Laserfiche WebLink
PERMITTEE NAME/ADDRESS O.aJ. FrWry.vw'l,ecnren r/Dlplwq - --~ -- <br />-~ NAME - 'YQit11B~{YIRY eoAL coePAYY ~-~----- ,- <br />ADDRESS ROADSIDE CIINF, K G S PORTALS <br />P.O. BOY 1436 <br />PALISADE CO d1S2b <br />FACILITY <br />LOCATION <br />aTTd: JUHN A• ACHk9. i•N i•:S Tft F.NT <br />~ PERMIT NUMBER ~ ~ DIBCHNIGE NUMBER I <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM _OI TO _Q,I 09 7TJ <br />/70.911 l17-731 171-151 176-771 178-791 !36311 <br />-_. ___ 4rF~gT APDroved. _. _ - <br />~$ -1-~--.~~Q L,Q~L 2040-000F _T~ <br />~saeR oc) e71~iE-e~ocr3,=s, <br />F - fINAL L 4 <br />MIUOR 1'7 <br />_ ~,~~ <br />rr: NO DISCHARGE ~#+ I~" <br />NOTE: Aeed Imtnlctiau bdon d-it Ietlnp this form. <br />PARAMETER la 6rd omp -QUANUTY OR LOADING !~ r,Fd only! QUANTITY OR CONCENTRATION NO FREOUENCV SAMPLE <br /> 146-531 I5I-511 !3815 I46-531 I545f1 - ~ ~ GF ~' <br />I37-371 EX <br />ANALYSIS TV <br />E <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS IQl.6s1 1y1-681 169-701 <br />i'tt SAMPLE 3F0##3 ###### irC##3# ( 12) <br /> MEASUREMENT <br />:U4U0 1 U U PERMIT ?: ;`$:C#TfL` .4]k#OOLI <br />' ### 6•'$. #0300.$ 9eU. ESKE! i1SITU <br />FFLUENT GROSS '~ALU~ REQUIREMENT :.: :: .: 0030 ..~ ~N. ~ . :~+.1 .. <br />~JL1GS, t0?AL SAMPLE #0#OL3 OC00## IROtC### t 19) rt <br />.. U J Y }: is it ;; J MEASUREMENT ~ ~ ; <br />US3U 1 U U PERMI;~f:".: ~`~~itF# <br />" 3~~!1f~4;11~. <br />: 000 ;~A#tO <br />C 5...' .:. .i 7~ <br />. <br />: ~e~~ ; <br />i~ <br />nFf'yUEdt GFt03S ':RLU/ .REQUIREMENT: . . <br />, <br />r:. <br />.:. ~ ~~# .. •- . <br />. . ., <br />SOLID:,, :i£TTLEAdL:. SAMPLE 3~x~3?0 a300#0 000000 ( 25) <br /> MEASUREMENT <br />0545 i 0 O P.R.IT ##r00# 3>fr004# ##s 00~l000 REPORT RBtbeT 1iC£/ :RxB <br />dPPLUEN't 17 :."SS YALUE REQUig~MENT ¢~# O . ~ <br />INUY, TOTAL SAMPLE ':::O=.;Y YOkO## 0310#: ( 19) <br />(AS FE.) MEASUREMENT <br />lU4S 1 U 0 ' :PE.RMIT ys#303Y ##0#Ip~ CJ~ R03#3.# j,5 jrU MCEf iRAH <br />'FFLUENT GP.OSS YALU :fiEnu~FiEMENT ;,;,:..: 0#0# ~ <br />AIL AND G$EASE SAMPLE #00##0 0+t¢II4 #3#=kOL ( 19) <br /> MEASUREMENT <br />3081 1 0 0 :~ .PERMIT.. ~~~. AT4?OrO:#~!...: :: ~.::.~~POOdiO ~ 0## RO~YI100 ~ RB PQ flT ~. 1D ~ ( ON'i'I:1 :RAH <br />iiFFLUEY? GROSS YALU REQUIREMENT OOCO ~ <br />'LUJ, IN COYDIiIt U8 SAMPLE ( 0;) OA##30 ####00 A4#000 <br />THRU 't HEA?BENT PLAN MEASUREMENT <br />U:/SU 1 0 U PERMIT RRPUHT I'CEPOR:! ~tLc#### ##t`Yat44i: 00+{`IF## ### EEKLY .NS?AN <br />cFPLIJENT GROSS vALU REQUIREMENT 3UDA AYG DAIL=. ex eGD 0#03 <br />~ULjDS, TOTAL SAMPLE T3##3: ##00## 0#4a#r ( 19) <br />Ls50 LY ED ' MEASUREMENT <br />/Gi~S 1 0 U PERMIT a:x~,Le## .. a##QI## ##a ~~.s00a REDaaT Rz~aR? TRLX 'RAB <br />.FFLUENT 6ROSG VALUE gEQIpREMENT ##4# RT$ AYG RTF l4AS HC/L <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I cERn FV UNDER PENALTY of Lww THAT 1 HAVE PERSONUiY ExAMiNED AND TELEPHONE DATE <br /> AM FA MILIAR NATH THE INFORMATION BUBMITTED HEREIN; AND BASED ON <br /> <br />~-' ~I ~ V ~ MY INOUIIIY OF THOSE INDIVIOVALB IMMEDIATELY gEBPON5IBLE FOR <br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IB _ <br />_ ._ <br /> TRUE, ACCURATE AND COMRETE. I AM AWA11E THAT THERE AAE <br />SIGNIFICANT PENALTIES FOP 9UBMITTIMG FALSE INFORMATION, INCLWING <br />r <br />~ D ~ ~ <br />5 I <br /> <br />(J' <br /> <br />/() <br /> <br />UJ <br />C ~ r THE POSSIBILITY OF RME AND IMPWSONMENT. SEE 18 V.S.C. 1 1001 AND ]] NATURE OF PRINCIPAL EXECUTNE / <br />J U.S.C. i 1]le. lFYIYIOi/ UM•I eM/A MArh. mrY kICArI1 Fibs W ro t IO,ODp AREA <br />TYPED OR PRINTED r/•rmut~m.n:mor:.>++.nrWhnv«nemendrsdey..ra/ OFFlCER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV <br />z~ <br />'~ t <br />COMMENTS AND EXPLANAI IUN uH ANY VIULA I Iun3 1ne7erence an ef(ecnmenrs nne/ <br />SI:'tTLBABLE SOLIDS LIeIT APPLIES ONLY IP ~lUYR,24HR PRECIPI?ATIONS £VEN? IS CLARE-. PERHI?TEE HAS <br />dURDEY OF PRUOF YF!EN REQUESTING RELIC"F FROtI SET?LEABLF. SOLIDS PRI!!ARY LIt1ITATIOt•5. <br />EPA Form 3320.1 108-951 Previous ediUone mey be used. (REPLACES EPA FORM T-0O WHICH MAY NOT BE USED.) 0 07 5 5 / 9 9 C 2 2 3 -125 b PAGE I OF <br />