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PERMITfEE NAME/ADDRESS R.e64 fsWryNr/f<rnIw UDlp..ml -- NAM~_ -3S)1lle HHORy OVAL CO riPANI. _..- _ AooRESSAOADSIDE n.INE, M 6 5 Poar4LS P.O. BOX 1430 t PALISADE Cd~r~526 FACILITY LOCATION a Y'I'N: JUt1h A. lSE:NaC, P!tESLUENT NAP ABPOEFUTANT DIBCHMOE ELIMINATION fiYBTEM'INPDESI D C ARGE MONITORING REPORT (OMRI - - 1-151 .- _ - - _. N-t9 D 7 4 PERMIT NUMBER DISCHMGE NUMBER MONITORING PERIOD YEAR MO DAV YEAR MO DAV FROM TO U 176111 l71-731 111-151 !16171 178-291. !363/1 F - FIIAL MINCR , ##$ NO DISCN~IRGB 11~ p'~ NOTE: Rud Instruction belLxi compMtinp !hie form. -- ~-•HAR~AMETER 13 Grd OnlYl QUANTITY OR. LOADING N prd-Oe(YJ QUANTITY, OR ¢Of1CENT~IT~0~1 _ -. _ ~ NO. FRE¢uEHCv 116531 154-5N /1653 /61+61/ I35J51 - EX 0 TYPE l32-371 MILLY5IS AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 117-s31 151-681. 159-701 H SAMPLE ;i## ~><~k ###### #010### , I ( 1 a) ~/' MEASUREMENT 7- / / 7. .~ J `U40U 1 U 0 PERMIT #rt.CA?Xrt #Cta#0# O#k :. '` 5 .:~ .##a»i±OA 4:i.Cf :: , : :: . b[T:: it5~ITU EFFLUENT GROSS YALU REQUIREMENT •. *### ;:~''w,'::: ;,; . .. ,: , , ,;' . ... .. ,...>: ... < i0LID5, TOTAfr SAMPLE Y;r#='t::;: ,..###J O~tq~A ~ r 5 g ~ 1 ~ " I ~ / ~ iUSPtNDEO MEASUREMENT ~- ' 5.j - ;.~ .. ~ 3~ ~-~~ US3U 1 0 :f0 ~ :~AERMIT #skG#4# ,-#.#0#G 001P .~ ~ r' ..~v..,,..~:.: . $$,;' Yj, - l .? :CAB 'FFLUEYT CpD35 BALD REQUIREMENT ~y#a4 , ,im t ~ s , C ON, TOTAL .. SAMPLE ::###L=:~ ##G##~= ;O~Q+C ~ ~ 19 ( ~ ~ /} (,9 r$) MEASUREMENT 2 ~ ~ 3~ `J'D G /~ JiU4S I 0 O PERMIT ~"•##~#':. . . ###a## ### #~71p### 3.5 ?'e0 H~Z~ ii18 'FPLUENT ~XOSS YLLU REnuIRENIENT. #### 3UDA'liG GAILI Fli C d- TH ' iIL AND $E SAMPLE `+=~~##I}# ###### #0###^ T9 ' MEASUREMENT 1V 3582 L ?.®~ O PERMIT =.~##O:a# ,f IS YA##L1 ##~ #*{Y#Ip~tl ABF A4 . 1:0 ~....:.. .. i ~ Ot1T.IN i$~U PFLU EN I",6$OSS YALU .REQUIREMENT ~ ~ ~ ~ ##9r0 ~ .~.3O~DA~~~A-G~~ ~ NS ~~:~~!! ~~~" G LON, ZN 'CONDO IT OR SAMPLE ~ U3) ####rs: #Oi### #00016• i CRRU TR$~ TMbNT PLAN MEASUREMENT GG I 2 t'C 1 ~ ~~ ~ L r 1 D I 0050 1 0 . 0 ~P..ERMIT ,:.... RFPOR~? :..REPORT ~ p~SF 0116## ##±WR.,: ~.;.:~: ?R3'*fS~1~#~: ~a ##0 .. , . ,£BALY :NSYA!1 ..FPLUENT GROSS VALU IREMENT REOV 30D1 AY G )SY DAILT !!GD in~: r : ;: ; ;' ' : : #+Q#4 . . . . : .. . , : :: : i: :: . .: . .. ~ ~ i L 5, O AL SAMPLE ##0##;+ ###0## ~ Oa#### ~ ( I9) ~ 1 IS50LYED MEASUREMENT 5 '~ 7~~ ~ //LI , .~ IU2`JS 1 O. O _ ...PERMIT. , ###R## 7r1RCbuR# 0 ### ~4+R?6>C# BEP~Ii'~` ..?.~t:~k.IJ61' RLI t8A8 FPLUENT 68055 YALU :REQUIREMENT ### ' ' Q$$.j.°'j/~' •:>Q$'j'f~.. [~`"~ NG~L ~~' B SAMPLE 34R#4.k ~ ( 9q) 4#OOA4 90+MC~01 - Ow•4#4 ~ -- iSUAL MEASUREMENT rl7 VT ~4D66 1 O O PERMIj.:.. # '3O. $EPOR'S. Y ES=S Rt+gIO6C10 i+0#4#M! •: : aC[>t'Fr#!Q 4## $BKLI. ISUAL FFLUL'NT GRO55 YALOE REQUIREMENT NAMERFILE PRINCIPAL EXECUTIVE OFFICER I cERnfY uNDEn PENUTr of AM FAMILIM WITH THE INFO Lww THAr I HAVE PERSONULY EXAMwED Mo RMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE r S~ U ~P r C MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTNNING THE INFORMATION, I BELIEVE THE BUBMITTED INFORMATION IS TRUE, ACCUMTE MD COM0.ETE. 1 AM AWME THAT THERE ME INCLUDING IGNIFICMT PENALTIES FOR SUBMITTING FALSE INFORMATION ' ~~ G % r~ , S THE POSSIBILITY OF NNE MD IMPNSONMENT. BEE 18 U.S.C. 1 1001 MD 33 BIONATURE OF NtINCIPAL EXECUTNE 9i Ie ~~~ lal / ~l / J ~ `/~ , U.B.C. f 131 e. /AInYeN. unNr tlwer .blahs nNY heAd~ hrf W ro S 10,000 .~ TYPED OR PRINTED ra nnraim.n inA'lo'F+n+t afMH.wr e~nenN+.nde Yrral OFFICER OR AIfTNOR12ED A0ENf CODE NUMBER YEAR MO DAV COMMENTS AND EXPLANATION OF ANV VIOLATIONS (Rs/ersncs sll elrechmsnts hers/ 'it1iS OUTF~LL:IS NOS ELIGIBLB FOR EYEtlPTIONS FR07 TCTkL SUSPENDEC SOLICS (TSS), 7CTAL IRON AND/UR SETTLEABLE SOLIDS LICITATIOMS - SEE I. A. 2. ~~ iy EPA Farm 3320.1 108.951 Previous editions mey be used. (REPLACES EPA FORM T40 WNICN MAY NOT BE USED.1 00 341 / 9 8 C 2 2 3-12.`.6 PAGE 1 OF