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PERMITTEE NAME/ADDRESS(Include Facility Name/Lpcafiun ifD~rmnq <br />NAME <br />1RAPFEEi rlxlxc, Irc. <br />ADDRESSr RAP4'ER PINE <br />P.G. UCt 1C7 <br />FACIUTVChAIG CO E1E26 <br />LOCATION <br />A ~TYN7 L. f,ONCCY GFTFFS- PR65 /GFh Rf.R <br />1 .) , <br />fJA710NA1P00yyLLUTANFDI$CHARGE EUMINAt10ryry S1'gg~~(NPDES) <br />DI$C~A~GE MONITORINGAEPORT (DMR;9f <br />PER I NU BER DISCHARGE NUMBER <br />MONITOAING PERIOD <br />YEAR: MO DAY YEAR MO OAY <br />FROM ~ G 0 TO C C ]' <br />(10-111 (1113) (1/16) (1fi~2]) 1(16-29) (30.31) <br />forinltpFroved. <br />OMB No. 2040-0004 <br />C I rC A Approval expires OS- <br />(SUEA Ni) <br />F - EIxEE <br />CISCRAFCE TC CC1fCSE CULCt <br />L>ra KC CISCEiAEGE ,~[[ ~;~ <br />NOTE: Read Instructions before'bZSmpletirlg this form. <br /> (3 Cab Ony) QUANTITY OR LOADING (4 Card Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPL <br />PARAMETER 46-53J (64-61) 36-45) (46-53) (54.61) F~( OF TYPE <br />(32-37) AVERAGE MAXIMUM ~ UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />f6S6J) ANALYSIS <br />(64.66) <br />69-70) <br />IL ANU GP.EASE SAMPLE .aauazl ( g~) rta30o0 >oea>o4: •CiCt>S <br />Y I S U A L MEASUREMENT <br />d4U6b 1 0 C ~ .'e <br />~ ~- 9?Fg36,0 1 _ ". Ees] I_ ~Ak# ~ ~AIF'~ ~1 /[t ,; ., <br />}t~1~iA!11n iL+6 .`-,h ~~ ~1~ <br />EFFLUENT G11055 Y~LfiE A ~NI' , QCs ~).;,:"'r., ~ ~~6(+ et ~*t t <br />1,. ..t~~; = C~iC . <br />ai. Y; ''~`- <br /> SAMPLE ~ ~ ~ ~ - , <br /> M,~ASUREMENT <br /> <br /> <br /> <br /> '$A -FIE <br /> MI~S.JREMENT <br /> w ~ - 1~ d. #'r- t <br /> <br />_ <br />,~ <br /> ( v <br /> <br />r' 4. .' S <br /> <br /> <br />~ j, i .: <br />~ - t 1.~ ~ <br />^fl.~ <br />I <br /> SAMPLE V ~fG <br /> MEASUREMENT <br /> i„ ~ <br />~ r - ^e i <br /> ~ ' <br /> lii ENT <br />$ <br /> SAMPLE <br /> ENT <br />MEA <br />RE <br />M <br />SU <br /> uN <br />f~~ <br />µ <br />yy <br />` <br />"~ {~ <br />" <br />, <br /> k~,1(h MENt <br />R d ~ <br />s , <br /> SAMPLE <br /> M <br />ENT <br />MEAS <br />U <br />R <br />E <br /> • <br />~ ( 1 ~' 'e. <br /> ~/ <br />~p <br />p <br />p <br />~~ <br />F~FIEI4IENt' ~ <br />' d! <br /> SAMPLE <br /> MEASUREMENT <br /> T s ri; <br /> "~~~ ~~ ~~ - ~- <br />t'~»j+ ms,., 1~ <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTI FY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY ExAMINED AND <br />E INFORMATION SUBMITTED HEREIN <br />AND BASED ON MY <br />ITH T <br />R TELEPHONE DATE <br /> ; <br />AM FAMILIA <br />W <br />H <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> <br />W. GOrdOn PeC@r8 THE INFORMATION, 1 BELIEVE THE SUBMITTED INFORMATION IS' TRUE, <br />TIONE A <br />I <br />~TNE <br />p <br />~ <br />R <br />A <br />OO <br />iI <br />970-824-4401 <br />00 <br />04 <br />2 <br />President/General EL3na eI NFORMA <br />Sl1BMITTING <br />ALSE <br />NCLUD <br />NG <br />FOR <br />ENAL <br />ES <br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE I6 U.S.C.410e1 AND 33 US.C. $IGNATURE OF RINCIPAL EXECUTIVE <br /> <br />TYPED OR PRINTED 4 1319. (Penetties under fosse sdrures may include loss up to Sf0,0170 entl or <br />muimum impdsonment of beMeen6moniM1S entlfiysers) OFFICER OR AUTHORIZED AGENT <br />~p <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/erence all attachments here) <br />.35 [. 'LOYAL IhGx I1C115 4I LL OF WAIVED, A9C ~ETTLEAE'EL £CLLCS LICI1 lFFLItO FCH <=1CYE,i4FF EEECIF FYEK1- <br />~tF dU?!DEN CF FhCCf FE;,UIE+Fl1ErT5 UNDER I.A.3. PEfCITTBE BUST TAKE ALI REASGxAL'IE lEA9LBf~ 1C FECCCE FR <br />~ Fbrm`3~ (B09) revious a itlons may nol a used. (REP E a MY-40 fCH E D.) ' ~ G ., <br />.. cccvziccclll-Ie~u ~ z <br />;~ <br />,~ <br />F1~ <br />