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PERMITTEE NAME/ADDRESS (Include Facilin• Namd[nmrion I(Digerentl <br />NAME <br />ADDRESS FAPPEF. CIt+IhG, 1hC. <br />CRdPF'c'R Y,ZNE <br />F.C. bC1I lE7 <br />FACILITYCb.AIG cc e1626 <br />LOCATION <br />A T9'N• ('l~~r+fN 1. F'T i•lc DT.CC /C4'L !•Ck <br />NATIONAL POLLUTANT DISCHAflGE EUMINATKKJ SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR; <br />1246) (Ir- 8) <br />S <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM DD Ctl U1 TO DC C 3C <br />(X+2;1 (22-19) /24-25) /26~2T1 f2B-29) f30-01) <br />Form Approved. <br />OMB No. 2040-0004 <br />!! I NG E Approval expires OS-31-98 <br />(SUER Ni) <br />F - FINli rct.l <br />CAI! bl iC Ells CL1Ch <br />~~Y' NC CI`CEAECE (~( #~C <br />NOTE: Read Instructions befor mpleting this form. <br /> !3 Card Only) QUANTITY OR LOADING (4 Cerd Ony) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (bs-53) 154-Bt) (3B-a51 (~s31 !54-81) EX of TYPE <br />(32J7) AVEFL4GE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />(6263) ANALYSIS <br />(64-fiB) <br />89-7D <br />'1L hNl: ::NEASE SAMPLE ~'~~~~~ 1 qu) ^''~'~'''~ a.s4"' A:,C:;t <br />I ~ IJ A L MEASUREMENT <br />+4Ubb 1 J U p&(1 - #~~#f $$FG&'! E°=1 >aa~0.fP~P~-.; .'4~##~~: ~ :.#'#~~~f~# ~? ~,t ~~Yf2 IStiAi <br />EFFLutr,'L ,RCS; VaLIE , <br />HE4t!!A ENT' -- ~ & T 87V 6C=0 - - ~ Citt <br /> SAMPLE <br /> MEASUREMENT <br /> PE i ~ ,r r 'a,~. <br />-~ . - <br />- <br />- - ~ <br />- - <br />- - <br />- <br /> R ~ <br />s-k7~«. <br />x <br /> i <br /> SAMPLE <br />~ ~'' <br /> MEASUREMENT /l <br /> '~ 17~11~IT". r. <br />~ ~ ~. , <br /> Nt; <br />~$F914~ ~1 <br /> SAMPLE <br /> MEASUREMENT ` <br />~ <br /> <br />lUl~;. ~ <br />~ <br />, <br />- . <br />~ - <br />tt <br /> ~dy <br /> SAMPLE <br /> MEASUREMENT - <br /> ~ <br /> Y ~~ .i .i ~ ~ _ - v <br /> ;At <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> ~F <br />~ ' + <br /> .. <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> N~$1t11W~ EtJT• <br />NAMElTRLE PRINCIPAL EXECUTIVE OFFICER I CERnFY UNDER PENALTY OF <br />AM FAMILIAR WITH THE INFORM LAW THAT 1 HAVE PERSONALLY E%AMINED AND <br />ATION SUBMITTED HEREIN <br />AND BASED ON MV TELEPHONE DATE <br /> . <br />INQUIRY OF THOSE INDIVIDUALS IMMEOIA7ELV RESPONSIBLE FOR OBTAINING <br />THE INFORMATION, 1 BELIEVE THE BUBMITTED INFORMATION IS TRUE, / <br /> <br />i/ ~ <br />.~ <br />W. Edon Peters <br />u ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFlCANT <br />INCLUDING THE <br />PENALTIES FOP SUBMITTING FALSE INFORMATION - 970-824-4401 00 07 25 <br />dent/General Mana 2T <br />Pr <br />g , <br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE 18 U.S.C. § 1001 AND 33 U.S.C. <br />P <br />trie <br />r Iha <br />sreNres T <br />i <br />lude noes u <br />ro SIO <br />IXM e <br />d ar <br />§ 1318 <br />x' SIGNATURE OF PRINCIPAL E%ECUTIVE <br /> <br />' TYPED OR PRINTED p <br />, <br />. ( <br />ere <br />r u <br />e <br />se <br />rey <br />nc <br />n <br />mex~mum tmpdsonmem or belween6months and5ysers.) OFFICER OR AUTHORIZED AGENT A <br />NUMBER <br />YEAR <br />MO <br />DAY <br /> C <br />COMMENTS AND EXPLANATION OF ANY VIOLA I IONS (lielelB.nce Bu aRacOmenfs nereJ <br />'F.~S b 2CTAL IBCN LIl775 4IlI EE -AIVEC, A-C SETTLI~HIE _CL1C5 lIt1T AFFIIEG ELF. <=]L'1F,<Ltf FEFCIF F1iEt1".- <br />:ct bL'RCEt+ OF.E6CCf FFQGIAESENTS UNDER I.A._. iD° MON21CEIhC - I.E.3. CIL b Gitrlc - ~tt l.t.l.(L). <br />eow~ :..,., zp T - I P wu e i l Ro e O I O FUSED.) PAGE OF <br />