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PERMITTEE NAME/ADDRESS (/nclude Faciliry,Vame/Lomrion ifDi$erenU <br />NAME SE:IIECA CCAL CCC'FIM[ <br />ADDRESSDf 1gER D <br />FACILITY ~ ~` ~~'"" ~• y-. <br />LOCATIOI~A[DE® CO 81630~~~ <br />F <br />ATTY: c. EiDD Bqu~N, CENFgAt rANA6[q <br />POLLUTANT DISCHARGE ELIMINATION $Y EM (NPDES) Form Approved. <br />IISCNARGE MONITORING REPORT (D/3R OMB No. 2040-0004 <br />(2-16J pZ: 91 h 1 N G q Approval expires 05-37-98! <br />~saea bb) <br />T NUMBER ~DI ~ GE NUMBER f - f' I b 11 ~ ~ iC U'S T <br />MQ,~! ~ ING~P CISCH~ACE 1C I,iIE/t1S8 ClllEb <br />3 ;. Q" ~~D. r. YEAR MO DAY 'ate' <br />TO Yy ~ ~1 ''u~ hC [I~CNA6GF s~~ <br />r;~(;y.ZSJ lss~zrl lze~zs/ l~o-srJ NOTE: Read Instructions befor(,z aq'Iplefing this form. <br /> /3 Card Onty) QUANTITY OR LO - (<Card OnryJ QUANTITY OR CONCENTRATION N._~ ~REOUENC SAMPLE <br />PARAMETER (46-53) (54-61) (3845) (46-53) (54-61) EX OF TYPE <br />(32-37) AVERAGE MAXIMUM ~ <br />- 'MINIMUM AVERAGE MAXIMUM UNITS' ~~~~ <br />J6z-s3) ANALYSIS <br />(64.68) <br />69-70 <br />SOLIDS, TOTAL <br />N SAMPLE <br />MEA ~~##~~ iA~G00 ~ <br />- <br />f Z <br />~ ~ 15? <br />Q <br />f ! <br />SUSPE <br />DED SUREMENT ~.7`~ <br />OOyiV I O U -1?~~1MfT' - # + <br />~~ ~, 4##i t9Lv :'t '-~ ~ ~ s4.: ;. <br />EFPLUENT GH059 tALO[ '~iEQUIF~I:MENT~ ~- <br />~ ~ t+C~o>~ - <br />~ }j' ~~ <br />~ !~~ CG/l t`•xa °;~, <br /> , ~ _, , <br />SOLIDS, SET?LEABLE SAMPLE <br />MEASUREMENT ~'~~~'`~` afooYo <br />~ L <br />~~ <br />' l <br />~o ( '~) <br />D <br />~~ <br />V <br /> . <br />_ • <br />s o rr <br />UOS4S I 0 0 p M rp#a# ### s>v>z ;~ r~~4 ~ ;. ~:_:. <br />EPFLOCNT G90SB YALUI ~f~~~.r1T' <br />y ~-..; xx>na ~:'~~ ~ ~ NL/I r`ti- 1C i" ~,, <br />IfiGN SAMPLE Y-LC;YOd OJ^t;Ar LA040#., ~D <br />O <br />( <br />/ D~ <br />0 ( 1 D ( I <br />TOTAL kECgYE$ABLE MEASUREMENT • <br />O • ~ b <br />OG98U 1 0 ,Q ~.. ~'„ ' a+av ;o~ ~ 0 ~.'0 ,. ,l - -_. <br />E,FFLUt:ST 6B0$i YALU ~~~ trter~. ~j~/ *~~ ~ /~ ~' l~.+ llG/I r~`' ~ 'i; ,, r~= <br />GIL ANU G E 9 SAMPLE ''` ~„•s,r .z: 7~ C i+LVA oL C <br /> MEASUREMENT O <br />O.f~N1 I O O F'' • #~I!F# 1 Y:+3 # # O ##~ Wl ~; ~,, 4 s ,. <br />EfFLUEYT GaQS3 YALtl ti"hr1P~: ~_'' ~ Lao. `~ ~"~1f~~~,` GG/I '"`' '~~'~ %' ~` <br />SOLIDS, TO RL SAMPLE ao°'~»» °~»»~ ~ uz naaa <br />L~ l <br />'~ ( 35) <br />~~ <br />UISSOLYBD MEASUREMENT I U (/ 0 d ~r <br /> <br />EFFLUEt+T CROSS YALD ~ ~ ~~~ ~~ toa-k <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> <br /> SAMPLE <br />. MEASUREMENT <br /> Cy~ k <br />N { ai ~~ ~ ~~S <br />S <br />~ '~ tl ~ 'i F•t">` ~ <br />~ ./ .. ~ f ~'.r1x. - ~ 'l. , <br />~"' <br /> I ~~yy]~~ <br />~ n ]Y•Sr?- {y~ <br />w- ~ <br />o Y t '~i+ <br />. e _ <br />~ t e.~i <br />p, <br />n Amt .~ I ~i _ ~ ~_ <br />1 <br />NAME/TITI.E PRINCIPAL EXECUTIVE OFFICER I CERTI <br />M F <br />M FY UNDER PENALTY OF <br />NFORM <br />R WITH THE LAW THAT IHAyE PERSO <br />TION SUBMI D HE <br />E NALLY E%AMINED AND <br />IN <br />AND BASED ON MV <br />1 < TELEPHONE DATE <br />A <br />A <br />ILIA <br />I <br />A <br />R <br />; <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING \ . <br />THE INFORMATION. I BELIEVE THE SUBMITTED INFORMATION IS TRUE, ~ <br />_ <br />\ <br />ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT ( <br />9.1r <br />. <br />~~ <br />l ' <br />PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE / <br />O ' ' <br />POSSIBILITY OF FINE AND IMPRISONMEM. SEE 18 U.S.C. § 1001 AND 33 U.S.C. SIGNATURE OF'? NCIPAL EXECUTIVE {l <br />§ 1319. (Penetties antler these sYdfuras may include lines up ro E10.000 end or <br />TYPED OR PRINTED maximum impnsonment of Oerween6monlhs end 6yeers.) OFFICER OR 1~THORIZED AGENT REA <br />pE <br />NUMB l3- <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference al/attachments here) .~„;.:" <br />IJJ LIflIT cIL1 8E NAIrED Ai0 SETTLEABLE 50L1D9 LL[Ii APFi,lED [CP <=l0Yq,2VNq PAECiF rtVlt7J 1.55 6 <br />S6TT;.EA8L8 SOLIDS lll"]T NAILED IOH ~10lq,2tl8q pFECIP FtEiT SDEJeCS 4G BORDEN OF igCCt 11 l.A.i. Gli E <br />r ~ <br />_ `-* <br />EPA Form33 •y0A:9 )' +ElevlbCSCAy'li~oC15. 8 tl~J- " :iz: ~'%E~ (9EP C ~ P ORM T-40 WHICH MAY NOT AE ITS~D) ; ~ ~~ky~.~~s n s R ~ f #'t1 ~/1G~ ~ OF <br />