Laserfiche WebLink
PERMITTEE NAME/ADDRESS (Include FaeiGry Name/Location iJDgTerent) <br />NAME SYNECA CGAL CClFAFY <br />ADDRESSDRAYBR D <br />HAYDEN C0 81b39 <br />FACILITY <br />LOCATIONIAY.D EN !1630 <br />A'LTN; G. 8UD BflOYN, CFMS$A)E'•A$!R <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDE3) <br />DISCHARGE MONITORING REPORT (DMR; <br />(YJ61 (Ir- B) <br />C4©L'G(:21 G 1 ~ <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR .' M DAY. .:~ ~ YEAR MO DAY <br />)M V u .Y~ TO U U~ U] .] 1 <br />(4(F2t) (2Z ?3)' (Ya~~ (26-2r) (29Y9) (3031) <br />Form Approved rt ~ <br />1! i N G fl OMB No. 2040-0004 <br />(S U D 8 N i) APProval expires 05-31-98 <br />- F111l1 FCU7T <br />SED. PC~C DSCGIi 2C G6ASSY CFTC. <br />w~. YC CI~CHAFGE (~ ~~_ <br />NOTE: Read Instructions before completing this form: <br /> (3 Card Only) QUANTITY OR LOADING ~_~ fs Card Only) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (Sa-st) (3a-es) (46-53) (5~-st EX of TYPE <br />(32)7) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />sz 63) aNALYSIs <br />(64-sB) <br />697 <br /> n ( <br />U L AYU Gtlt;ASC SAMPLE "r ~'':~~ 1 9t1) a+Pgig4 ~ 9ti0049 [:9h~v '-7Y ~/ <br />~ <br />Y I SU Al. MEASUREMENT ( <br />t34Ubb 1 U 1 PERMIT' Yit>EY34 <br />~' ~ <br />~ FS 1 _ r4 w t„ <br />~ <br />~~'• ~"~'~'~" : Oi>oili A iu+C f IICF/ " DAL <br /> <br />EPPLOEYT GROSS YALUk <br />.REOUIRENIENT <br />I$~ ,` ~. ~ <br />IC U <br />~ '°~ ° <br />s, ~~ <br />~ s z - LAOC 6C~N.2t <br /> SAMPLE <br /> MEASUREMENT _ <br /> . .,PERMIT ~ - - ,,2 - - ~.'~~'= , <br />' ~ Gr :n, p <br />~ <br />v <br />'v5lt <br />Y <br />` - <br />- <br /> ;REQUIREMENT - Se rk <br />' . <br />- <br />~+ <br />e <br />'- <br />' <br /> -. <br />r+ <br />Vii. <br /> SAMPLE <br /> MEASUREMENT - <br /> <br />- x. ; <br />'~ e{b <br />~` <br />`~ <br />~ <br />~~ <br />'~ <br />' <br /> -REOU REMENT - ~ cu"' <br />'~-f:.>, '._' <br />-'r <br />; <br />'N ~feV: ? <br />" <br /> SAMPLE <br /> MEASUREMENT <br /> `°PERMIT'-; <br />"- - - - <br /> <br />~ <br />$t <br />~ <br />~ <br />. <br />.t <br />f r <br />~ <br /> <br />~ <br />~ ~. <br /> . <br />`REOUIREMENY - - - x ; . F9 :.G <br />,3c ~ _' i <br />t , <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - <br />' ~ <br />" "3" ~ <br />T~ <br />~ ' <br />~ <br /> REQUIREMENT " - jy <br />' ~ <br />°~~ <br />- <br />'~ <br />•" - ..y <br />F <br /> . ,:rx: ., <br />, <br />, <br />t . _ <br /> SAMPLE <br /> MEASUREMENT <br /> • - 4 *,~ <br /> <br />- <br />, ~:. <br />, <br /> <br />.: fit;, <br /> >REQUIREMENT ~ , ,,.. .. - -. ° -. <br />3x;'Kk` <br />i - - - ~ -, ,, <br />g ;.. <br /> n. t ri <br />. , <br /> SAMPLE <br /> MEASUREMENT <br /> ." PERMIT- i <br />~ ~:~..~ y ~7' .'a' <br /> 'REOI'IIREMENT - <br />: <br />~ ~ : ' <br />' <br />~ <br /> , . { _ , <br />; az ,_ <br />- <br />NAME?ITLE PRINCIPAL IXECUTNE OFFICER I CERTI FY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY E%AMINED AND : ~: TELEPHONE <br />- DATE <br /> AM FAMILIAR WITH THE INFORM ATION SUBMITTED HEREIN; AND BASED ON MY ' <br /> INOUIRV OF THOSE INDIVIDUAL S IMMEDIATELY RESPONSIBLE FOR OBTAINING ~ ~" <br /> THE INFORMATION. I BELIEV E THE SUBMITTED INFORMATION IS TRUE. <br /> ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT _ ` ` ~ <br /> PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE ~ <br />v <br />' ~~ <br /> POSSIBILITY OF FINE AND IMPRISONMEM. SEE 1B U.S.C. § 1001 AND 33 U.S.C. SIGNATURE OF PRINC AL E%ECUTIVE J <br />L J <br /> 4 t319 IPerelUes under These sfalufes may include Imes up to St0,000 entl or OFFICER OR ALIT GRIZED AGENT <br />7 A <br />NUMBER <br />YEAR <br />MO <br />DA <br />TYPED OR PRINTED menmum impdsanment of heMeen6monlhs end5yeers.) <br />COMMENTS AND EXPLANATION OF ANY VIOLA I TUNS (Helerence all eaecnments Here) <br />P5~ G iN(JN LIMITS 11I1i 8E YAIYEC AND SETTLEAPLE SCADS LICKS APPLIEL F A <=lUYB,"s4Y6 FFECIF E>fE~2; 255 r; <br />I~+ON LI11IT5 YaIYED ECF ~l0Yfl,24i1R pRECIP E9EYT SUtJEC2 TC dUNDEM QE QfiCCF IN I.A.e. Glt E G6EASE-O_EF <br />EPA Form 33261 (OS-95) Previous editions may not be used. (REPLACES EPA. FORM T=40 WNICW MAY NOT BE USED.) C 012 7/ 9 S C 6 s" 7 ~~ '~'` PAGE 1 OF <br />• r ..e+.~r.~ 'Fti'rsi_.N.a:.:.i~~~"~"`k i1"A'rt` t ~c . <br />