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PERMITTEE NAME/ADDRESS (Include Faciliry NamdLOCarien ifD~erenr) <br />NAME <br />ADDRESS riAPPGF l:INIt:%, INC. <br />TeAFkk,4 lyIhE <br />P.G. L'~a 1"7 <br />FACILITY CI'AII+ CO d16tb <br />LOCATION <br />L S'T Il• •ICI'.PL iLRGiG CG GC"/P:. L' In f-b <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (OMR; <br />(2461 f1]- 9) <br />(. 4 ` <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING AERIOD <br />YEAR MO DAV YEAR MO DAY <br />FROM G O G 4 0 TO C E 3 C <br />(2021) (22171 (2<-?51 /26-117 (2619) (30411 <br />Form Approved. <br />OMB No. 2040-0004 <br />C I N C i; Approval expires OS-31-98 <br />(safe h~) <br />F - EIAlI CCF:.~ <br />IGtrC 6~ 1C CILLIF FYEA77 iLLLi <br />zC~ NL CISCNAFCF ~~[[ ##~ <br />NOTE: Read Instructions l9efo!e~T.ompleting this form. <br /> (3 Cerd Only) QUANTITY OR LOADING (4 Corti OnyJ QUANTITY OR CONCENTRATION N0. FREOUENC SAMPLE <br />PARAMETER (46-53) (5467) (36-457 (46-53) (54-61) EX OF TYPE <br />(3837) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />(621,71 ANaLr616 <br />(64661 <br />69-70 <br />N SAMPLE ~+#«Ih;- '~#;:.;:C #CC^'.' ( li) <br /> MEASUREMENT <br />(IIaUU 1 u L ;t~i~iT ,galtilrxial' oe#a4a :. :~r 8.5 aaca4aa 9.C $BlI,2Y rs~~Ia <br />EE'E'LUEd7 GhUSE YALLIE A6(7E11Rp1AENT Cap;: Ip 21 M I EE d'C. Ll <br />-.f.Ll UJ, iCTAL SAMPLE rAaOaO dir.## ##:;#C{: ( 75) <br />:~ tJ [+ P E f• D E L MEASUREMENT <br />UU:,.iU 1 u L ~' z; m'dtlaa+P." C## maaoa# * t1 <br />~~' t~/. ,fiAE. <br />fiFE'LUEG'i uPC55 YPLLC ~~~ ~ ~ ~ '`r <br />~ '-- tC4# '~G Atl6 I ~ CG I .i <br />`-i L:L1C5, SETTLE ABLE SAMPLE vC#14 <br />#S# :tC##X: K~~####' ( <<) <br /> MEASUREMENT <br />!~~U7 1 u U -'-PfBMIYF' _Raaa~#~ aa-10~0!a~. t ~ >oa>6c a TICAAI FEFCET ,~ <br />- 6A.E <br />LrF'LUiN'I uliCS`C YFLLE {it11gR'MENT Core Oi Atl I !'L I , <br />InUI+, 'ICIAL SAMPLE '+C#';''•`^ #:7?#fi•. <CC9 ~ ]~) <br />(A`_ FF) MEASUREMENT <br />ivuS I G C '`{2~- <br />.IT ~+Y)triilNAt -- AiaS4714 ,af, C#0 9sOtD 3.U .G hAE <br />5F'FLUENT GhCS` YALLE , <br />~~~ .. NT ' CCC -G A AY A L .!!i %C 1 E <br />'IL AND GN;rA~E SAMPLE r'CC.sYa ~ ~`~' 1 .C.ao,o >::;~:<tr; ( Ic) <br /> MEASUREMENT <br /> ~ <br />i R~~f ~ <br />~•-~ C4 aoaa~+a +o#nat>a 1C ~l.t <br />~ EAE <br />TFLUENT GA095 fALUE ~ ~ r <br />C ~~~ ~ _~ <br />'r't'e' ' ~^~'% IN3 EA CG I '~-' I <br />~~ 1' <br />'LOY, IN CONDOIT GF SAMPLE ( C ~':oa{'• ~~•~• •. .:CC <br />NNU TF;EATl9ENT PLAAT MEASUREMENT <br />0050 1 U C : '; <br />~ .°. I$~ `° arrtit>•xi ##oe#z a+@{,~C,` a# ",li lfFKIt l~TAN <br />YFLUENT GRGSS VAlIiE _ <br />~~, ~~~ 3 ~=,f~ ~ ~ s` [GC ~~'- :r' <br />:,~. X'ICx <br />GLIDS, TUTAL SAMPLE :7+C#+++% O# #S i~#>SA<.r, + ly) <br />I S S O L Y E C MEASUREMENT <br />70195 1 U C aEti,~I <br />Id' ~,4'~AAa i ,'Iaa.wOa#- C## aa016#a FTICBAL ~E~G. 1F1.1 EAE <br />k:F'F'LUhN1 GdC55 YALIt _ <br />AE0~11 ENT "' r,q;.:,. [rT AYG 11dILI ~ PC I <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT 1 HAVE PERSONALLY EXAMINED AND <br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN: AND BASED ON MY TELEPHONE DATE <br />INQUIRY OF THOSE INDNIDUALS IMMEDIATELY RESPONSIBIF FOR OBTAINING / ~/ <br />~ <br />THE INFORMATION. I BELIEyE THE SUBMITTED INFORMATION IS TRUE, ~~/ J~ /'-L <br />N. Gordon Peters ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT <br />FOR <br />UBMITTI <br />G FALSE INFORM <br />INCLUDING THE <br />NAL <br />T <br />ON - / 970-824-4401 DU 07 25 <br />N <br />A <br />I <br />. <br />PE <br />TIES <br />S <br />President/General ,tans er POSSIBILITY OF FINE AND IMPRISONMENT. SEE IBUS.C.4 7001 AND 39 U.S.C. <br />h <br />i <br />l <br />d <br />i <br />0 <br />000 <br />tl SIGNATURE OF PRINCIPAL EXECUTIVE <br />en <br />or <br />§ 1319. (Penelbes under t <br />ese slazutes mey <br />nc <br />u <br />e l <br />nes up ro 51 <br />, <br />TYPED OR PRINTED merimum impnsonmerrtorbeMgen6manths entl6yeen;) OFFICER OR AUTHORIZED AGENT <br />COD <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerence all attachments here) <br />T`5 .. :L:'!AL LFCh LIF175 :ILL eF wAIYLD, AxC FE^-'TIEAFiLE: °CLIL° CIC17 AIrLIr:: FL,: <=1CYE,14EF iFfill eyiF'I- <br />!~c _., .. .;.h CF 6'FCCf FE~UI P.FCcNTS CNCF;e I.A.?. 7C°_ "1CNITCb IAG - I.t.=. CIL E crrF°_E - E L. ..1. )[). <br />A Form 33 o-1 (S- Previous a itlo s may no a use E OR IC ~ BUSED.) PAGE OF <br />CCi.Sc/~:.Clil-1E:4 i ) <br />