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PERMITTEE NAME/ADDREBS p.rArs~wryN../[aura UDOc..nl <br />NAME TNAPPP.P '"[4iNr;, Ivy, <br />ADOnESS T R A P P E R '" t •' <br />P.O. RO'; l ~ l <br />CkA IG r-n HT {, 2', <br />FACILITY <br />LOCATION <br />.'T;.; ~. CORD~~: u{~TF•4~, PRr.':/';~tt "~8 <br />PARAMETER 13 Grd OnlYl QUA <br />132-371 116-531 <br />AVERAGE <br />VSSOA(• MEA' <br />+:1066 1 0 U I <br />FPLUI;XT G90S; VP1. 17 "REQ <br />SAMPLE <br />NATIONAL POUVTANr ascHMDE ELIMINAnoN BY6TEM /NPDESI Forth Approved. ~~~ <br />DISCHARGE MONRORING REPORT lOMRI ~ [ ,I 0 P OMB No. 2040-000A <br />1-161 17-191 <br />APProvel expires 05.31-95~ <br />` <br />0 D 0 3 2115 x!19 S (S"'~ a ° V ~ a <br />PERMIT NUMBER DISCHI1flGENUMBER o _ yr ~ ~T <br />- ~ MO p;~ <br />T` <br /> , , <br /> n~en ~~ ~ r/~ . ~TD„L:. DT~sI^t ~''LE'R !'~:iy~ <br />MONITORING PERIOD ~4 . <br />YEAR MO DAY YEAR MO DAY <br />` J <br />~ <br />FROM TO ¢;<'~ N1 q*`; r•n 4r~•-r }~1 .^C ,[' <br />126211 l12-231 !26251 126-271 ITB-191 !34311 NOTE: Read inetructlane befor compbtinq this form. ¢. <br />TY OR LOADING 11 Ord OnlYl QUANTRY OR CONCENTRATION NO FREQUENCY SAMPLE' ~~? <br />!566/1' !38-15 N6-53 !5661 <br />EX OF <br />TYPE <br />MAXIMUM UNITS MINIMUM ~ AVERAGE MAXIMUM UNITS l62~6J µµrMS <br />166681 169-701 ' i ~~ti <br />.:... . ~,...~,...:...: ~~tL~wvnr:...a <br /> <br /> <br />NT <br />VT' :, <br />NT <br /> <br /> <br />NT <br /> <br /> <br />NT <br />VT <br />NT <br />VT <br /> <br />1. l'"~-:' h~` ~ ~~:~..::'~r:~C',a:.:~.l~ic::..;.!-: •_..:.:....':':::5.:!..;:; 2I,.::i'kr':r:::.~::.:'::: .-. <br />~'" <br />.PERMIT.. , . ...~ ... ~ . <br />,. <br />REQUIREMENT:' :~:: ~ ~ . ..... :. ~~ ~~ : ~ :: <br />.....;: <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I cERrIFY uNDeR PENN.Tr of uw rHAT I HAVE PERSONALLr ExAMINED AND TELEPHONE DATE <br />AM FAMILINI WITH THE INFORMATION BU6MITTED HEREIN; AND BASED ON ~~ n ~(/ <br />MY INOUIRr Of THOSE INDIVIDUN.B IMMEDIATELY flESPAN5IBLE _PoB L -JL <br />OBTNNING THE INFORMATION, I BELIEVE rHE SUBMITTED INFORMATION IS <br />v:. Gordon Peters TRUE. ACCUMTE AND COMPLETE. I AM AWARE THAT THERE ME 970-824-4401 99 I~~ z7 <br />SIGNIFICANT PENN.TIE9 FOR SUBMITTING FN.9E INFORMATION, INCLUDING <br />7YwN1riY(~t ~„enETdl MBRuEE:T THE POSSIBILITY OF RNE AND IMPNSONMENr. SEE II U.S.C.E 1001 AND 0J <br />- D.S.C. E i 3I B. iiwriw. uwr m... m.,.:., .+r r.::,aa rns: :i » :;c,00D iIONATt7RE of PRINCDAL EzEDUTNE AREA <br />TYPED OR PRINTED .ns ormuinran YRm'aRalu'Ir et Barwaanemonrha rNSY+'al I OFFlCER OR AUTHORIZED AGENT ICODE~ NUMBER IVEARI MO I pAY I ~~ <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /Reference d/ ittschm~nts herN <br />YS:; ~ TOTAL CROR [.[7iTi WILL Fr: RRIY':D, A4D v?TTLF>fliLl 5?LIDS LT4IT APPT.T'~ cn^ <=1074,?FIND nplrrn rVF9T- ~ <br />y'r f. 3U'08N OP PROOF REJUTRP.KONT; U9DER I.6. 3. TDS "`:ONTT7RIVC - T. 0.3, n?L ~ "~rA SF. - ^.c.: 7.9.1. (0) r <br />iU DRT AY t;P~:F i5 RIGRRS° !".JRTiiL' :Y E9A.; (? DORIM PPR [;~D 'FPOR°FO~ <br />EPA Form 3320.7 108.961 Pnvlaue edltlons mey be Dead. IREPLACE6 EPA FORM T~0 WHICH MAY NQT~~D.I n nn c 7 / 4 ~ ~ rt ~ t _ T Q 7 < PAGE ~ OF <br />