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FERMliTEE NAMF/ADDRESS Q•abi FrYryNrr'larrlrr yDDl.wp <br />NAME <br />TMENTYNILS CO-L GONPAN7 <br />AooRESSNINES 1 6l SOUTR, E ECKNAN PK <br />29515 RCR t27 <br />FACILrtv OAK CREEK CO 80467 <br />LoaTION <br />OAK CREEK CO 80467 <br />PARAMETER <br />AVERAGE <br />IL AND GREASE <br />ISUAL <br />4066 1 0 0 <br />olaatxa;< <br />SAMPLE <br />SAMPLE <br />NATIONAL POILDTANT OIYCNMOE RIMIYATO~pt IYYTEM /NPDfSI <br />DISCHARGE MONITORING REPORT /DAIR/ <br />I SER DI o UMlDI <br />Farm Approved. <br />OME No. 2040000M1 <br />HAJOR <br />(SUER JC) <br />!~--~p]L ROUTT <br />ECKNAN POND A TO POIDEL CREP.R <br />FROM TO ppyy nn Tt~~~~((~~{{~I^^yyrrpp tt~~ ~~ <br />~ NOTE A•Yd IM6UttldAbga~ e~MtMp thb lam. <br />QUANTITY OR LOADING GUALI7X OR CONCENTRATION NO. FREOUENCr SAMPLE <br />OF <br />EX ,WKrya TYPE <br />~` MAXIMl7M UNITS MINIMUM AVERAGE MAXIMUM UHRS <br />9u) ~ • to•aa* ~ •aleaaa ~ asoasr <br />a <br /> <br />NAMERTTLE PRINCIPAL E <br />R<<h~~ <br />~--n Vi /{n /h~n'ft <br />. - - F..p.l.d.~wr r~ml..n <br />,~~ le•wrtrYN •eeYYW Oei <br />.nrltl.e. Yr.e ee mT n <br />er Ins pnr• dlncllr n <br />A h ~ v.Al11eA 15 M IM1e 6ul e <br />I .w...n 4.1 m.n.n <br />D Inaml.t Uw premy er <br />V~SvRI <br />u.I PN •onrrwl erm r.ll«Aru.N..n TELEPHONE DATE <br />«r,n.uo, <br />ie «uN•ne .11n e.nte. •vlplm <br />,l <br />rrl Pewd1 dIY« eb nWre IYr IerwwrUa• ` <br />Arr atu»,.Iyw «prm.ne •r•.p u. ml.w <br />.eYw t: plienq u. IefamrUa <br />u.Inbrw•Yon ~ <br />2 <br />/ <br />, <br />7 <br />7Q y10 <br />W <br />n <br />tl ^/ <br />r <br />rv <br />dp end MYef, rw. emnm.e <br />nr•,letr. <br />MINq <br />E7(ECUTI 4/ <br />-AL <br />VE <br />iYU•t F.Wtla far winrlrtlq hbr bfernreee. {IONATIINE OF <br /> <br />r eM Ir,rbeiur.n r« Yno.feY rMrlep OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />ON <br />ALTERNATE LI1lITS POR TSS 6 SE?TLEABLE SOLIDS (LOC '0') APPLY ONLY IP <= 10-YR, 24-HR PRECIP EYENT IS <br />CLAINED. SEE I.A.4, PG 8, POH BU$DEN OP PROOF RBQOIRENENTS. OIL E GREASE--SEE I.B.1.D, PG. 11• <br />EPA Form 3320-1 (Rev.3/99) Previous editions may 6e used, ,T h15 IS 3 O- art ~ORII. PAGE OF <br />,00005/011119-005 3 <br />