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PERMITTEE NAME/ADDRESS NarbLfrWryNw/focanm gOrd..a4 <br />NAME StNnCA CUAL COt",FFI'.Y <br />ADDRESS DRANt:h <br />HAYDEN CO 81039 <br />FACILITY <br />LOCATIONRAYDtiN CU fl163D <br />ATTN: .a• UUD BaDYN. G£N~;LP.L `IA's AG :A <br />NATIONAL POLLUTMT DISCHMGE ELIMIHATON SYSTEM /NPDESI <br />DISCHARGE MONTTORING REPORT IOMRI <br />!7-/el !17-r91 <br />cooouo~zl C1] A <br />PERMIT NUMBER DISCHMGE NUMBER <br />MONITORING PERIOD <br />YEAR ~MO DAY YEAR MO DAV <br />FROM 70,fi_CL UL TO tlC L ek <br />vn9ilS%77-131 111-751 !16771 178-791 !34311 <br />s}c. Pc*~D r/sccr. <br />(SUPR MY) <br />F - FINAL <br />*'IhGFi <br />Form Approved. <br />TOMB No A2Q41}0004K <br />Approvelexpi 4>j05-31-98 <br />'+"r NC D75C1?ARGE jXj #~~:: <br />NOTE: Reed inetruetime belora complatinp this form. <br />PARAMETER !3 Grd Onlyl QUANTITY OR LOADING (I Grd Only) QUANTITY OR CONCENTRATION Np, FREQUENCY <br />F SAMPLE <br /> 116531 l5L5I1~ !38-15 14653 150-5II E% O TYPE <br />l37-371 AVERAGE MA%IMUM UNITS ~ MINIMUM AVERAGE MA%IMUM UNITS le]-4]I Mxrsts <br />/5}68( 15&)OI <br />YD SAMPLE C:FRy:F: ;7 . +:xl: Y+4"+:x'-~ ( 12) <br /> MEASUREMENT <br />U0400 1 1 D PERMIT .. i:t':sx:;<C: .'I?ixt:#-~ r ~ b.5 ~d~~x:-w 9.D )NC}:~ ENSITt: <br />cFFLU}:NT L:ROSS VALUI REQUIREMENT r,.gx::;: yl~.jKV.~ Mf!II':Ut! SU M013TR <br />r JNa Lh CUNUUi OR SAMPLE ( D3) OBa+Sg4 r,+Y.'Ctx: x`L:}'.`L'-^• <br />2NRU Tn~ATt:EST PLAN MEASUREMENT <br />SOU50 1 1 U PERMIT REPDAT REICi$:T;r: a':~.A'~w?F Olp^.:7C4 x+fiL^::`'= :+``'::: I ,;IC'v/ [~1:iTA}~ <br />EFFLUENT L:kDSS VALUI REQUIREMENT 3UDA ,AVg .17AILI K`~- RGD x'x'x:x- rar+T" <br />U L ANU Gi{EASS SAMPLE +x~x':`.I~rf ( ri4j AAO:l40 ~ •fi LOY .'%' ?L .'7b:? <br />V I S U A L MEASUREMENT <br />ti4UGb 1 1 0 PERMIT 0~'+~x'TM+= A£POIiT E5=1 G90~rPSC ~~~#~'~ ~~t,~x"% "°'~'~ + )'iCEI /ISUAL <br />:;Fr'LUENT GhOSS VALUI REQUIREMENT It75T CA% NC=O - -~;y:r:} ~r}NT!{ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT ~ ~ ~ ' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT. <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />NAMElTITLE PRINCIPAL EXECUTR7E OFFICER I cERTIFr urIDER PENALTr GF uw THAT I NAVE PERSONALLY EAAMINED AND TELEPHONE DATE <br />ANI fAMILIM WITH THE INFORMATION SUBMITTED HEREIN; MD BASED ON <br />MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br />1 BELIEVE THE SUBMITTED INFORMATION IS <br />M <br />~UI+ :i OeTNNING THE INFORMATON <br />IA <br />S <br />. <br />. <br />\ <br />. <br />( TRUE, ACCURATE MO COM0.ETE. I AM AWME THAT THERE ME ~ ~ ~' <br />1 SIGNINCMT PENALTIES FOq SUBMITTING FALSE INFORMATION, INCLUDING _ <br />L!a \~ ~~ THE POSSIBILITY OF RNE AND IMPRISONMENT. BEE 1B U.S.C. ! 1001 MD ]] ~ / - C / '] <br />K 11 ` <br /> <br />NthNa faMa u <br />ro t IO <br />OOEI <br />f 131 a <br />IMWN <br />tlwa <br />mnrha rrM <br />S <br />C <br />/ <br />V BIONATURE OF PII dPAL EJEECUTNE <br />A <br />R <br /> P <br />, <br />. <br />Y <br />. <br />. <br />n In <br />n <br />a <br />. FFlCER ORA HORRED AGENT A <br />E NUMBER YEAR MO DAV <br />V TY OIt PRINTED en0 ormvinun lmA+laamMRtMMAYaasemontha en06yrral O CODE <br />COMMENTS AND E%PLANATION OF ANY VIOLATIONS IRererenee ell sttsehmsnts here/ f <br />TSS t. IKON LIMITS SILL HE NAIVED A0U SETTLEA9LE SOCIDS LIMIT APFLIFC FCR <c1CT9e,74NR PR£CI? EVE"T-, TSS u <br />IRON LIHITS YAIV£U FL'F. ~lUYt,2UeA PrZECIP EVENT SUBJECT TU 2URCE6 CF PFOOF IN I.A.2. OIL G GRF,AS£-S}.£ <br />i rf 1 D TOS Pf)N TTf1LTNf -'FE 7 F 1 s <br />EPA Form 9320-1 108-961 Previous editions may be need. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.1 ' Q Q 13 3 / 9 ~ 1a 31-1513 PAGE LOF <br />