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<br />PERMI7TEE NAME/ADDRESS /IneW4 F.cmryNw./Lec.um yplp....q <br />NAME LOiILhCI'iU -'C?. :. Cs; ~,pA,y'f '" <br />, LL.. <br />ADDRESS LOFctiCIT ~.:A-1Y+.',~ ':C;:F <br />1311 nF'/1 :,n'L` i13I7% <br />EVAtISYILLF Ctt LL7711 <br />FACILITY <br />LOCATIONUE ;'CON CU 41091 <br />nT:hi A.L. PEk~tY. "RbA:cd <br />NATIONK POLLUTANT OISCHMOE ELMINATION [YSTEM (NPOESI <br />DISCHARGE MONITORING REPORT IDMRI <br />1-l51 !i)-191 <br />U <br />PERMIT NUMBER DISCHMGE NUMBEII <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />R67I1 !77.731 !14751 !76771 178-791 l30-311 <br />PARAMETER 13 fird Onlyl OUANTFTY OR LOADING !1 6rd On/YI QUANTITY OR CON <br />3 <br />7 16-531 151-611 !38-151 !4653 <br />7-3 <br />/ <br />l <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE <br />MA%IMUM <br />UNITS EX <br /> <br />l67-691 <br />MALVAS <br />!54881 TYPE <br /> <br />(83701 <br />FH SAMPLE L=#R#G;t L¢;F::s? wZ~fi#+: ( I2) <br /> MEASUREMENT <br />VVuVU i 0 U PERMIT: ark#pglq aOrirgsglyl pq$ g~J. IC /.<9A# 9.0 EikLY C1i5IT <br />r.}'FLUENI' .;ROSS YALU :REQUIREMENT .: pA## ~ I Clr ~ <br />;OLlUS, TOTAL SAMPLE skaa~## oaaa#a ao+ooet ~ lg) <br />aJ.iL ERU6U MEASUREMENT '.; <br />UJ~lU 1 0 0 ::-;:;:PERNIk7::';".: <br />~ '~:#Ip?A##. .. -. b@OO~lipl., #A4 ,stet+Tt'o~.. :~5 7.Q -;MCE/ ;ftAB <br />EFFLUENT 'v LO XS Yl LU- ; <br />FE.QUIREMENT` .~:~ ~ ~ ~ ~i~: O004 ~ ~ .~ ~~~ ~ ~~ <br />~:. . _.,..A ~~` ~~ ~~ ~~N~~~. G <br />,.. . <br />IkUk, TOTA ~ SAMPLE L~•rS::.:::: 4#ri#StJ .'19aAAt ( 19, <br />(AS ,~ MEASUREMENT <br />U104S 1 ! 0 PERMIT 7s-sO tz :O skit=kCiY. '.: S-^ fi#A#9sF =,Q <br />~ {•© I7Ct/' a <br />alhB <br />EFk'LUc"NT 6 55 YILU :REQUIREMENT ><;.=::# TCC YG '-A IY MG , <br />M ' . <br /> SAMPLE <br /> MEASUREMENT <br />0 <br /> PERMIT ~ ~ _ ~~ <br /> REQUIREMENT - <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~..~ ~ '~- ~. ~ ~ - <br /> .RE~UIREMENT ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> .REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT. <br />NAMElTITLE PRINCIPAL EXECUTNE OFFICER I CERT <br />AM FA FY UNDER PENALTY FLAW THAT I HAVE PERSONALLY EAAMINEO ANp <br />MILIM WITH THE INFORMATION SUBMITTED HEREIN; MD BA4ED ON TELEPHONE DATE <br />V,u~ IFT t/ n <br />: <br />/ MY INOVIRV OF TNO4E~ INDIVIDUN.S IMMEDIATELY gE4PONASLE FOR <br />OBTNNING THE INFORMATON <br />1 BELIEVE THE SUBMITTED INFORMATON IS n^ <br />/ <br />/ <br />(/ <br />! <br />, , <br />TRUE <br />ACCUMTE MID COMPLETE <br />I AM AWME THAT THERE ME <br /> . <br />. <br />SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATON <br />INCLUDING Q/ <br />( <br />1.( <br />~ <br />} ~/( ( , <br />THE POSSIBILITY OF RNE MD IMPRISONMFNi <br />SEE 1e U <br />S <br />F 1001 AND J9 <br />C / <br />~ <br />j . <br />. <br />. <br />. <br />U <br />S <br />J1 e <br />h <br />I <br />E <br />C <br />f <br />A <br />M <br />C eIONATURE OF PIIINCIPAL El(ECUTNE <br /> . <br />. <br />. ( <br />Nr <br />•a pafar t <br />aw mnma m,y <br />. <br />1 <br />xAda <br />n•a 4o ro <br />10,000 <br />TYPED OR PRINTED and wnraYrlvn inpiauwl•nr e/Mnrwn6montlo a+W6yrAl OFFICER OR AUTHOR4TED AGENT CODE NUMBER YEAR MO DAY <br />CDMMt:NIS AHV tAI'LANAIIVn Vr grvT VIOLA IIVND IMIFNMCe a//IRGCOTIOFS /lefel <br />:S:i, IHUVP SETTLEAHLE :iOLIUS LIMIYi ':ILL ~'UT [3E 4AIY°D PU5 <=IG4A,"s4Y.F P3FCIF EV£KT n:: F'OP. >19YR,2aHu <br />?kdi:1P EYENT• UIL S l",Y.EASE - SEF. Ii•1•i a <br />EPA Form 3320-1 108-951 Previous edition4 may be used. IREPLACEB EPA FORM T40 WHICH MAY NOT BE USED.1 ~ U 2 j P ~ 9 ~ 111 1- 17 C Y PAGE lOF <br />~ vfi i r ^VY' ~1 ~ '~- <br />CiSCRAPC! 70 LORE41'~Rl~°Fl~oa~o <br />APProve a PN 3 1, <br />(SUFF ~E) i'I+S~ <br />r ,9. <br />- FINAL r^'~-~ <br />"IPCF r <br />YFfifi NC DISCHARGE ~~~ fir: t; ~ ''I` <br />NOTE: Rsed Inetrudlaale before ompbdnp this form. <br />CENTRATIO <br />N NO. ENCY <br />FREO <br />U SAMPLE 1 <br />~ <br />-5/1 O <br />F <br />i! <br /> <br />