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PERMITTEE NAME/ADDRESS pwdiJ. FsdlryNwdlamw dDlf.~.+0 NAME TF. P.eF'F':: i ~i?. ~ , ADDRESS T tt A 1' d c '~ ` ::. ~' Ci 1It. 7 FACILITY LOCATION NATONAL POLLUTMT DISCNMOE ELIMINATON SYSTEM INPDESI DISCHARGE MONITORING REPORT lOMR1 lT-161 17-191 00003:]15 CIE A PERMIT NUMBER DISCHMGE NUMBER MONITORING PERIOD YEAR MO DAY YEAR MO DAV FROM '• TO '~ - 1762/1 !77-731 /14151 /16771 ITB-291 !36311 Form Approved. L I° C H A F G F T O s A G fDn~B~!°•-2oao-oooa ('' p [ P 1• +d) Approval.Le>~r9ec05-31-98 F - FINAL "I!:CF NOTE: Reed Insttvctlorr beta compMtinp thls lorm. PARAMETER !3 Grd Onhl QUANTTY OR LOADING !I Grd Onhl QUANTITY OR CONCENTRATION NO fREOUENCY SAMPLE 146531 I5a-611 I3B-•FSl 11653 I5L61/ EX OF PE 132-371 AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS 1sT-s]1 MALYSIS (5a-6gl TY /69-70/ +' SAMPLE ~ ~ •, 4~Y#t:};t~ ;Itt%!,^-^ ( 12) MEASUREMENT L:'J4G 1 0 0 PERMIT ':=YG### ~ =i iR:'-JfG~=f ti A•; SaFi~. ... 0>IOO+Yfi .~rQ ~ ~ ~ F.~IrKL ZPt$.IT! ~i FLUEAT t;R05.:, V~;.C REQUIREMENT ~ :-.-: ~~. ~:. '.:. #>7fiC ~fL~I<IllU!! ~ ~ ..~ >~ .. ~ ~F!~11~K~7 R~ti I4~:. SU L ll~F TnL SAMPLE ~+,4### rtlp utl tA. #ADD#,: { lg) a U.i P t: A D Fi U MEASUREMENT ,/ JU.S U I Q /' PERMIT ? #..a% ..:. :<':.~~'SF ~.. b- :. O## ~:::~ ..'d.0'~l:A:~ ~ ~ ~.5~ .: -~:.C ~ ~ :. ~ ~~~~:~ ~tA li ~ cFYLUEN'L' GROSS 'J .', .. REQUIREMENT ,. #OYr;i +' .. 3C[A AYG : A~IX KZ ^sG/L '' 'rid' " ...1~ J , :, c.. .1 .. SAMPLE ;:,: 4#:= ^~##': ;: #L#L#d ( S) - MEASUREMENT JUS45 1 '-4 ' ~ PERMIT ~ x .'•~' Fi'- ~ •?~v cfix+##a - CItAL RE#~PT ~ NCF:( ~RAD b ~. F f' L U E N T 'PF.$O:i ~ Y A L J REQUIREMENT. . - ~ ~~`'~ Y,. ; :::: _2 r A AY, J;AIIY ,'iX r.L/t +, 70N~ %J SAMPLE ?+~+` +~Y;=O## O^t4't ( ]y) (h 5- F °.) MEASUREMENT ~s R~G :],JUS 1 D '~ PERMIT. ~.% ##4# tit ~. :.f :.l „rR ik 6q# #;rt#~Oy 5~ 5aS] NCI;/ RAF LFYLUEwT GRJ55 VALS, REQUIREMENT >A#;+# g.EaEA AYG ;8,1.I1Y K% riG/L ~Ot:'F.'11. ii ~ N i.n •. SAMPLE 4-^#'~ =?#00{~+' QtC#%7L ( ~Q) MEASUREMENT U3;b1 1 0 !? PERMIT:. ` '::.: >x: #-•.~:;: .: >e 'C ~#». ~~... .. '0!J^IH ;RAF cf FLU tN1' GRGSJ J^Lil ~REQUIREME117~ ~~. ,. :.::: ...: ~. #fi~-4 .: ...-~:.. :.: : " ~ . yC/L ~: J.m „- r, ,. SAMPLE ~ ( 03) ?A#t#t t{##;•:? r(:}:;-:;: '!'n~~' THLA1'tlcF" :'I: ". MEASUREMENT ~JU,J 1 0 'i PERMIT REP 3R IRE i~FFT 4ta #,L fit>D#%:% Mfif,a^%gt; p, e _r LY lws~s. ;:FF:.7;: t1 '1• VR')=: ~ ~i ;. '_.U :REQUIREMENT 3UDA AYG.~ DAI~L7 AX HGD ~ ~_:: _~~# ~ -- •~~ r ~ SAMPLE ~ ^° •'• ( ] 9 f: I ~., ~~ L Y ° U MEASUREMENT 701/5 I G u - -'?'`• 8L!. RPFORT THLY ;>?AA ;, c'F LUEHT GRJS`, YALII REQUIREMENT ~ ~ ~ - LC`.:# ~ eP."F. AYG. ~~. ~'LAI IY N:X f!C./L NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I NAVE PERSONALLY EXAMINED MD AM FAMILIM WITH THE INFORMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE MY INQUIRY OF THOSE INOINDUAl4 IMMEDIATELY RESPONSIBLE FOR OBTAINING THE INFORMATION, 1 BEDEVE THE SUBMITTED INFORMATON IS ~ ~I /~ / (_ / 7~~/~•~ W. Gordon Paters TRUE. ACCUnATE MD COMPLETE. 1 AM AWME THAT THERE ME SIDNIFICMT PENALTIES FOR SUBMITTING FALSE INF011MATION INCLUDING / 970-824-4401 98 4 28 P den 8 . THE POSSIBILITY OF RNE MD IMPRISONMFNT. SEE 10 U.S.C. ! 1001 MD 33 BIONATUgE Of FRINCNAL EXECUTNE U.S.C. E 1]1e. lP.rWOi/ 1/\1A~ FMw merrw ,rMY /nrA.i4 !/Ma w ro 110,000 TYPED OR PRINTED war nrah..rr irp•Iwrnw,r olarwwnemp%dM rN 6YFra/ OFFICER OR AUTHOR12E0 AGENT CppE NUMBER YEAR MO DAY COMMENTS AND EXPLANATION Vh AN7 VIULAIIVNS IFlI/eI10C111/IRICDmIOtl b1/4 •,S c: TOTAL IF.'ON LIRI'I~ +11LL 3~ ~AIYFD, ANG SETTLu"AtiLZ S7LiI5 LI~7T ACFIIFD FCF <=10Y4,14H' PR°CIf' :;VEItT- ,r. r. kiUHDe:6 OF ~5L~OF HE(UIYEBENT-r. CNUP:i I.A.3. ?CS RONITJIiIhG - I.P.3. OII E GPF,ASL' - FEF I. A. 1.(;,). Jlr I,AY AYi13AGF. i~ HTGHF';T P: :iNTN LY AYERA :R ^[Ik iNC pPq T(5B 7F Df FTFf_ Epp Form 3320.7 108.951 Previous editions may bs used. (REPLACES EPA FORM Ta30 WHICH MAY NOT BE USED.1 C 0 1 c U / Q 7 ] ~ ] 1-1 61r b PAGE lOF