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PERMITTEE NAME/ADDRESSp YL FrISyNaWLrenoe UDlp..wp NAME i.YF/nU5 rM('lkt. LuKr'~i(ATluly ADDRESS P U UUX Otl <g.GRAIt, w a16tb NA710NAL POLLUTANT DISCNMOE ELIMINATION SiV6fFM /INPDESI Form Approved. DISCHARGE MONRORING REPORT lDMRI OI~~ 7A04R•OOQ4 . 2.15) 17-19 : ~ n c / :) I ~ - a h ]'!' d :,udrf N.i ~APProv6 s~w47 5=31-98 PERMIT NUMBER 'olscHARDE NUMBER r - t- I hAl , MON FAL~ ITY ITO NO PERIOD h 1;J IJh; L I.YP;tUS cMPlkt CUKPLKAT IUN 'YEAR IvTO DA Y ~ ~' YEAR MO DAY ~ LOCA71oNLKA1 `v GU 41025 FROM ~ 4 O" Jt, ~ ### ~~ U p~5C1~l AitGE 'I'#~` A 1 (i ~ hl : L, n A t L ti . L U u L G ~ , v E Nc k A E M Gat r262 n r22+23i nr- 126271 !2849/ 13631) ~ NO - ..d nstruetfora 6sitR. eompfstlntl thb form. PARAMETER !3 ord Onlr1 OUAN';FITY OR LOADING tird Onlvl QUANTITY OR CONCENT ION - NO. FREQUENCY SAMPLE 11653 51-61 132-37) /38.15 /I6 3 W-BI OF EX- TYPE AVERAGE ~~ .MAXIMUM UNIT ANALYSIS MINIMUM AVERAGE MAXIMUM UNITS ~ /sj.IS) (5/-681 153-701 1L AfvU Urtt A$E SAMPLE ###### 94 #d#### ###?## ##444# V 1 "~ U A L MEASUREMENT ' o4JDO I U U .:~::'::PE~};MIT~::~~ REOUI FM EN7 "~~~:.VItM~IF*::~~ .~ " . ~:"..:: .~::~;~'~`:~:;:~ -::.a ~ " I :::"~.~ ~: :.. ...?~:~:~:: ; ... , ~~ :; t ~:,:~4di#>pl:~"~..::.. .,.. : -`~.j~#~I!+9~.$F":::. „. . 4## ~~~~ ~~';~ "~~L'":U'~t1L ~r LUt)11 .. IiUJ$ VALUE : F . r . :. .: ..~ .i. : .., .; .. ~ .. ~ . , .: t SAMPLE MEASUREMENT ~-~~;: ~ ' ":::.:::'~:PERMIT~~ ::"~~ ~ ~ ~" ~ ~~:. ~ .. ... ~ ~ ~ ~ ". ~ <f.. <. - .. .'. ~ ~ ":'~:a:" "~ .y.EQUIREMEN7~. :: ~ .: :::~. ~ ..~ ..:..:.: ~:::;`:N;~,.F....; ~... ; ,. .,:>:.:~.:: . :: :.:~ :. SAMPLE MEASUREMENT ~•r~ ::: ~::.r" PERMIT ~ .:. ... ,,::: :". :' %=:.... :.~ ~:;;'~' . . ~RQUIREMENY'; ? ... :r .: .. .~. .. ~:.. ~ ~ .. , a ~r. ~. ::.:;.. .. . . :.: : .SAMPLE ' MEASUREh1~NT ~" . ~ ~~:.pERMIT? ~~ ~ ~" ~ ;s .~.... ~..: , ' ~ ~ .:.~~:. RE QUIREMEN~~ ':~~ ~, .: . ... :. ~;, .: %. fs . " .. SAMPLE MEASUREMENT "PERMIT .:: :r ~ ~~ : ~ . ~ ~ ~~ , ., ... ~ ~ " ~ ~ "~ ...:. . ...:: .. ~ . ~:~: -c«:.....:::: :.;:. :. ,.: .:.. ~~~~ " , : :REOUIREMENT~ :~ . .. . .. .. :r':... SAMPLE MEASUREMENT "~~ PE MIT ~:~;. " :: .. .. .. .: . . .:<.::.: .. ..:. .. :~. REQUIREMENT ~ " SAMPLE ' MEASUREMENT ,. ;.;. PERAAIT:' :~:~ :;;. ~.. i. ~ ~ ~ ..~.z :.:.: ~. ,. ~:. , •HFtO.UIREMENT. :.~~'... ~...-.~~. . . .. ~... '.~ ~- ~ NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I eegrl AM FA FY ugoeR PENUrr of MILIAR WITH THE MFO uw THAT I NAVE PERSO RMATION SUBMITTED H NALLr ExAMIN EREIN: AND BA ED AND SED ON / ~ TELEPHONE OATE ' MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIB LE FOq / / 1?Irh~ rci 11]1115 ' OBTNNING THE INFORMATION, I BEDEVE THE SUBMITTED INFORMA TION IS / / l !L1 F i TflUE, ACCUMTE AND COMPLETE. I AM AWARE THAT THE SIONIFILANT PENALTIES FOR 9UBMITTINO FALSE INFORMATION INC RE ARE LUDING .~ /N j / / ' ro:Tlhenta :IV ana P.C g , (970 )870-1751 7 Z~ 9~ THE POSSIBILITY Of RNE AND IMPRISONMENT. SEE 1B U.S.C. 1 1001 AND 7B g10NATURE OF PII PA UTNE E u.s.e. 1 Isla. /AwMN4. Wr reeae moms IN.r AKA.d. n,.. w ro /ro.oaD INCI L EI( C AREA TYPED OR PRINTED eMrnM.MUn irwlnvlMTr e/Mrween en,vrmaweyws/ OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY COMMENTS ANU tJFYLANATIUN OF ANY VIOLA I IONS IFrI/IFenCS u/ efreCnmen(s Ds/el .;cfiLtAoL.~ SLILI~S lIr?lI wAIV~U Fuh IJTx,24Nk ('lE(:ih' cY~_/vi-5~L I..:e3, NU IV, FUR kE4,t.llttMcnTS. u1L ;. ~kLA~t IiKNL SAMPLI: At.ALY~IS ii:.dUIkEG Ih VlSlciLt StitE1, 15 Ld~trc'JtU• QriMLY SAMPLInG !ir'Si.~iUCiIUNS-I.L.•s, i•,. s . EPA Form 3320.1 108.961 Previous editions mey be used. (REPLACES EPA FORM T40 WNICH MAY NOT BE USED.( U J c ~ b / 3 u L U J 1- I ; I I PAGE 1 OF