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PERMITTEE NAME/ADDRESS R.~. FsMryNer/laanan UD~.wO <br />NAME SEgGCA .^-~3A(. CO!MPA:~3 <br />ADDRESS DBANER D <br />HAYDEN <br />CO 81639 <br />FACILITY ' <br />LocpnONHAYD`EN CO 81630 <br />ATTk: G. BUa BRDNNs CEYlrNAL NANAGI;R <br />NATIONK POLLUTMT DISCHMOE EUMINATON SYSTEM /NPDE$l <br />DISCHARGE MONITORING REPORT (OMRI <br />l1-181 ~ 17-191 <br />coooooi2~. .: _ Q~i A <br />PERMIT NUMBER'°""" I>x.~ DISCNMOE NUMBER <br />MONITORING PERIOD <br />. YEAR MO DAY YEAR MO DAY <br />FROM ~ ~.6: ,~ ~,]. DI TO YSS 1L 31 <br />l7PI11t. !11131 l36Y51 /16171 118-391 130-311 <br />Form Approved. <br />S£D. POND DSCGN TOMB~Noo20y40-OOOe4$.~ "~ . <br />Approval expi[fes OS-31-9BIFF <br />(SUER NFl) 1E14•J .h <br />P - PINAL,~ <br />eleoe <br />NOT Rd,Instruetlorr 6dor' complsUne ffib form. <br />PARAMETER l3 Grd Onlp QUANTITY OR LOADIN G <br />q"R <br />' !I Ord Onlyl QUANTITY OR CONCENTRATION: • <br />~ NO; FREOUENCr SAMPLE <br /> ~ <br />!4653) !56811 M , <br />w <br />f d" (3Bd51 46531 54-671 ~~ ' <br />~ . EX ~ TYPE <br />131-371 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS" Isa-e3l MKY99 <br />186681 !66701 <br />JIL AND ;FHEASE SAMPLE ##maaa ~ 9a) «xG##4 ###; as 3#t#t# ' <br />VISUAL MEASUREMENT <br />b4Dbb 1 1 D PERMIT ::-zr.:~:a;x. ~EPDiT ES=1 <~°xiz~a~. <br />;'~ #~:.##r• a;`-t~~.t v#>Q :::'. ::~. NCE% : OIa~1Ai: <br />EFFLUENT G805S YALUF REQUIREMENT - TNST IxA:S NO=p <br />l . <br />~~ss:.:;;. . <br />4 <br /> SAMPLE <br />MEASUREMENT '~ <br />w <br />~ <br />'~ .~l <br />"" <br />' ; <br /> , ~` <br /> PERMIT ~: ... <br />.. ...:: <br />.~ ~ .; <br />;,..... <br /> <br />~ . <br /> REQUIREMENT .. ~ :>Yi"t,:., ~ :.:.. <br />-~:. . . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~. ~ ~ .. ~ <br />~ ~;~. :1 <br />~ .,.. <br />~ <br /> REQUIREMENT ~ ~ ~ ~ <br />~: ~ ~ <br />.:'. ~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT .. .. ~ : .. <br /> REQUIREMENT ~ ~ ~ _ !.;ta"::::.:~-:~ ~~ . . <br />. <br /> SAMPLE <br /> MEASUREMENT <br /> ' PERMit ~ ~... ~~ ~ ~ ~.. ..'::... .. ~ .. . <br /> ..REQUIREMENT. :.. .. :.~ ~. ~~ ~ ~: ~ . ~ ~ ~ ..~ ~ :~ i,~: ;;-:~;}':"~~~: <br /> SAMPLE <br /> MEASUREMENT <br />~ <br /> .PERMIT .. .. ~. .. <br /> REQUIREMENT ~~~ ~ ~~ ~ ~~~'~~~ ~ ~ . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT . ~ ..... ...... .. <br /> REQUIREMENT: ~ ~ ~ ~ ~~ <br />NAME/TI7LE PRINCIPAL EXECUTNE OFFICER I ce6n <br />AM FA Fr uFIOER PENKTr of <br />MIUM WITH THE INFO uw rNAr I NAVE PERSO <br />RMATION SUBMITTED H NAIlr EXAMI <br />MD B <br />EREIN NED Mo <br />ASED ON TELEPHONE DATE <br /> : <br />MY INQUIRY OF TNOSE INDIVIDUKS IMMEDIATELY RESPONSIB LE FOR ~~ <br /> OBTAINING THE INFOM1AnON, I BELIEVE THE SVBMITTED INFORM ATON IS 1 <br /> TRUE, ACCUMTE MD COMPLETE. I AA1 AWME TNA7 TH <br />IN <br />610NIFICMT PENKTIE9 FOR 9UBMITTINO FK9E INFORMATION ERE ME <br />CLUDING ^ <br />~. <br />E ~ (,~ <br /> , <br />~ 1 <br /> THE POSSIBILITY OF FlNE MD IMPN90NMENT. BEE to U.S.C. 1 1001 MD 3] T <br />NE 1 <br /> U.S.C. 1 1315. IP.'Wd.. uW OMs mOm.. m.r YcAIM ffMS ~ a 110,000 eIONA <br />URE OF PRINCIPAL EXECUT <br />TYPED OR PRINTED mdnmulnw.n hW1.I+L+~+r arbtwwlemwdu YMeF.va1 OFFICER OR AUfNORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /RsJsrenea ell strechmsnfs hero) <br />T55 E IRON LIMITS HILL BE 4AIV>;D AND SETTLEABLE SOLIDS LIAIT APPLIED FOR C=10YRs24HR PRECIP EVENT; TSS.i. <br />IHOM LIMITS RAIYBD FOR >lUYR,l4HR PBECIP EVENT SUBJECT TO BURDEq OF PROOF IN I.A.2. OIL E GREASE-SBB <br />r.a.t.D. rna >,nrr*nR~Nr.-¢cc r_..~~~'_ <br />EPA Fam 3320-T 108.961 Previous sditiona may be Used. IREPLACEB EPA FORM T40 WNICN MAY NOT BE. USm:1 PAGE OF <br />r=~010.9/9M091+t^0923 - ~' <br />,. _....: s. ~.~... <br />