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PERMITTEE NAME/ADDRESS (Includ¢ FaciGry• NOTP//-pCOIIOn ifDi$erem) <br />NAME SEYECA CLAL CCC'FAhY <br />ADDRESSU ii6Y E:h U <br />HAYDEY CO 81639 <br />FACILITY <br />LOCATIONAAYDEN CO B16jU <br />ATTN: G. BUD HRUYN~ GE4E8.AL dANAGEF <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOES) <br />DISCHARGE MONITORING REPORT (OMR; <br />(2-tfi) ~ (l)~ 9) <br />COOOGC2~7 0 2 A <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR' L;MO DAY ; ~' YEAR MO DAY <br />FROM U Y ~I, UJd'' TO U U U~ 1 1 <br />l2021J' ~;l;! 2Z31. IPd~25) l26~21) (2829) (JO-3p <br />Form Approved ~ #~ <br />ri I N 0 F OMB No. 2040-0004 <br />Approval expires 05-3 f -98 <br />(SUBH MN) <br />F - EIN,1[ BC~f91 <br />CISCHAE6E TC SAGE CbEEA <br />amp NC [I;CHAEGE )~j aot <br />NOTE: Read Instructions befon, ompleting this form. <br /> (3 Card Onry) QUANTITY OR LOADING 14 Cerd Onry) QUANTITY OR CONCENTRATION :NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-61) (38-45) (46 53) (54-61) EX ' OF TYPE <br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />lfizca) ANALYSIS <br />!sa-se) <br />69-70 <br />PH SAMPLE YD{t4u9 ~7S O+F7 :J %7aG .'a ( Ii) <br /> MEASUREMENT <br />UU4U0 1 D U PERMIT' aaIIao~v °'~~'~'~' tAA ""-( # ~ 9 <br />rt C YCE! YSIYU <br />EFPLUENS GNO55 VALUE FiEOUIREMENT <:- ;~>~ ..> ~t - <br />~~~j,~~E SC RCY7E <br />SOLiUSr TOTAL SAMPLE 'r''~"'O1` '~IP''~~~ ~'F y}MA079 <br />': ( ]5) <br />SU~PENUED MEASUREMENT _g _ <br />00530 1 0 0 <br />PERMIT a o4a ~ vasaoa~ ; xr>C <br />~ ,orA ~ ' ; <br />~'y ~ <br />... ~. •CE! ;FAE <br />EFFLUE'eT Gh055 YALU! REQUIREMENT 4tA;: "~ <br />j r{~ j)~j <br />jr~ ;~j }SG/( IICY'lY <br /> fi <br />, ~ , <br />, <br />SOL]U5, SETTLEA6IE SAMPLE -r"'T"'- 'rCa~'";' ~'~~ ~~' 1 I-) <br /> MEASUREMENT <br />UOS45 1 U 0 =PERMIT ', A4vra a+s Y^rf { ~ - t <br />F~, :. i <br />- <br />S <br />Y <br />~- ~ iir1E <br />F:FFLGE.IT GRO.°i5 YAL[rE •REOUIREMENT ~ ~~%~~' ' <br />'~~'~ ~ r <br />V <br />;q,]l~~; dL/1 ; , <br />~~~.~ <br />~~~ <br />, <br />yy~ <br />1Mi~'~]f ' <br /> ,, <br />laON, TOTAL SAMPLE ova^:a a:ccr:o aa+coca ( ]5). <br />(AS PB) MEASUREMENT <br /> <br />O104S 1 O 0 .-:'PERMIT ~ <br />smpsl~ <br />+va~aa x <br />yraa <br />as n • ~ ~ 64Q Iv ~q <br />;~ <br />': }~ <br />r <br />~ii~~~ ijLB <br />CFFLUEItT GHO55 YALLE FiEOUI,RElu1ENi ~ ttrl>z 3GDF.~!EC ; <br />~ <br />biI$>r}~:; N4/I I' R~C~T# -' <br />UIL AND GbEASE SAMPLE IOIDO*a al+7 4Cti#+:n COL~~D :S A~.Ano9 ( ]9~ <br /> MEASUREMENT <br />U JSF31 1 0 U ''PERMIT ~. , 'ii A4~t1P ~ QgR9A0~ k YA.`. 9+Di 900 - jti!'Yr4A~-:-, I ~ jar I+.~~.- <br />EF'FLUERT GRJ55 YALUE REQUO7EMENT -; i>r;o r ~~8''#:NA; H6/1 ~ <br /> _ _ . <br />. l <br />FLOM. IM CONAUIT 06 SAMPLE 1 03) ~~yrn~n aaa~aa» n>oASCw <br />THRU TREAT17EN7 PLA NI MEASUREMENT <br />SOU$U 1 U U ::.:PERMIT - '*~~~ <br />~ <br />~ piFQB Y4s4 ~ 491444 >dgyCx A L>OC j~~jj TtlfTt <br />EPPLUENT GHUSS fiALUE 'REQUIREMENT ~ <br />i <br />;~~~~'b~~' 8,/Gji;t EI1 EfC ~ Oi90 or <br />SGLIDS, SOTAL SAMPLE v~aa4a ~~~''~~'~ aaa a ( ] ) <br />UISSOLYED MEASUREMENT <br />7U1HS 1 U U ;,PERMIT ~Y+II'lIi±RV <br />~ i!4 V i <br />'~ '~A1: 41N4A44 <br />~" (} EtF1: <br />~ AE.f~b1 ! " <br />~` i!i'.8 <br />EFfLUEYT GRU55 YALUb REOUIREME~JT t <br />- <br />;~ xna.~ ,~~~ <br />, ~pFjjT ht. !!G/I r <br /> ; <br />, <br />- ~ .rz , _ <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED AND <br />AM FAMILIAR Wml THE INFORMATION SUBMITTED HEREIN <br />AND BASED ON MY \ <br />\ TELEPHONE '. DATE <br /> ; <br />_ <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING \ <br /> THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE, ' <br /> <br />ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT <br />PEN <br />T <br />E <br />F 1 <br />^ <br /> <br />' <br />1 <br />L <br /> <br />AL <br />I <br />OR SUBMITTING FALSE INFORMATION. INCWDING THE <br />S <br />~- <br />O ~~ <br /> POSSIBILITY OF FINE AND IMPRISONMENT. SEE 1B U.S.C. § 1001 AND 33 U.S.C. $IGNATURE OF PRIN PAL EXECUTIVE <br /> ude lines up ro 410,000 and pr <br />m <br />y <br />m~ <br />nnsr <br />~ <br />m O <br />GENT <br />TYPED OR PRINTED mu <br />a <br />m <br />pnmento mouse <br />~hs ~d5 <br />6 <br />P Yaers.l RIZED A <br />OFFICER Ofl ALIT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerence ell attachments here) ~ <br />T55 F: IKON LItlITS N11I GF. aAIeED 6 SETTLEABLE SULlLS LIE1iT A~pIIEC Y06 C=IOYR,24EF EfECIb F1EY7I !SS E <br />IRON LiElITS LAI'rED tC.F ~lUYH,24Hp PRECIP E9EYT SIIEJECi TQ &{1BDFY OE F6CCF TN I.A.2. CII G 6.EEA.E SEE <br /> <br />'A Form 3320.1 (0$-95) Previous editions may notbe used. (REPLACES EPA FOR~ {!M~~T~~ -''40 WH(rCHOT BE. U$ED,), QQ j38~ 99 Q ~ ~ ] - j 6.4 3` ~ ~~ yPyA~GE ~ ~. OF <br />_a_a. .-. ~. J.. n _-. .. _ ~. - - _. .- .. s _ ... ..-r -._tiSYnv'~~~HiS~.? ~ -.. .-.. ...~ ~- ..~.. .._. ..le ~.., n~Lli~'-`ii"u: ~ ~ iZ:td.i :.-~ <br />