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PERMITTEE NAME/ADDRESS (include Facility Namr/Location ifD~erenp <br />NAME <br />1'i+RIFF.H :1N1NG, IhC. <br />ADDRESS,. <br />lRePYf:R CIS.. <br />P.C. :;CY. 1N7 <br />r FACILITY CRAIG CiJ 1'1u26 <br />LOCATION <br />LT fa • r'r•Ohf c C LR ] t c DLAC /r'L L MC. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (OMR; <br />(2-161 !f T- 9) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM UC C4 UI TO GC Ct 3 <br />f20~11) (22131 124.25) fffi-2i/ (2B-29) (3P3iJ <br />Form Approved. <br />OMe No. 2040-0004 <br />h I NG fi Approval expires OS31-98 <br />1~U5F NYj <br />e - fINAI PCFr'[ <br />fCNC 7c 7C tA~7 tCi~Ai[ CL1C1: <br />K#= NC CI:CNAf.GE +C#x <br />NOTE: Read Instructions befo! ompleting this form. <br />- (3 Card Onry) QUANTITY OR LOADING (4 Caro' Onty) QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER l4s-53) 54~fiT1 (sa-4s) (4s-fis) (s+-s1/ EX of TYPE <br />(32-371 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />f62-53) ANALYSIS <br />/64-68) <br />(69-70) <br />F'H SAMPLE cty~;~;:'s ^a#a=:}r,' ::r0',~9'. ( li) <br /> MEASUREMENT <br />UU4GU 1 U C ~P.EFiFy1}~T a>aaso~a axiaa#SI'. <## .5 ##4:Ra <br />- 9.C ~ ~. FKL1 1{5].SU <br /> <br />F.FFLUkt.7 '.HC55 YA1 E R T11RFlMENfi <br />~ ~ ; Y ;_t ~ ~ . <br />' <br />OLIDS, .~EIYLEAeL'c SAMPLE :##°.'CG 9:K :T~ 4L r,: r,.Y ( <<) <br /> MEASUREMENT <br />DuSUS 1 ~ c 3 <br />A1~0!!f,%~ a#aaao ~ • <br />~ aaaaaa . ~ IcilL 6.5 >Et~/ 6A& <br />E'~Ff'LUEti'f ~:iOS_ Yd UE R~ BdT t <br />. ''~' caa ~ Y L I . <br />IL ANO i~h:,ASE SAMPLE ..>:'?4f:? Ct0 .~) ~~ :r:.r.:: ( 15) <br /> MEASUREMENT <br />G3sd2 i U 0 PERMIT aOa+P:RO #aaaz , *+cn //~~ #aaa## #Kaoa# IQ ':, <br />~-~ t~!.TM 6AE <br />E F' E N I G E'. U 5 5 V A G t REQUIREMENT •# ~!(i ? r~ I ~•- <br />E'LU4~ It: CG.`IGCLL GF SAMPLE 'G3j °%~ ;'=% •- ~'~#4;. ) <br />~'" <br />ThilU TFLP,'L>;Eri7 LLANI <br />MEASUREMENT <br />~; <br />SOUS U`" 1 ') C PERMIT' BEFOR hT_ #a##~# r~oxsx# ##Iatad .{t EsiY II:tA <br />Ef'FLUENI GiiO"_ VALUE REQUIREMENT ~© Q - tK L{ '' _ <br />`ULIDS, TG`tAL SAMPLE ~~~ aKOZ~ ~K'%~ ~`~ i 15) <br />'1.riSOLVcU MEASUREMENT <br />11295 ! ~ C ".~ ~, <br />>w~~ <br />~ a~aa <br />~ ,v* a#aaa# `FIICSAL 8~-_ <br />~ ; 'AMY. fAE. <br />E(FE'LUEti; GSCS° VALUk ~ <br />~~~d ~ , <br />; <br />' '~-,<`r. ~;'` {'%~' F YG . MG <br />IL AwU ;F.:ASt SAMPLE '%~+#4an I 9u) •~-":..,•.. ~ oa#aae <br />Y l :i U A L MEASUREMENT <br />tfUU61; i U C :..`P1;F14d1'4' ~ galaYA~* -,'AEFCq'2~:.; E~=1 a~itaaC dv4t<~~ ~,,. , <br />~;ii..: ## i E IY ~ISUAL <br />EFPLUkn: LNCSS YALLE ~~~UTAra4dCNT- % kIl lC=C .,X <br />~ .r- #t## h <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> P.EFF~~MMIT <br /> REQtlIF1EMENT - <br />NAME(fITLE PRINCIPAL IXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF <br />AM FAMIUAR WRH THE INFORM LAW THAT I HAVE PERSONALLY E%AMINED AND <br />ATION SUBMITTED HEREIN; AND BASED ON MY TELEPHONE DATE <br /> INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br /> THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE. <br />C <br />la. GOZdOil Patera ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT <br />R SUBM <br />TTING FgLSE INF <br />RMATION <br />INCLUDING THE <br />EN <br />E <br />F 970-824-4401 UU 07 '~5 <br />President General Mana eT , <br />P <br />ALTI <br />I <br />S <br />O <br />O <br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE to U.S C.410ot AND 33 US.C. SIGNATURE OF PRINCIPAL E%ECUTIVE <br /> <br />TYPED OR PRINTED § t3t9 (Penetties antler these stetules may include Imes up to E10,000 entl w <br />maximum rmpnsmment ol6eMeenfimonlhs end 5Ysars.) OFFICER OR AUTHORIZED AGENT A <br />NUMBER <br />YEAR <br />MO <br />DAY <br />~. <br />,7 <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Aelerence a» attachments here) <br />~eTTL?'.nt'LL. SULLC~ []E1: n6Y '_iC ;AIYEL FU" ~If1b,2DEF PckClr EVcL: - EEi `li'IrP;iF Li!:;7lLC:: LE~fI <br />:. A.1.:, RNC' ALSC ELFCEN CF PFGC!' FB-: U1kE9EAT5 ONCEP I.A.3. CiL ~ L: --_ - -~~ l.~i._.li) ':L_~ <br />E t1 or~Yi ~2b- ,OB-95) pr~'vious editio s may no be us (R 5-E A kl N A FJ T B SE .)~ 1j ~J - ~ '~ .I L ' I PAGE OF <br />CCi /C .-If, 1 <br />