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PERMITTEE NAME/ADDRESS pne7ude Fanbp~ Name/Location iJDigerenq <br />NAME SENECA CCAL CC!!I~hY <br />ADDRESSD R.A Y E H D <br />NA1Dt11 CO 81G39 <br />FACILITY ~ ~ " <br />LOCATION) d f U E N ~ ~+-~.:+E`Q ~ 810 30 ~ FROM <br />ATI'N: G. bUD FAOYN, GENERAL aA!:AGEA <br />IAL POLLUTAM DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approvedy ~ °rl` <br />DISCHARGE MONITORING REPORT (OMR; OMB No. 2040-Ob04 <br />Q U Q (i 21 ~ L 14 A <br />~.~ <br />(306fl,..Ai) <br />~ Approval expires OS-31-98 <br />,~~~~, ~ <br />PERMIT NUMBER DISCHARGE NUMBER ~ ~ l~~J>L bC~Z <br />MONITORING PERIOD DISCM~.i~ E TC S A G k C F k E N <br />EAR ~MO DAY'" ~ YEAR MO DAY ~ ~ "~ <br />L V1 TO VV U1 ..71 Oi~b"~~~;, iC1ECHABFE ~ _~ Z~Y'` <br />Q-21J(!~(22-281 ~ (za 25) Rs vI rze~z9l (30~O1J NOTE: Read InsVuclions befo completing this form. <br /> (3 Cerd Ony) QUANTITY OR LOADING +. (4 Cerd Onty) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (46-53) (54-67) (38-45) (46-53) (54-81) ' EX' OF TYPE <br />(32-37) AVERAGE ~ MAXIMUM NITS MINIMUM AVERAGE MAXIMUM UNITS <br />f6zrnl ANALYSIS <br />/67-68) <br />69-70 <br />U NO {;HSASE SAMPLE "a'~~'A~ ( 9Y) YVY4Oq 9GOpAfi vCRLDO <br />r I S U A L MEASUREMENT <br />H4U6b 1 V 0 <br />'PERMIT '• " <br />`+~ <br />, '~^, ~ 7 15=1 <br />' laor,!t $ IF ~~o ''':,C #~[! ' lI9GAS <br />EFF-LU6NT GROSS fALUE RE~l71REMENT s <br />" ~ ~~~~}~ ~~` <br />`' lC=O +,ex ~ <br />; ~"_~~- CCZO !~~'~~~I; <br /> _ s "~; . <br /> SAMPLE ~" <br /> MEASUREMENT <br /> --~PERMITs--. - ~a - .,, ~ x <br />. r°4 ,~,.d-~ - - <br /> FiEQUIREMENT .a~ ~ <br />~,, ~a~ I'""i . <br /> SAMPLE ~~i~. <br /> MEASUREMENT <br />- <br /> -~-PERMIT- ~ "r "~.i"~»~-~•- <br />`~~` <br />' <br />~ ; ~" - <br /> REOUIREMENT - - ~ <br />~ <br />~ , +_z. ," - <br /> SAMPLE <br /> MEASUREMENT <br /> =PERMIT <br />' - <br />~ - ~ ?~ <br />:~ e N7 ~,il ~ ~ f r e,e <br />, ~ - I t' <br />- REQUIREMENT ' _ ~ a~ ~ r~ <br />°-, <br /> SAMPLE <br />" MEASUREMENT <br /> " ~ ~~ u <br />~~ '~ "~ ~" <br />~ Yr ~'' ~ r: <br />~~d ?;" ~'~ <br /> REQUIREMENT. <br />" ~ " - s ;» kn j <br />;, * * <br /> SAMPLE <br /> MEASUREMENT <br /> :; +~: <br />~ '+ ° : <br /> ~REOUIREMENT' . .:'' <br />, <br />~ . <br />~yu <br />x ~^ ~ T " i i '~r . <br /> , <br />;r r .e <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT s - ~"`:., <br />~` `~~ <br />~ ,.T''°q E •,~ ~ <br />~ -!-~ 'x <` - ~ -~;_- <br /> 'REQUIREMENT-~ _-. a> } ~ - " <br /> , <br />NAME?ITLE PRINCIPAL EXECUTIVE OFFICER I CERTI <br />AM FAM FY UNDER PENALTY OF <br />ILIAR WRH THE INFORM LAW THAT I HAVE PERSONALLY E%AMINED AND <br />ATION SUBMIT7ED HEREIN' AND BASED ON MV TELEPHONE " DATE <br /> <br /> INQUIRY OF THOSE INDIVIDUAL S IMMEDIATELY RESPON519LE FOR OBTAINING <br /> <br />THE INFORMATION, I BELIEV <br />E THE SUBMITTED INFORMATION IS TRUE, / <br /> ACCURATE AND COMPLETE. <br />PENALTIES FOR SUBMITTIN I AM AWARE THAT THERE ARE SIGNIFICANT <br />G FALSE INFORMATION <br />INCLUDING THE r ~~~} <br />N <br />I <br />/ '^~ r~ <br /> , <br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE 1B U.S C. 5 1001 AND 33 U.S.C. _ <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br />' V <br />V v u <br />TYPED OR PRINTED ) s up ro E10,000 end or <br />ar <br />~ <br />meximum~~onmenl of between 6monett en 5( OFFICER OR AUTNORIZED AGENT ~Rp NUMBER YEAR MO D Y <br /> y <br />. <br />y E <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re7erence a/7 attachments here) ~" <br />TSS :: IHON LIMITS MI11 UE rAIYEC E SETTLEAEiIZ SCL7C5 LIMIT APPLIED FOk <=l0YA,24EF FAHCIF E11EH7~ T55 G <br />IRON LIMITS YAIiEO FCb ~lUYA,24AB PAGCIP SPENT SUEJECT TO BUFDlN OF FSCCF IN I.A.e. CI1 L 6FlA.E - SEE <br />7-u_t-n TnC rAYTTf Cirr: I^1 c <br />EPA Form 3320-1 (OB-95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) CQ 163/ 940 8~?~i 6$.~;°.'" PAGE Z OF <br />.... ., <br />