <br />( MEASUREMENT <br />~ }+,zR.~_r <br />- FERMI? _ ~ _ . <br />~ <br />` <br />-~ :.:,1- p, I. ~: <br />:~ <br />_ <br />:-:~ <br />~~ <br />- REQUIREMENT: <br />.... ~. <br />, .. <br />:.'. <br />: ' <br />.± <br />' . <br /> SAMPLE I - - ~- <br />"~, <br />: = - - <br /> MEASUREME(JT . <br />. <br />- <br /> <br /> REQUIREMENT ,~ ~ ' - ~4 <br /> SAMPLE .. <br /> MEASUREMENT - <br /> -PERMIT - ~ - . <br /> REQUIREMENT ~ ~~- <br />R ~ <br />NAME(TITLE PRINCIPAL EXECUTIVE OFFICER I OERTIFY UNDER PENALTY Of <br />AM FAMILIM MATH <br />THE INFO LAW THAT I HAVE PERSONALLY~E}( INED MD <br />RMATION eUBMITTED HEIIEIN; eABED ON - TELEPHONE DATE <br /> , <br />MY INOUIM OF THOSE INDIVIDUAL9 IMMEDIATELY AEBPDNSIeLE FOR v~ /J <br />~ <br />-" <br /> <br />W• Gordon Patar• OBTAINING THE INFORMATION, I BELIEVE E SUBMITTED INFORMATON 19 <br />TRUE. ACCURATE MD CDMPLETE. I AWME THAT THERE ME <br />ATION <br />INCLUDING <br />TI <br />BM <br />TT <br />SE INFOR <br />T <br />R <br />G 1 C rrwF <br />^ 970-824-4401 99 U7 14 <br />Prasidant/Gansral Pltnagar , <br />M <br />BIGNIFICM <br />PENAL <br />EB FO <br />SU <br />I <br />IN <br />FK <br />THE PoesIBIDTV OF flNE MD IMPRISONMENT. SEE to U.S.C. E 1001 MD 33 61ONATURE OF PRINdPAI EXEfA/TIVE <br /> <br />TYPED OR PRINTED U.B.C. f 131 e. IMreiu uldr rMr nxrona m.Y iKhrl, lxw, W ro 110,OOD <br />w«mrim,n irrwdsewnm olMrwrn swpnolarW s FrAI <br />OFFICER OR AUTHORIZED AGENT <br />CODE <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANV VIOLATIONS (Reference d/ ettechmsnu Nerel <br />SEE I.A.Z. !P 7-0, fOR bETAILS OP TFST PRDC°.CURB. REP7RT LCSn - ^.•TATTSTI~+L P'fI9T F"TT`hTF VpICM i5 <br />LP.THAL TO 50s Of TF=,T ~RG1RIStl5, ABD ATIACH'A^tiTP. T07fICTTT TFST R°I'ORT FOeM Tn ~rB, Coplr•~ nP ALL <br />orm - 1 8- reviouF a Mona may a use ( O AIA T BE ED.1 ~ ~ -~ p - <br />^~te~/~anh2 ]-%ni-~ ] <br />~---~ -- M - --c <br />