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/ERMrtTEE NAMFJADDRESS pdi~lrYryN~Y/Gerrm VOUi..Y) <br />NAME BLUE. CIOUNTAIN ENF.RGYF INC. <br />ADDRESS DESF:RADO tiINE <br />jbU7 COUNTY ROAD b5 <br />RANGLY CO B164B <br />FAaLm <br />tocwTlDN <br />ATTN: JEFF UUBdERT <br />" Farm Approved. <br />NATIONAL POLLUTANT dSCNMOE EIIMINATIOM fyerfAl NPDESI OMB No. 20460004 <br />DISCHARGE MONITORING REPORT IDA~A) 'ISO H <br />(SU~SR GM) <br />PERMIT NUMBER DIld1AROFNUMeD1 F - FINAL HBLAN <br />RA-2 LOADOUt TO RED MASR <br />MONITORING PERIOD <br />D Y M D Y a4# NO D~dARGE ~~~ ~`#'~ <br />FROM TO ' <br />NOTE: Reed etlar before eompMtlnp thM loan. <br />PARAMETER <br />VISUAL <br />tl1Ubo 1 ) U <br />~FFLUERT GccG~S VALU <br />QUANTITY OR LOADING <br />AVERAGE MAXIMUM U <br />E5=1 <br />~ ,'}s,~ N0=0 <br />' t";.~ak ynbr~ <br />J... : '~ ' .~ :'.r.. p...~ 5..,. <br />QUALITY OR CONCEN~TION <br />MINIMUM AVERAGE MAXIMUM <br />NO. NIFOUENCY SAMPLE <br />OF <br />UNITS EX µKY4e TYPE <br />p>a+r:a <br /> REOIIIREMENi z <br />` <br />' ~' "', ~$ <br /> :-z ~ 4n x2§' <br />. a .. ~~>. _ ;; <br /> SAMPLE <br /> MEASUREMENT <br /> "'PERMIT. ." t <br />~ _ .s." ., <br />` ;•~- ~..~,„e <br />~ <br />i ,1. <br /> pEOUIREMENT - `=-s ~ . " ~ :~~ ; :~ <br />,~ <br /> „ <br /> SAMPLE <br /> MEASUREMENT <br /> aw;< <br />E'~~ <br />" i <br />' <br />~ <br />~ ` ` <br /> RE,OUIREMENT a ...,~s.'*~ °x :`'~ I <br />., ~ <br />, <br />I <br />~ s9~ ~ <br />g, <br />~` ,. <br />eI".."°° <br /> SAMPLE <br /> MEASUREMENT <br /> :"PERMIT ~; ;,~ _ ? ' ' iA ~;F 1 .. ",L" .~ h. <br />~ _ <br />` <br /> REQUIREMENT 5 <br />~,. <br />i <br />&-rrA- <br />' ,~, : I „a :~ ` ~ c. w x ~. ; <br />, <br /> , <br />~ <br />a <br />, <br /> SAMPLE <br />NAMElTtTIE <br />v. - <br />TYPED OR <br />OFFICER .....,,I.,,.o,.~..,.I.~,.~~.....,...~.......no ...,~..,~,......... <br />vRwRa Ylr.r nr sllttlbw «nIPr.MYw a NavN.Yae .Im ..nl.Yl mr«a <br />le Mrt I{N NW e.e prranM PrYvYdl FYIIwr YM t.YtYYIe IM In(YrwtlYY <br />l4wNled. {YN s InT IIhY1rT a(IM Fnf«I «Mlb« .M IIY..Ff Yr gf1.R <br />« Ihe« pNSn grF[rl( reFYtll1. (w {YUYNq ue I.fYRIlYr1r4 IhY Inr«nIY11YY <br />v{M{b b, u the {sI NnT YYewYe~. YN MYN, Im, YRV nIY, YYe tYln,41e. <br />I .r...n IMI Ihln .R V(Illnclnl MIINII« IO. NITIItlnL Mr InIMwYtlM. <br />IIItl11Nlr, the p.rhIY1T r n« YM IYI,rhYYYleYI r«.In.InF Hal.uen. <br />f10NA711RE OF MINCMAL EXECU7rVE <br />OFFICER OR AVFNORQED AOEMT <br />TELEPHONE I DATE <br />1r. G7S~7t~s2 a /~ I~ <br />Sni NUMBER YEAR MO OAY <br />TJS ~- TOTAL IRON LIMITS MILL BE MAIMED, AND SETTLEABLE soLiDS Llnir AreLl,u rule ~=lvin,~wnn. rnacir e{cR~- <br />SEt 1.A.1, PG V, FOR REQUiREHF.NTS. OIL E GREASE P.EPORTING-SEE I.B.1.F, PG VIZ. QRTRLY SARPLING <br />r cmu rrmrnuc i C h O(' vi <br />oA Form 33261 (Rev. 3/99) Previous editions may he used. OO ,-1 B ~ ~~QI~~ PACE QF <br />r <br />a~ <br />FI <br />;~ <br />