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PERMITTEE NAMEfADDRE55 (l~iri FrmyNrWfsraum l/DI~i.arJ -' -- .; t-- - =--~3/A7mNI~pOFEtliA}it-0IiCHMDE~UMINALONSVSTFI.1_(NEQESL:.-_.. _ _"~_ F4fOt'~gVProVed. je' ~i <br />DI$CH. E . ,lTQRING,REPORT- OMR/ wn>•w ~ n ~n n <br />NAME- pQ~~$~~-CU-AL } 2040-0004 - " <br />ADORE55 RO A,DSIDd KINE, F 3 5 PORTALS ~ (SUBR ^C) - q~RITe~05- - <br />e P.U. BOY 1430 PERMIT NUMBER DISCHMGENUMeEn F - FIIiAL <br />11 PALISADE CO 81526 MONITORING PERIOD NIN09 .1 <br />FACILITY <br />LOCATION YEAR MO DAV YEAR MO DAV ~ <br />FROM 1- - 7 Ol TQ fll 09 3Q ~~~ NO OISC:IAP,GE ( `~~# il' <br />:~ T T N 7 .I O H Y A . !i (' N a H . DA N ~ T T! R N T rzo-z n 121-131 !z1-~51 126171 118-291 136311 NOT€: Rped Irowctlonp bflon• plstlnp thu form. <br />'i <br />.PARAMETER ~ l3 Grd OnlYl QUANLTY OR LOADING. (1 f,~rq On/yl QDANTITY OR CONCENTRATION <br />- ND FREQUENCY SAMPLE <br /> 1/6531 151-611 13A-151 !16531 <br />f5L5/1 <br />EX OF <br />TY <br />131-371 MKY515 PE <br /> .AVERAGE ~ MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS !e]~e]I l645B1 !59.701 <br />,•;1 ~ SAMPLE #LFP#OP #'-JI#4t1'0 #0##191? ( ~-Zj <br /> MEASUREMENT <br />GU4UU 1 0 :p PERMIT '. ###>AnIII ><>rlPq"illb ,'}#,: 6•.5 o#Oi4>i<>~ 9eQ 3($KLY NSI7 <br />tFPLUENI' 68033 YALU :REQUIREMENT: <br />~ <br />~~~ .: <br />~ #~« <br />... . <br />;ioLIUS, TOTAL sAMPLE #aP#C# oo##o# - #a~o#lo ~ lq) <br />J U $d G 1'~ i3 `, D ~ MEASUREMENT - <br />D530 1 4 0 ;::.;;pEAMiT~`;. '=~+1~'~~~4"'.::: ';,,'.??M~#~F!~ <br />:: 440 ?I~:,tiaiPtt .. .~.g :~.:.. .I:~;".:.::-.,':.';!: ,'':.;:: 'M~l." 3..R~H <br />EPFLU$MT G4USS YALU •REn~REM.E.NS . <br />. <br />,.. ' .:; i: soPa . - `: ;. ~ ,,r: <br />SOLIDS, s~TTf,E4BLe SAMPLE #aa#G# #o#PO# otp10041# ~ ash ~. - <br /> MEASUREMENT -~ <br />OS4S 1 ~ Q 0 PERMIT.::-' #,:PP#Yr <br />~ oapoPO #C+ Roosl~# RE PORT RB.PDRT NCL! . i u~t <br />~ <br />~ <br />~ <br />EFFLUENT ~OS:> rAL'Jf <br />REQUIREMENT <br />ytp0# <br />D <br />:`~?;. <br />~ <br />IR~Y, TOT$I1 SAMPLE X:',-0#;,# ~: a~:str ####GO ( 1q) <br />(A$ J!1r~ MEASUREM T <br />'1045 1 0 O P~RM ,"F:t£aAlr7$ >(~okr7# ~~ PYJIPO4P 3.5 ~~0 NQE/ >RAB <br />•FF'LUENT GR09S YALU iRE4~:~ -~ YP;a 0 Yt' <br />IL AYD GiIEASE SAMPLE :k#a#r~a T-aa>k>zal #40#3# ( 19~ <br /> MEASUREMENT <br />35U2 1 O D `.';p ;c PERMIT.: :::.#>Sk#i'I: +G<a#oalD o#x P#4>YP# RE FD.$.T I."~ ONTIN :$AS <br />GPFLUENT QiDSS YALU ''REQU.IREMENT: .. •"" ' <br />~.:.. .. :.:~.. <br />... <br />OPd <br />~ ~ <br />:.. D ;... ~~ <br />.- <br />•LOii, IN IRDSDDIT DR SAMPLE ~ Oj~ ',!#Atr## otpaloo# #saoa~ <br />I'NkU TH$A?H$NT PLAN MEASUREMENT <br />U05U 1 0 0 PERMIT.:: :. FtgpO.RT dEP(9RT PoP#C# oxFaatpa o44##P . #rt4 -LERLY .NSTAN <br />FFLU$YT 6YD95 YALU REQUIREMENT:: ~a®JI AYFi i?.A~L"~. iS 9lGD ~i##fi <br />.:o LIDS, TDT1L SAMPLE 3P dlati#Q a#OS/tP #>at?it#0 ( lg) <br />IS90LYED MEASUREMENT <br />/U2y5 1 U O PERMIT... ###LIPO ###R}# 4PC Poo#~~ REPORT REFDkT TRLY ;RAB <br />'FFLU$NT GRDSS YAL[l AEQIgRE9ilENT? P+63# ,., 8T@.>1Yi"i fIRTF. t4A;< NG L <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNpER PENKTY OF <br />AM FAMILIM WITH THE INFO UW THAT I HAVE PERSONKIY EXAMINED AND <br />RMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE <br />S-~a Je r <br />~ OBTNN NG THE INfORMATIONDII^pEUEVE ITHES BMITTEDEINFORMATION IIS <br />- . TRUE, ACCUMTE MD COMPLETE. 1 AM AWME THAT THERE ME <br />SIGNIFICANT PENKTIES FOR BUBMITTING FKSE INFORMATION <br />INCLUDING <br />l J <br />l <br /> , <br />SIBILI <br />F RN <br />MPN <br />EE tp <br />! 1 <br />T <br />O <br />ENT <br />D 70 . <br />. <br />/DI <br />-r~ <br />Lf a I / ~~ ~~ <br />(+ 001 M <br />HE POS <br />TY O <br />E M <br />I <br />SONM <br />. S <br />U.S.C. <br />J3 ONATURE OF PRINCIPAL EXECUTIVE / -1 <br /> U.S.C. ! 1]tp, IAwMW. ullir r5rr NIU1.. nrr IxAW ~.+. 4. ro (!0,000 <br />J TYPED OR PRINTED wlxnrx:.e.n Mlrirrtrnrlr of e.n..«len.ww. rNePrral OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO pqy <br />COMMENTS AND EXPLANATION OF ANY VIOLA nVN3 llTenrencs en ertscnmenrs nersl <br />SETTLElBLE SOLIDS LIFIT kPPLIES ONLY IF <=1DYR,24HR PRECIPITATION FYF.NT IS CLAItED. P£RNITTEE NAS <br />t1UHUEN OP DROOP .IHBA fiE;lUESTING RELIEF FROM SETTLEABLE SOLICS PAIMAAY LIt1ITATIOMS. <br />EPA Form 3320.1 108-95) Previous editions mey be used. (REPLACES EPA FORM Top WHICH MAY NOT BE USED.1 ~ 0I 1 S / 9 A C 2 2 3 -12 5 t; PAGE I OF <br />