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PERMITTEE NAME/ADDRESS(IMi4.fw~Wry Nsu/Loranon t/DlBfrnnO
<br />NAME C1L'Jfii'CJ •. .."n ,, .. L ~~`~~. ~'i
<br />ADDRESS 'h I ti = ~` • t • ~
<br />OAK Cr •. CO 55~,/
<br />FAaI-m
<br />LOCATION
<br />NATIONAL POLLUTMT DISCNMGE ELIMINATION SYSTEM (NPDE$l
<br />DISCHARGE MONITORING REPORT IOMR)
<br />2-16'1 17-191
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<br />PERMIT NUMBER DISCNMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAV
<br />FROM i' U~t 1 TO ! 9 UO J U
<br />/IQ211 /11-031 U6251 tl67J1 /28-291 /30-311
<br />Form Approved.
<br />5 C. C I P .~.: ^_ ^. U 'r ^ F P OMB No: 2040-0004;_ L
<br />(, ~, ;, :i „.^) Approve expires 05-31-98
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<br />PARAMETER l3 Grd On/yl QUANTITY OR LOADING !I Grd Only) QUANTITY OR CONCENTRATION ' Np. FREDUENCr SAMPLE
<br /> !46531 !5461 l3B-451 !4653 154-611 EX ~ TYPE
<br />131-371 M
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<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS /42-e~1 /64681 !6&701
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<br />NAMERITLE PRINCIPAL EXECUTNE OFFICER I CERTI
<br />AM FM FY UNDER PENN.TY OF LAW TNAT I NAVE PERSONALLY E%AMINED MD
<br />tILIM WITN THE INFORMATON SUBMITTED HEREIN; MD BASED ON
<br />~ ' TELEPHONE DATE
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<br />
<br />Richard tiiills MY INQUIRY OF THOSE INDINDUN.S IMMEDIATELY RESPONSIBLE FOR
<br />OBTNNING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS
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<br />! TgUE, ACCUMTE MD COMPLETE. I AM AWME
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<br />INCLUDING
<br />SIGNIFICANT PENALTIES FOR SUBMITTING FN SE INFORMATION ~ / ~
<br />i1' .~. 9JO-8JO-2J1J J ZH 99
<br />:ianager
<br />cnvironme~tal , _
<br /> THE POSSIBILITY OF NNE MD IMPRISONMENT. SEE 1e U.S.C. 1 1001 MD S3 gIONATURE OF PRINCIPAL EXECUTNE
<br /> U.S.C. 1 1010. lMWrir•=eww N..r man, m.y YCh.N fvws ~ ro S/0,000 AREA
<br />TYPED OR PRINTED ws~nn..irunl t+:MswNw:=orbMwnemantln rMeF.va/ OFFICER OR AUTHOR2ED AOENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IRelerence ell sttscnments Aerel
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<br />EPA Form 3320-1 108-951 Previous editions mey be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE U6ED.1 PAGE OF
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