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PERMITTEE NAME/ADDRESS pweY4 FsreyNr'lx.nu dD1~ rwV) NAME T1; rl PpER MINIM :~ T.'7C. ADDRESS T F- A `J I' F S ~ i N F C4S[:~ ."~ '_11625 FACILITY LOCATION h'C°':. . GUNL?7N Or~T^a :• nftc;/G5ft ~C:4 NATIONAL POLLVTMT D19CHMOE ELIMINATON 9YSTFM /NPDESI Form Approved. DISCHARGE MONRORNVO REPORT lOMR1 ~ F q ^ ~ OMB No. 2040-0004 l1-I61 17-191 _ p ~ ~ (r ~ n R T, V ~ Approval a><Pires 06-31-98 PERMIT NUMBER DISCHMGE NUMBER P - PT N } L '~Q P /~ 1 R ^nTP vvT T~tiTler '1,' 7 . MONITORING PERIOD YEAR D YEAR MO DAV FROM TO ~ .. ,.t R.T DT SC49P':° ~ ~ ;: ;: ~: vaz11 naz31 n4zs1 n6-zn l1B-19i l3a311 NOTE: Reed IrnWetlone bdon compMtlnO tole form. PARAMETER !3 Grd onlYl QUANTITY OR LOADING l~ Grd On/FI QUANTITY OR CONCENTRATION N0. FREQUENCY SAMPLE lab-53I !54611 !38 5 11653 15F611 EX of TYPE !31371 MALYSIS AVERAGE MAXIMUM UNIT$ MINIMUM AVERAGE MAXIMUM UNITS !s1-sn 164561 /63701 _ _ SAMPLE +-^ ""k#r:t 'L-Y#~^^ ~ '?T~ C E R I U U A =` N N C q MEASUREMENT i'AR38 i U '1 .~~ PERMIT ~. ~~~ ~:: .:.I k.:: .$f.'i ~~.~~: :.:~.~: ,:,:~..:. .... •~.. ##.'F :. ~:.'#:. ;. .~ $': E4- ~~ ~' : :;?~:'~ ~: : ~; R':. •.FFLU,. ,RCS,, Vg1.1. ... .. REQUIREMENT. . .... .. 4#a# ,. rPy . •: :a,;. . ..:... 3F Y !{ A _ SAMPLE ~~ aaR# 43a##a a:l#t## ~ ?3) PIREP'7' !.~?5 MEASUREMENT AN6C 1 U 7 PERMIT% : .'. . , :.::.:. . ,.. ## ~~ ~ F,°.- YF °: ,.bA ~- 1 c "' A .FFLOENT ..905 - ., 1. : REQUIREMENT. ... ..:. ~ ~ ~~ ~.. ... . .. ... ........:~::. .. ~ ,.,. ;.... #as ,...: ...~ ~::-.. -_.::~. ,~}:k:,..t~~~ L! : . r.: rP SAMPLE MEASUREMENT .::.PERMIT. .. ~ .... ...... .. ...: ...: ~ ~ SEQUIREMENT~ ~ ~ :..::.: . :~.~~:. ~.::. ,:: ~.. . ~. ~~~ ~~~~ .. SAMPLE MEASUREMENT ~ / ~~~ . PERMIT ~ : . : ~ .. ~.,:':.:~:~:`i<:>~ .: ..: ~ ......:: .. ...:,,~:~ ~ ~: :.:~ ~... REQUIREMENT: : ~:~~: . ~ ::.: .:. .:. ...:. ~. ~. SAMPLE EASUREM :.PERMIT. pEQUIREMENT. PERMIT ... ... .... .. ~~ ~ ,.... .... ~ :~ ~ .. ~REQUIRE.fiIENT~. ~ .::. . . : : . .. :.. , NAMElTITLE PRINCIPAL EXECUTNE OFFICER I CERT AM FA FY UNDER PENALTY OF MILIM WITH 7HE INFO LAW THAT I HAVE PERSONALLY EXAMINED MD RMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE MY INOIRRY OF THOSE IMDINDUALS NAMEDIATELY RESPONSIBLE FOR ~~~ ~ GOrdOn Peters W OBTAINING THE INFORMATION, 1 BELIEVE THE SUBMITTED INFORMATION IS 970-824-4401 99 1C1 Z] . TRUE, ACCUMTE MD COMPLETE. I AM AWME THAT TN EAE ME SIONIRCMi PENALTIES FOR SUBMITTNO FALSE INFOIIMATION INCLUDING President/General Manager . THE POSSIBILITY OF RNE MD IMPNSONMENT. SEE to U.S.C. E 1001 AND 30 In nwc n NI rMe FYFfY ITNF NA E F N L TYPED OR PRINTED U.S.C. 1 131e. lPwWM• MIOr MM PfNel• m•F' %KR.V• rYM• 1p ro i i0,uwi w..n...~~,wn>++wraan...nsmmn.wswr,.l I . _.._ _ ._ .... ... .. _.._. _... _ OFFICER OR AUiNOR12ED AOEM ~ AREA cODE ~ NUMBER YEAR ~ MO ~ DAV ~~- COMMENTS AND EXPLANATION OF ANV VIOLATIONS lRelerencs el/ettechments here! i; f::' I. q, ~e PP 1-~F YV Y. fi'-a'FILti ')~- TF. S'i PR7~:iDU!'t'. HCPJKT LC'+I! - 5'*~TI S'T1~41, ~-7 FS'r'I~s'"`~ '+''LCt i~ Lr:1tAL TCJ 50~ 7c' TYST '7~t.r.q'+ISt+Ss ANA ATTBCR gC(STP. T07[I^iTY TES'" RPPrTorT Fnp'c ,.,1 ~~~, r^nIFS nF 4[. T. INF'73'IATION .°US" Rr SF~T ifT EP1. W9'.N I:F.T TEtiTICG M:7T 3E0D, P'1^' "NAT °""~L1T!tH^-""'s' •~r~ ~'N'~F^ ~vLY" "' EPA Form 3320-1 108-961 Previous edmone mey be used. (REPLACES EPA FORM Td0 WHICH MAY NOT BE USED.) ~ U n ~ .1 ~ ~ q .i y ~ 3 _ I 1 i n PAGE