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PERMITTEE NAME/ADDRESS(/neude Facility NamrlLocation ifDiJjerent) ' <br />NAME <br />ADDRES TRAPPER CIHIliG, IUC. <br />ST'HAPPER MIRE <br />P.C. UOI 1H1 <br />FACILITY CRAIG CU eIt16 <br />LOCATION <br />A'I"fN: k. GCHGCN FETEf°. Ph E'S/GEN CGR <br />Nki1(3 'D15CH RCEOMO ITORING REPORTS~Y ~~(NPDES) <br />(2-161 (r~~ 9) <br />PERMI NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM OC C 0 TO OC 0~ '] <br />(ZO-21A (z2~zJ) (24z51 (z6-z ~) (z6~z9) (]0-J I) <br /> Form Approved. <br /> OMB No. 2040-0004 <br />!! I d C F Approval expires OS31-98 <br />tiSUEF FY) <br />F - Fi 8l1 hCfA2 <br />ACUTE kE1 TE59IA6 ECE C1]P <br />0-0>fi NO C1~CHAFEE >:tt <br />' <br />m ~'~ <br />NOTE: pleting this form. <br />Read Instructions befor <br />"C3 <br /> !3 Cerd~Onry) QUANTITY OR LOADING (4 CaN Ony} QUANTITY OR CONCENTRATION N0. FREOUENC SAMPLE <br />PARAMETER (46-53) ,(54-61) (38-45) (46-59) (5b61) EX OF TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM- UNITS ~ <br />(6z6]l ANALYSIS <br />(s4-se) <br />(69-70 <br />L::SU STATHE LLdHH ACU SAMPLE ooOa-0~ oC-0o4A 0-00-0La ~SiCCC <br />( ~ ) <br />CEkIODAFHNIA MEASUREMENT ~~qp~ D /~ <br />.Ar..ia 1 U U ti. -.-~ <br />? ~ ~' (:I -0-00 ~''`,;x4f~ x ,:~rR?~~~ r?#~`?~, ~~::, EE- '~~ <br />- ~ <br />3~~, <br />LF°LU'~`•T GROSS 0 DE f!~" <br />~ ;, (r- <br />, , '? ~" i-0o>a ~~•., <br />5 -~I'5~.~~ <br />' t - <br />,.. c' .,. <br />.,t <br />Lc:SU ~: r ~'RB 96X9 ACC SAhN!'4E #>Q~01-0ICr# ~>•#-0-0Ib 0-0-0>s-0-0 <br />~ %kYi+ib4 l ~~) ~ <br />(' 1 ' :- `r !1 6 L E 5 a~S`tfBQMENT <br />MB _ - ~ <br />/Lad ~ ~ _ ~ Q fp <br /> <br />~Ah~JL I O V I~ <br />~~I 't-C y~y~y <br />.:T'A~1• ~ <br />~Y ++ <br />YI y~ <br />]~ <br />.N iy - ,~ <br />... <br />~- { E <br />Dye <br />ji - <br />(}. <br />rFFLLet;T GRD35 VALUf ,. ~ ~ <br />; ~?`~ ~-~,-~- -0OAO I C ~ ~ .`.t '~ rfii-~; <br /> SAMPLE, <br /> M <br />MEASURE <br />ENT <br /> ~ <br />/~ <br />~~~ ~ 11 I i y i ~ ~ +Y ~' f ' <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> 1r ~N.1 1~ - iF. <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> <br /> SAMFILE <br /> MEASUREMENT <br /> <br />ANENT <br />~ <br />+ <br />: <br />)' .~ `r' ~ <br /> -. <br />.. it _ <br /> SAMPLE <br /> MEA <br />SUREMENT <br /> w <br />" 41r- Ar fi ~ •~ ~- ~. - ~ - <br /> <br />NAMErTITLE PRINCIPAL EXECUTNE OFFICER I CERTI FY UNDER PENALTY OF lAW THAT I HAVE PERSO NALLY IXAMINED AND TELEPHONE DATE <br /> AM FAM ILIAR WITH THE INFORMATION SUBMITTED HERE IN; AND BASED ON MY <br /> INQUIR <br />THE IN Y OF THOSE INDIVIOUAL$ IMMEDIATELY RESPONSIBLE FOR OBTAINING <br />FORMATION, I BELIEVE fHE SUBMITTED INFORMATION I$ TRUE, <br /> <br />~ <br />' <br />GI, Gordon Peters ACCUR <br />PENALT ATE AND CQMPLETE. I AM AWARE THAT THERE AAE SIGNIFICANT <br />INCLUDIN <br />IES FOR SUBMITTING FALSE INFORMATION <br />THE .r. <br />~ <br />~~- 970-824-4401 00 O4 Z7 <br />Pre LdH t GHIIeTaI FId11II er , <br />G <br />POSSIBILTTV OF FINE AND IMPRISONMENT. SEE 18 U,S.C. § 1001 AND 33 U.B.C. <br />319 <br />P <br />tli <br />tl <br />th <br />t <br />bl <br />i <br />l <br />t <br />f 10 <br />000 <br />§ <br />d <br />li <br />tl SIGNATURE OF PRINCIPAL EXECUTIVE <br /> <br />TYPED OR PRINTED . ( <br />ene <br />es un <br />er <br />ese s <br />a <br />u <br />nes up <br />o <br />, <br />1 <br />es may <br />nc <br />e <br />en <br />or <br />maximum impdsonnarnt of benveen6months entl5yaers.) OFFICER OR AUTHORIZED AGENT <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />SrE 1.A.2, PF 7-5, fCF D='T.hi15 CF" TEST FHCCECURE. REPOI;T LCSC - STATISTICAL FCIAI ESTIlP7f kFICE IS <br />Li.T%tAL TU '~C7, CF 'It~7 OL•SgF.Lc;1~, ANC ATTACH ACUTE TGXICITY '[EST REfCFT FCEFi TC CFf. CCFIE~ CF PII <br />E~ FGrm 2tFxl `(tl8-9 ) ~" Previous edilSo s may noT be used ( P •E •4 Y BE •) L C C b B / U 0 C 1 I ] -1 E i 4 GE I O <br />