HYDRO26952

• Permit No: C1981010
• IBM Index Class Name: Hydrology
• Doc Date: 4/11/1998
• Doc Name: COLO CDPS WET TEST REPORT FORM ACUTE
• Permit Index Doc Type: NPDES
• Media Type: D
• Archive: No

PERMITTEE NAME/ADDRESS O+dwI. FSWryHaWlormen!/Dlpw..q
NAME TRA~YER "1 '. ',~t,, ,;'C.
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uAnDNOISCHARCE MONITORNiO REPORT %DAIR/POES1
12-16I 17-191
CQOd32115 C C A
PERMIT NUMBER DISCHIWOE NUMBER
MONITORING PERIOD
YEAR MO DAY YEAR MO DAV
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(2621/ /22-231 12~-251 (26271 /29-29/ (36311
Form Approved.
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NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY Of LAW TNAT I HAVE PERSONALLY EXAMINED AND
AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN: AND BASED ON TELEPHONE DATE
MY INQUIRY OF TNOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR / /) ~/~' '~

Ii• Gordon P~tere OBTAINING 711E INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS
TRUE, ACCURATE AND COMPLETE. I AM AWARE THAT THERE ME ~~
`•,`/ L f/j
970-824-4401
98
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SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INF011MATION
INCLIANlG
President Jcenaral Mena 8r ,
THE PoSSIBIUTY OF FINE AND IMPRISONMENT. SEE to U.S.C. E 1001 AND»
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TYPED OR PRINTED .ndwmu:+R.nhWAerve.eeWMrwwn tmonM.rW 6 yAral OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV
COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRefer~nca all atrschmanrs here)
~i =iJ & 1'OT;.L I~.01. LIRE:: ~1LL br. WAITED, ANJ :i E'!'TLEAEL° SQL ICS I1~I° lFILIFD FCk <=I ^, '/F., 249P YR P.CI I' "Vf.l:T-
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EPA Fpm 3320.1 (08.951 Previous editions mey be used. (REPLACES EPA FORM T-40 WHICH MAY NO BE USED.) U n r n ~ / 9 ~ 1 Z 11 ~ 164 !~ PAGE ; OF
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