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PENMI fTEE NAME/ADDRESS e,.~re. emery n...u Lo~~„a ,/ o,p,,.ne <br />FInIAE Tit 11YP P,R rINIk!'. Ilv l'.• <br />ADDRESS TRAPPF,9 'SINE <br />P.O. BOL 1P7 <br />CRS,'G <br />~0 9155 <br />FACILITY <br />LOCATION <br />ATTBI: ~, GORDDV P!'.TP.RS, PR£5/G£A MGR <br />NATIONAL POLLUTANT DISCRMGE EDMINATON SYSTEM lNPOESI Form Approved. <br />DISCN1 R6 E MONITORING REPORT lOM9/ r T a (1 p OMB No. 2040-0004 <br />CO 3 !50RR KN) APProvel expires 05-31-98 <br />PERMIT NUMBER DISCHARGE NUMBER ~ _ !'T NAT - C7''"° <br />MONITORING PERIOD PL7Nt} *q DF.PP GDLCN <br />YEAR MO DAV YEAR MO DAV ' <br />FROM TO CRS N7 A7SC'!1~R!:B 1~~ RRR <br />110-1I1 !11.13/ ll~s-15/ !2617/ 118-19/ !3431/ NOTE: R.sd irawcllar baton eompMti^p tYt» form. <br />PARAMETER l3 Gre On/vl OVANTITY OR LOADING !1 G/d On/yl QUANTITY OR CONCENTRATION ~ NO FREOUENCr SAMPLE <br /> ~ !IS-531 15b611' 138-15/ 1653 I5L611 OF <br />!31.371 EX ANA<YSS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !sJ-sJ/ 161-681 16970) <br />DIL ANU GRBlV56 SAMPLE a4CCRa ~ ~ CraRaR a$aaa- <br />~ I SU A L MEASUREMENT - ' <br />BG066 1 D D PERMIT CRRRCR .&. "JRT E3~1 R¢'11s1eb4= .~ AitdlRtdlE!AD!.: R3gigRES*!. Rrn.; •::.: ~BR'LT ~9ItRI <br />F.FYLDEIET GRDSS <br />/~LlS REQUIREMENT !IS ,RR fOcO t~td~ <br />_ _ <br />SAMPLE <br /> MEASUREMENT --~/ <br />- PERMIT _ <br />~ <br /> REQIIREMENT _ <br /> SAMPLE <br />- MEASUREMENT <br /> PERMIT .., .. .,'~::: ~. •,., ..: .. ~.~~.. <br />. - <br /> REQVIREMENT :r.~v - r `~3tr:'•, ..!y,,. i:, -~.<!.: . I~ <;':.~ :`s <br /> <br /> SAMPLE ~ - - -~ rr <br />- ~ MEA;SUREMENT ~' ~'~ $ ~~~- <br /> t. <br />. <br /> FERMIlt .. . ;.: <br />::E::< _ <br />. <br /> PEQI,fIREN"1ENT ." `~a~: : ~ .. <br /> SAMPLE <br />I MEA;iUREMENT <br /> <br /> F- F~RMIT ~ - <br /> <br />~NEQ!lIREMENT <br />'. .. _...-. _. _ <br /> <br />..- . •:- <br />.. ..... <br /> <br /> <br />~ <br />-..~ <br />~b.;. <br />. <br />.. . <br /> SAMPLE - ~ <br />,; ., ~ <br /> <br />~ <br />a' - <br />. ASUREMENT <br />~ .. <br />~ ~- .. ...~ - <br /> P <br />MIT ... <br />~ ~ <br />~ - <br />~ <br />~ :-~. ~ <br />~.-~-. :.. <br />~~~ ~ .... <br />~,~.: ~ <br />~. <br />' <br /> }iEQU1REMENT . <br />.. ... ;;. <br />... <br />. . <br />j..:: <br />. : <br />...:;..:.:. <br />. . <br /> 5 MPLE ~ ~ - . ~ - <br /> MEASt,IREMENT <br />~ <br />~ <br /> = PERMIT ~ .. <br /> <br />~ .... : <br />.,:.... <br />.: <br />~ ~ - <br />~..:, <br />~ ~ - <br /> <br />::: <br />~ <br /> REQUIREMENT - ~ ~ ~ ~ t?M1 <br />~ <br />NAME/TRLE PRINCIPAL EXECUTIVE OFFICER I [ERTIFY UNDER PENALTY OF L <br />AM FAMIUM WITH THE INFOR AW THAT I NAVE PERSONAriY EXAMINED AND <br />MATION SUBMITTED HEhEIN <br />AND BASED' ON TELEPHONE ~~ <br />DATE <br /> MV INQUIRY OF THOSE IN ; <br />DINDUAlS IMMEDIATELY. RESPON96LE FOR / /1 d-- ' <br /> OBTNNING THE INF011MATION , 1 BELIEVE THE SUBMITTED INFORMATION IS ~ <br />~{../ (~ <br />1~ <br />W COTdOII P~C~T• TRUE, ACCUMTE AND COM <br />SIGNINCANT PENALTIES FOR q.ETf. 1 AM AWME THAT THERE ME <br />BUBMIT'i1N0 FILLSF INFORMATION <br />INCLUDING / 970-824-4401 99; 07 14 <br />PS~sS 1Q -THE PoSABILITY OF NNE AND I <br />u <br />s <br />e <br />f t st s <br />/Awrrs". uw , <br />MPRISONMENT. SEE 10 U.S.C. E 1001 AND JI <br />swA..nanw, .r. <br />fxAq" rn.. <br />ro ! ro <br />050 SIONAT/R9E OF MIINCMAL EXECUTNE <br />TYPED OR PRINTED ~ . <br />. <br />. <br />. <br />. <br />r <br />w <br />rw orny.irvn/'na+l+amti+r el err.wnemmN. Ares Yrn.l OFFICER OR AURfORRED AGENT '"' A <br />CODE NUMBER <br />YEAR <br />MO <br />DAY <br />GVMMtN I J nrvV onr~nnn nvn yr nn r vw~n nvna Ino."mce sn ~aecnmmrs n./q _ <br />TSS E TUT1tL LRDN LT"!IT.S MILL B£ StAI-£D~ IIMD SET?L$IIBLF. SOLI^5 LT11IT 'PPI.IR^ PDP <=I^~~~~U~~ ^nIrCIP EYFNT- <br />SEL" BUkU£N OP PRODF R-:2UIRENPIITi OMOER I.6.3• TDS I!D!IITORTN^ - T. R. ?. '1FL °, ':R%~SF, - -rc T"T+.Z.(q~~ <br />EPA Form 3320.1 108.95 Previous editions m4y be use _ . 1 NI CT USED.) <br />- /Innn.a/OOnlt?]-1Q7P PAGE ~OF Z <br />