Laserfiche WebLink
rtNMll Ikt NAME/AUU°'~ -S(1nrYdc F•ctllryN.„dLoc•Ilm yDlpn.nc <br />NAME COLO'rl} ~OAL COMP,IHY L. P. <br />ADDRESS COLONYO ;a Cilr <br />5731 S'PAi'L: II .T.GrIHAV 13 <br />MGEI:aR CO 81641 <br />FACILITY <br />LOCATION <br />MwTIONAI POILUTMT D" 'MOE ELIMINATION SYSTEM /INPDfSI Form Appr '. <br />DISCHARGE ITORINO REPOR7 IDMR1 ~~N1 <br />-15 11-,9, LOADOUT :~F.DI PDlJDoM ~~7 Dr. R al!~~RR <br />Apdrove~ eStdl/Z 3'~-31-J8 <br />(SOUR Na) 12345 <br />PERMIT NUMBER DISCHMOE NUMBEA <br />F - FI NAI. <br />MONITORING PERIOD MINOR • <br />YEAR MO DAY YEAR MO DAY __ <br />FROM 97 U!4 U1 TD 9R 06 30 '•°~`~= 40 1~I SCHP.Af,F I ~ ,~#'~ <br />.__ _ _. __. .__ ___ .__ __. .__ _.. Ml1TF• O.. L..rmnrlnn. 6.In.J PrO•. LUnn rhl. Inrm <br />r~ _ _ <br /> <br />PARAMETER ! J Grd 0nl 1 QUANTITY OR LOADING ! I Grd 0nlvl QUANTITY OR CONCENTRATION <br />NO' iflEQUENCY <br />SAMPLE <br /> !4653 54-51 35-a6 4663 154-51 EX DE <br />131-311 ~ Muvsls TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS I BZ~FSI 154591 153-701 <br />OlL ANU l;Ak:ASL•; SAMPLE ###### <br />fl ( Dy) ;:;t±;::; . ..,,- ~-•y:t :;: r: <br />D ~j <br />~ <br />YIS/n~ <br /> MEASUREMENT v <br />VISUAL <br />i74Ubb 1 U ll ;PERMI.T::.. :. ;.#Y:;~.4i##:; <br />~ . <br />U.: <br />.':I. <br />:: ES-1 ~`#~~:: ::'.; ;i~:Y:k:»~ ,::~A?x.CTx;F:x..''. .:;;:;: KLY <br />EE ISllA] <br /> REQUIREMENT ~~ <br />~ ~~ " ^~ ~~ ~~~ . <br />. <br />. <br />. , <br />E L 'N rf ; 1 <br />.:.::.- <br /> SAMPLE <br />SAMPLE <br />... rcnml I <br />REQIiIFiEME <br />SAMPLE <br />MEASUREM' <br />PERMIT <br />MEASUR <br />PER( <br />T .. <br />VT <br />IT~ .....:~ ~ : . <br /> : : . <br />..:::.: <br />ti <br />: <br />. <br />.:... <br />....:......... <br />.:: <br /> <br />.:...:. <br /> REQUIRE.MENT, .: <br />:::.:.::r : <br />: ~~~~'::~... ~:•:•::.:;:;::,.~:~s:':; ::.:. <br />.:............ <br />' :.~::::::.::.::<:.;.::~,: ~..'::. :::.. . : <br />: <br />. <br />.. . ..: .. ........... : .: <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMILIM N1TM THE INFO LAW THAT I HAVE PERSONALLY E%AMINED MD <br />RMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE <br /> MY INQUIRY OF THOSE ~ INDIVIDUALS IMMEDIATELY RESPONSIBLE FOfl <br /> OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION 19 <br /> TRUE. ACCUMTE MO COMRETE. I AM AWME THAT THERE MF <br />SIONIHCMT PENALTIEB FOR SUBMITTING FALSE INFORMATION <br />INCIUDINO d ~~' <br />0 <br />!~ <br />D ~ , <br />THE PDSSIBIUTY OF FlNE AND IMPRISONMENT. SEE le U.S.C. E 1001 AND Ol <br />a TYRE OF PRINCIPAL E%ECUTNE / <br />~D 2`I-~b DD q <br />TJ V <br /> U.S.[. 1 1 e1Y. IP•w•/Yr• uwr N•a •oum•• m.Y ~IChd• IY..• y ro f 10,000 AREA <br />TYPED OR PRINTED u.d wnrd.nmi.lAd•cwrwrE elbnrwnsmonm•rWSrwal FICER OR AIfTHOpIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS !Rs/srancB s!I affschmonls hare! <br />SE'CTLEAUL". 571,IDFi i.IMTP APPLIL'S ONGY IF C= 10-YR, 2y-IIR PRF,CIP EYPNT IS CLAIMED. IP CLATM APPROVED DY <br />4r1CD, TSS LIMN LIMITS WILL NOT DE APPLIED T~ REPORTr;D 9EASLIREM8NT5--SP.E I.R.lA, PG 4 A)ID T.R.1D, P~ 6. <br />E~P}1~'orm'3320=1'108=95j Previous editions md'y be used.' "' (REPLACES EPA FORM T-00 WHICH MAY HOT BE USED.) n n n _ - - PgGE OF <br />