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PERMITTEE NAME/ADDRESS (Include Faoilip~ Name/Lomrion fDiJferenr)
<br />NAME Sk;NECA CCAL CCtFANY
<br />ADDRESSDRAMEA D
<br />NAYDEY CO tl1639
<br />FACWTY
<br />LocATIONItAlDEN CO b1E30
<br />ATTN: G. UGD FiROYA, GE9EHAL NAiAGEA
<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPOESJ
<br />DISCHARGE MONI70RING.REPORT (DMR~9j
<br />cnonoL721 m.->. C .t A
<br />PERMIT NUMBER '+ iJ... DISCHARGE NUMBER
<br />~;., MONITORING PERIOD
<br />YEAR. HMO... ,.,DAY YEAR MO DAY
<br />FROM V U ?~~~ ~?, U 1 TO U U U ~ .7 1
<br />ROaU l2~3fa (24-25) (2&2r1 (26291 (30~3t)
<br />Form Approved. «I ~.
<br />r I N o H oMR No. zoao-d6oa
<br />ADproval expires 05-31-98
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<br />NOTjFieed Instructions befo .completing this form.
<br /> f3 Card Ony) QUANTITY OR LOADING = (4 Certl Onry) QUANTITY OR CONCENTRATION : : ,s:~ ~
<br />~ NO. FREOUENC SAMPLE
<br />PARAMETER (46-53) (54-67) (38-05) (46-53) (54-61) EX OF TYPE
<br />(32-37)
<br />AVERAGE
<br />MAXI
<br />UNITS
<br />MINIMUM
<br />AVERAGE
<br />MAXIMUM ~ ~ • ~
<br />iY UNITS
<br />6863 ANALYSIS
<br />(64-6e)
<br />69-70
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<br />PN SAMPLE :'r7.4:v tlAAOS.t~ LQ09~C ~ ~'~`.
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<br /> MEASUREMENT
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<br />PERMIT. 9~AAfi.A >pcsaaa s >caA ,.. ~
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<br />EFFLUENT GA05S YALUE REQUIREMENT ;tt,>Ft.,>~ FIXN3F 4, ~*I~[t$11 ' SU ~ ~BM1I1
<br />SOLI D5, TOTAL SAMPLE °~"%''`~'' ";~'~'~'~ ~ P aoosso ( I5} :'
<br />SUSPENDED MEASUREMENT
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<br />OU530 1 0 D
<br />PERMIT
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<br />EFFLUENT GROSS YALUf 'REQUIREMENT ;q0:r ~
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<br />SULIDS, SETTLEAOLf; SAMPLE '~'~''0"''~ '~Oa°~" sasa>oa
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<br /> MEASUREMENT .'
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<br />PERMIT AAA9m>rY AA>OALPO tl tA>?
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<br />EFFLUENT CROSS YALUF REQUIREMENT tL's:r7l
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<br />laoN, rorAL SAMPLE "~'w~~~^ r,~gr,.r,~r~>,Y 70071Ai i ]:)
<br />(AS FE) MEASUREMENT
<br />OlUY7 1 U 0 PERMIT 4;iAAA~ $A;Atii >< ;3:: 4>4A>V - "}c '?`'~ (}i0 > ~11f ,
<br />EFPLUit~T GROSS YALUE REQUIREMENT ;~^7 ~~+~y, ~~ ){] t,G/I
<br />ULL AND GREASE SAMPLE 'J~~'x"}" "}4At't, 079A>~~. ^~~ 4AOAA. ( 15)
<br /> MEASUREMENT ~~'; T;. _
<br />0350E 1 0 0 C-'PERMIT - AAAAOA A616 A+FA ; {A;F OAOt0i~4 '~
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<br />EFELUP.tiT GROSS VALUE '.REOUIREMENT X•:OY~ ' " '
<br />F`LOY, IN COYDUIT 06 SAMPLE I 03) GCTi900 ,iA#AAA Osa+i;x
<br />TARO TBEATNf EIT PLA A7 MEASUREMENT
<br />5CU5C I U 0 PERMIT: REl;t1i3T FEFOBT saoaa
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<br />EFFLUENT GROSS 4ALUE REQUIREMENT ' ~Q}}j' j~P, Q/jjS GI PGU "~ '
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<br />SOLIDS, TOTAL SAMPLE CLOVax: aa;'xrs;' A%'JF~+L
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<br />UISSOLYED MEASUREMENT ';;
<br />%OLYS I U 0 'PERMIT ~ . li+~'!r~1i!# 4T0170A9A ~ S+# AiA>•07 OJi=iG~JfL `, . N,IEJiClt ~ TI1L]•' 'fAH+'
<br />EFfLUETIT GAUSS rALUE REOUIREMEN~T= '. :.~~' ~ ;~;'t• ~" {0~1) ]~fi, Dj~~3
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<br />NAMEJTITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED AND
<br />AM FAMILIAR Wm
<br />THE INFORMATION SUBMITTED HEREIN
<br />AND BASED ON MY / TELEPHONE DATE
<br /> 1
<br />.
<br /> INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />
<br />THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE, ~
<br />~
<br /> ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICAM
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<br /> POSSIBILITY OF FINE ANO IMPRISONMENT. SEE to U.S.C. § 1001 AND 33 U.S C. SIGNATURE OF PRINCIPAL EXECUTIVE L
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<br /> § 1919. (Penetties under these statures may inclutle litres up b E10,000 end a OFFICER OR AUTHORIZED AGENT
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<br />TYPED OR PRINTED mavmum rmpdspnmenr of beMeenBmpmhs and5yaars.) pE NUMBER. YEAR MO DAY
<br />GOMMtN 1 S ANU tXPLANA I TUN UH ANY VIOLA I ION5 (Hete2nCB 811 attaCTlmen[5 T1eTe) r -
<br />T:,S b IKON LIl7IT5 YILI A£ YALVED S SETTLEA9L€ SCLJCS LIPIIT 1PRJit:JED FCi <=l0YR,2uhE FFEC]F •E1J)'i7i 755 E
<br />IRON LIt1IT5 YIIYED ECfi ~lOTA,24HA PAECIP EYENT SUEJECT 7C BUJI~I~,M OF FFOCF LN I.A.i. CIL J3 Gf'EASE-- SEE
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<br />EPA Form 3320-1 (0&95) Previous editions may not be used (REPLACES EPA FORM •T-40 WHICH MAY.NOTJBE~USED.) PAGE ' OF:
<br />r.:, - m . _ 991501 99 G f 17 1f33 .{~ ), ~,; _
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