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PERMITTEE NAME/ADDRESSpM,4 fsWry Nw//x.nm IJD10i..wr1 <br />NAME Cl]1rii+XJ CURL COtl7ANY L.Y. <br />ADDRESS CU LOYYU !LINE <br />5731 STATE NIGHYAY 13 <br />MEEKER CD 81641 <br />FACILITY <br />LocnnoN <br />PR E52fi P.5? <br />NATIONAL POLLUTANT DISCNMGE ELIMINATION SYSTEM lNPOESI FOEm ApplOVed. <br />DISCHARGE MONITORING REPORT lOMRI C)MB No. 2040-0004 <br />n-r61 rn-!sl GULCH ~ ShDI PO`lC II I,I ~.v..~ r'p <br />r, /: H c n r ~ I Appro~el expires OS-37-98 <br />PERMIT NUMBER DISCHAIIGE NUMBER ~ S U @ R h Y) 12345 <br />=iKr Y - PII~AL <br />~- " '~' 'l I h C A <br />MONITQRINGI6ERIOD <br />' YEAR MO DAYS FYEAR MO DAY __ <br />FROM gU G1 OA TO'''.9B C3 .1 Y/:y ,y N(' DT.SCHpRGE ~ ~ _}'{# <br />!16111 l11-131 111.151.116171 118-191 /363/1 NOTE: Reed ~netruCllaN bslae-CDmpbTlnp Thu IDrm. <br />PARAMETER !3 Grd Ontyl QUANTITY OR LOADING'. 1 Grd On/y) QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE <br /> !46531 151-61/ - ~~ s 138-151 116531 151-611 <br />E% of <br />l3Z-371 <br />AVERAGE <br />MA%IMUM ;, <br />UNITS <br />MINIMUM- <br />AVERAGE <br />MA%IMUM <br />UNITS <br />rs1-sal ANALrsls <br />!64 <br />581 TYPE <br />16.T7o1 <br />=1{ SAMPLE <br />MEASUREMENT Y};t 4tTC3`. ~910.T$Yk :k .~`'a.•.~ ^ <br />~ ~ 9~9%}fF L` ~' <br />I ( IZ) / <br />I <br />1 1 <br />~ ~Ay <br /> !: I <br />1 I ~ / <br />U4U0 1 O 0 PERMIT ye>r,4 ~Si fiT '.=MC#:?k i#' A '=93 .Tj:. '-~#iCY14 9.D ~ EE8LY1 %RA:1 <br />2FFLUENT Gk055 VALUE REQUIREMENT ~.##y :.~„yt. w reY Ftn» n <br />'ULIDS, 'LOYAL SAMPLE YjG;,;Lr~: O.Y#•'.,Rfi <br />~»pA0 <br />( 13) <br />I <br />USi•ENDED MEASUREMENT <br />~ <br />. ~ <br />~. <br />- 59.5 '~~ 2 /~ju Grnl~ <br />0530 1 0 D PERMIT.:. >;=~n~r>:><:.. $~::yp:r:s :: ; <br />t#~I ~- iiAl:iyQ. :t <br />. 7fl C 11C£1 I ;RAB <br />FFLUENT GROSS YALUF :REQUIREMEhIT ###1s ' rVC ~T rY. H wr r ri u <br />i(/LIDS, SETTLEABLE SAMPLE <br />ME =yr4Ctt:: ;::xuca, s#sisa <br />~ ac#n## <br />~ (~ <br />~ ( 25) <br />b I <br />/ <br />h <br />C <br /> ASUREMENT , 3V i rr. <br /> <br />o5y5 1 0 0 PERMIT Y„ ~:;t y~re;; <br />Yz:>;:o:::~ >:: <br />~; <br />K.~ <br />#:m.i~F:.., <br />..; ~aar#.a A <br />~.,~.... <br />c <br />xc~~ , <br />:n~R <br />•FFLUENT /:ROSS V-LUE REQUIREMENT: 4~s.# . <br />~ ~ T.1. wv wr wnw~u <br />)IL AMD GREASE SAMPLE :x::v;:r.:y :::z:::r.:-; »t <br />ygas ax#k## D ( 19) <br />'AtUN EYTR-GRAY MET9 MEASUREMENT / <br />p <br />JOSSG 1 U U PERMIT •°:':,.;:'.=K+ :: L`.S~#;=:= iF vAlt ;:Y}LA~O. #A~4itt4 . ID C DNTIN+ :RAA <br />;FFLUENT CROS$ VALUE REQUIREMENT ~ ~ ra':Y <br />::~ ~7 E'a:7: ~~ R1 Y. Mf, ti:YM <br />~$Uh, TOTAL SAMPLE <br />E -'.:J7:y':C.^- fi'y~Y,:~:} ###fi0t ~ <br />O ! ( 19) I/ <br /> <br />(AS FE) <br />M <br />ASUREMENT . (a <br />JI f 7/p Urn/} <br />lU4S 1 0 0 PERMIT. ^-i::T~vr: <br />~ :;t;: /ALt:ytt >r <br />~ }r:y G#>ia»L ?;s <br />~ 7.;D S 71C.~G~ t .AAD <br />:FFLUENT GROSS YALUe .REQUIREMENT <br />. ~ ~ ')CC A <br />AVf T.1 Y MY Mr/ ~:~~ ~Mtl111TN <br />'LUW, IN CDADUIT OR SAMPLE q ( <br />03) i1###0; asY,.lr}:y :y~:y;;,y,y <br />fNkU TREATMENT PLA NT MEASUREMENT ~,~ 1Z Q,~g~ O I/, 7„~1n ,T <br />UuSU 1 U 0 PERMIT. 1FTi0NAL REi'DRT Y##t47 ##i#:~= w~tra"•.'} + #~s i EEKLY' 1i5TAN <br />FFLUENT t:R055 VALUE REQUIREMENT 30DA. AYG DAILY M'L "1CD `ai lb### <br />; . <br />:. <br />iOLIUS• TOTAL SAMPLE ;:4Cxr4d L`71R44C La#L8t 93A##9 ( 19) s <br />I:iSOLYED MEASUREMENT 3Sv 0 I9O ~ain~ <br />10295 1 U D PERMIT. +-=r4{:.',;+T..' <br />~ ~ ?}:y71:~:k t. tw: }4r} OC#~#0 t0-'.ar:.'i~. ^AL.FORT t !~AL11 I RAB <br />iFPLUENT GROSS VALUE <br />REQUIREMENT <br />~~ <br />~~~ <br /> <br />~ ...:: .'. <br /> <br />G##:: <br /> <br />~. ...: .:~.. <br />:-:.;... <br /> <br /> <br />DAILY. MI <br /> <br /> <br />C/L <br /> <br /> <br />.. <br />NAME/TITLE PRINCIPAL E%ECUTNE OFFICER I CERTI <br />AM FA FY UNDER PENALTY OF <br />MILIAR WITH THE INFO LAW THAT I NAVE PERSONALLY E%AMIN <br />RMATION SUBMITTED HEREIN <br />AND BA ED AND <br />SED TELEPHONE DATE <br /> ; <br />MY INQUIRY OF THOSE INOINDUALS IMMEDIATELY RESPONSIB <br />OBTNNING THE INFORMATION <br />I BDJEVE THE SUBMITTED INFORMA ON <br />LE FOR <br />TION IS <br /> , <br />TRUE. ACCURATE AND COMPLETE. I AM AWARE THAT THE RE ARE <br /> SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />IN CLUDING - <br />, 1 <br />1~ N [_ / M EM , <br />TXE POSSIBILITY OF RNE AND IMPRISONMENT. SEE 13 U.S.C. 1 1001 AND ]] <br />gIONATURE OF PRINCIP <br />L E <br />E <br />~ ~~ <br />7d 'l 00 A <br />"I B <br />'I D <br /> <br />TYPED OR PRINTED U.S.C. E 1]10. IFrMICY. MKr elr~ mtMx. nMY /'NARY/ rA, w ro J/0,D00 <br />Ane s•nn..ir..eA.rpr'AVrnwNWNrr,.nemonrhA FFN6yAAIA/ A <br />% <br />CUTIVE <br />OFFlCER OR AIfTHORIZED AGENT AREA <br />CODE ' <br />NUMBER <br />YEAR MO <br />DAY <br />I:VMMCIY ID AMU CAr'LAIYAIIVlY V~AINT VIULAIIVNJ f/iBTBYBDOe a//BReCDTIOb Ofle/ n~,y ;,~~ - <br />SETTLEABLE SJLIDS LII!IS AFPLIES DNLY IP <= 10->!IC;`l~ NR PRECIF EYtN1 ]S CLRIMEC. IF CLAIH APPROVED BY <br />YvCD, TSS E IRON LIMBS PILL NUT BE APPLIED TO AEP'CRTSD !IEASUEEMFEIS--QLE I.B.II. P(: a AND I.8.1D, Pu 6. <br />EPA Fain 33201'108-961 • Previous editions mey be ueed.~ ~ ' Z' /REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.1 PAGE OF <br />aoD2a~97~11a-o911 ~ <br />_ '~". _.., a ..:. - _- .. ,.;:;;;.':w~~~:;r .. ~--... <br />