Laserfiche WebLink
PERMITTEE NAME/ADDRESS pnrlurk Fa/Ln Nome.~Loa'a/ion JD~ffereny <br />NAME <br />THAFFiH hIhlhC, INC. <br />ADDRESSS k r. F' P E li ". I N F <br />..~. :cx _..-.r <br />FACILITY C 4 A I G C Ut l t 2 z, <br />LOCATION <br />R1'Th: .. i;.~}!LL:N Ft1tF;, P1?E5/C;tN CGh <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (OMR{ <br />f2-16) (O~ 91 <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM GC CU G1 TO CC C` ~1 <br />(202]) (Y2~23) f24-25) IJ6.2D (28-29) (J0-31) <br />Form Approved. <br />OMB No. 2040-0004 <br />Y. I N C F Approval expires 05-31-9R <br />(SUBn ~.) <br />P - tINPI C(i:~I <br />IIS~hAFCi 'll CCiCIx i~CLCt <br />=~~ NG CI~ChP.FCt ~~~ tLt <br />NOTE: Read Instructions befor mpleting this form. <br /> (3 Cerd Onyx QUANTITY OR LOADING 14 Card Onyx GUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE <br />PARAMETER (4fi-53) (54-61) (38-45) 46-53) (54-6/) EX OF TYPE <br />(3237/ AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ANALYSIS <br /> Ifiz.6a1 (64-68) 69-70 <br />:I SAMPLE ~vY~~;%4 #>5;4;:;,. 4r. ,; :, .. ;. ( j~) <br /> MEASUREMENT <br />f)oUU L J L ;pip *i~+/~4fi »410>art~+ tc; ,§ 4s~~4~ ,. .0 ,~ 11ftiY ISI <br />r'£L,.1.'~T ~:t;15~ YALCC ~?EWUHE;MENT K[:+~ I+I Pl i" YI ~:. <br /> SAMPLE <br /> MEASUREMENT <br /> -a~RM1T <br /> REQUIR&MENT <br /> SAMPLE <br /> MEASUREMENT <br /> E <br /> A~©1f <br />1. ANT , . ' <br /> SAMPLE <br />~ <br /> MEASUREMENT LL <br /> ~ ? 1 / ?~ ~ <br /> R~NIENt <br />AE4UI , . " <br /> SAMPLE <br /> MEASUREMENT <br /> - 9 <br /> - ( 14 ~ ~ ~- <br /> ~ <br /> SAMPLE <br /> MEASUREMENT <br /> s <br />X <br />~ ., t * + <br /> ,~ <br />g~ <br />~yy <br /> r <br /> SAMPLE <br /> MEASUREMENT <br /> - <br />~ ~ <br /> ~R~Fi16 AAilENT ~tl <br />, <br />p _ .. <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTI <br />AM FAM FY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED AND <br />ILIAR WITH THE INFORMATION SUBMITTED HEREIN <br />AND BASED ON MV TELEPHONE GATE <br /> ; <br />INQUIRY OF THOSE INDMDUALS IMMEOfA7ELV RESPONSIBLE FOR OBTAINING <br />~ <br />J <br />. <br /> THE INFORMATION, 1 BEDEVE THE SUBMITTED INFORMATION IS TRUE. ~ <br />/+~ <br />'~ <br />~ <br />W• Gordon Peters ACCURATE AND COMPLETE. 1 AM AWARE THAT THERE ARE SIGNIFICANT <br />PENALTIES FOR SUBMITTING FALSE INFOAMATION <br />INCLUDING THE 970-824-4401 UO U7 25 <br /> <br />President General Mane eT , <br />POSSIBILITY OF FINE AND IMPRISONMEM SEE 1B U.S.C. 4 1001 AND 33 U S C. <br />4 13t 9 <br />(Penalties antler Ihase salutes ma <br />incWtle lines u <br />ro 510 <br />000 entl or <br />SIGNATURE OF PRINCIPAL EXECUTIVE <br /> <br />TYPED OR PRINTED . <br />y <br />p <br />. <br />mexr'mum imprisgrmerNdbelw>3en6monr115 entl5yeers <br />) OFFICER OR AUTHORI2ED AGENT A <br />NUMBER <br />YEAR <br />MO <br />DA <br /> . O Y <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />TSS G TG,bL 1hON LIP.775 PILL LF rAIYeU, ANp SET7L'EAEYL °CIIC5 LIkIT AIFLIEC FCF <=ICYE,~4tF £FtCII E1E!'1- <br />5EY UCNL:'h OP FkCCF FFQUTAFC6N75 UN-EH I.11.3. FEFDITIEE hGST 7ANE ALL FEA5GNAhIE f'EAELFES 9C FILbCE 'r: <br />PA o~m` 20- ( 1 vlous e i Ions may not use . (RAP S 1h QRNfT-40 D. ' ' ~ - G F <br />CCCU]/CCCIl]-lEi4 ~ <br />