Laserfiche WebLink
._1 <br />C <br />~. <br />P£RMITTEE NAME/ADDRESS (!viii FsWry Nar/L«mla; (/Did "ap <br />NAME LUnc.hCITU :;G.~1. C(:"HA.~YF LLC <br />ADDRESS LOh%hC[fiI ::Ati'(i,!. ~ I!iL <br />1311 Hc8?'.~~CJ pct. c <br />EYAh:iYIL:.c: iA 4771.1 <br />FACILITY <br />LOCATIONy ,C,jTUk CO 81091 <br />;,TIA: d. t. PEnnYr r,dNA.,cit <br />NATIONAL POLLU'rMT DISCMMOE ELIMINATION BYSTEM lNPDE$l <br />DISCHARGE MONRORING REPORT IOMRI <br />!7-I Sl i1-191 <br />000045C U <br />PERMIT NUMBER DISCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAV <br />FROM 70 <br />/16711 /77.731 /11-751 1(6(71 !7B-I91 1363// <br />Forth ApproveD. .' <br />CI9CHAj;C.F: 20 LORE~I~ 70 0 rr <br />F - FZAAL <br />NI':CA <br />oo>; NC CISCHAkGE ) ~ ~'~ <br />NOTE: Reed InrrtrucOone befor completlnp this form. <br />PARAMETER !3 Grd Onlvl QUANTITY OR LOADING !1 Grd Onlvl QUANTITY OR CONCENTRATION ND. FREDUENCY SAMPLE <br /> !16531 151-6 /1 I3B-15/ 14653 15L6/ EX ~ <br />y T <br /> <br />131-371 M <br />L <br />yS <br />YPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !61.61/ !56681 !69701 <br />NN SAMPLE Li04IIk. 41CEfi4.'s3 L'+E1d44 ( 12) <br /> MEASUREMENT <br />UJ4G0 1 0 U PERMIT >rdlxprf0 gQtiAlpiyYf Ofi# F)e.~ tp1trR0II4 9~a EirRLY IYSI2" <br />i.F'FLUENT GR03S YAL'J REQUIREMENT . 1p0IIP y <br />JJLIL'S• TOTAL SAMPLE tk460P4 piY#g41d /!Ot)9IIfi ~ 19) <br />SJ S V E N D E D MEASUREMENT <br />UUSJU i 0 0 zi::..,P ..MITa.S::: : _:e3#A-~#iti Mt#aip#~?; #to tk4,~'1taC,il <br />. :b5.. 7Q : <br />'- <br />:` NCE/ ;3AB <br />EFFLUENT 6@A$5 4AL0 ;A~J;!UREN7EN7 ~ aoso . y . <br />:: . <br />G <br />fl' <br />jULT USF St., LE RLE SAMPLE ..3 fi•><g:~ fi?Cfi4II dfil00L~ ( 25) <br />+~~ <br />D <br />I MEASUREMENT <br />5 <br />`OS4S 1 <br />V' <br />,~ytO PERMIT 3=Xt4;%{r .: :. IItt?91 CL#. fiCii PQ414II RPiCR7 RG~Oi;T NCE/ iAAd <br />EFFLUEYT GI~s£ YdLU 'REQUIREMENT i(r .y:jp 30 A 4G f4 0' <br />INONF TOTJLe SAMPLE :=:Fi};:II fi:F4fi~Ffi OOgL ( 19) <br />(AS TC) MEASUREMENT <br />1045 1 - 0 0 PERMIT ~~Ya;-GGAs ?~ny1RtR ~ la9+J0IIA ~.C <br />y 5.'.0 ?tCE! rBAB <br />tFFLUENT Oi1D55 YAL'J REQUIREMENT fiOU4 3CC! AYG CAI .Y !IX !IG/ (SON !f <br />LL ANDvREASE SAMPLE iat~aerfi IIIIa:a aaaoor xseIIIIS: ( 1~) <br /> MEASUREMENT <br />35tl2 1 ~ 0 PERMIT rtGIIfirk+P IIaIIIIfiv IIQ;: AP4#04 9iDfifi0l.tr 10 .ONTIN iRAF <br />r.'Ff'LUENT GIi055 VnLUF REQUIREMENT IIL#ir IN3 t!A$ NC/ GEt~ <br />f'LO4, IN COBDOiI CF SAMPLE ( 03) ooo~to i0CaC4fi aiEaa~a <br />IHhU TkEAT $eMT i'LA;Y MEASUREMENT <br />~U050 2 0 0 ~ PERMIT REY 33~Y ~ REPORT r>':Q4i0n dY~i9t+~# :ig.~}i6CIIit ~,•>< °EY,LY •NS 2AN <br />~FF'LUEN'f CR055 VALUh REQUIREMENT 300A AY6: .DAILY MX 171iD 0>rfiII <br />ZL d1lD GNEASF. SAMPLE ' >k G;tII? ( 94) 9a01LLL t,{r:O t:ry :1 ~fiQY,i'i <br />Y i $11 A L MEASUREMENT <br />tl4 UOb 1 U 0 ~ 'PERMIT. fi#ICt 1Y>~*Lo ~ ~~ REPDkT E~=1 LIIOV.~>c>} IIC Y,04k AY/Lr`t0 • 'L}, r,• EEFLY ISUAL <br />r.FFLUEtiT GROSS YALU NEQUIREAAENT INST !l.AX NC=O p#i3fi <br />NAME/TITLE PRINCIPAL E ECUTR7E OFFICER I cERTIFV UNDER PENALn of uw THAT I NAVE PERSONALLr EzAMINED MD <br />/ <br />~ TELEPHONE DATE <br /> AM FAMILIAR N'17H THE INFORMATION SUBMITTED NERDN; MD BASED ON <br />/ <br />/ <br />~Y <br />( <br />~ MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br />( <br />E`IA W <br />~ OBTAINING THE INFORMATION, I eFLIEVE THE SUBMITTED INFORMATON IS / <br />\ <br />,~ <br />~ <br />~~ <br /> TRUE, ACCUMTE MD COMPLETE. I AM AWME THAT ?HERE ME <br />SIONIFCMT PENALTIES fOR SLIBMITTINO FALSE INFORMATION <br />INOLUDINO / `y PQ <br /> <br />6 , <br />THE POSSIBILITY OF RNE MO IMPRISONMENT. SEE 18 U.S.C. E 1001 MD 3J <br /> <br />BIONATURE OF PIIINgPAL EXECUTIVE <br />~ ~ /~ <br />(/ <br /> U.S.C. f 1718. lMrN4. udr IMw FbNhA nnF IneAdA FxwAW ro F IO,ODO <br />TYPED OR PRINTED ..ennreh..rl L+wlsmwnr o/e.rwAn emanNAW S1wa1 OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br /> <br />I`~ <br />.~ <br />f; <br />I;' <br />~` <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /RBfer6ncY I//~fteMmints hrie/ <br />'f5j fi IkOk LIlfITS uILL BF. paIVFU E SETTLi:A!!LR SOLI CS LIaIT APFLIE[ PtE <=1^YFFiUHF P~iECIP F.YSf,T; T5 ., <br />iHJR G Sr.TTLEA9I.E SOLID:, LI1"LT`. I+AIVF.ID FOR >1DYR,2UHR PRECIF f.YENl SGFJF:C? ?C EIPD~N OF PRCC-° I:Y I•A•<. <br />l.T1 L <V C T l r <br />EPA Form 3320-1 108-951 Previous aditlons mey a used. (REPLACES EPA FORM Td0 WHICH MAY NOT BE USED,1 0 0 2 L E / a 7 I'L 1 1- I ,15 E•! PAGE LOF <br />