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PERMITTEE NAME/ADDRESS prY6 Frulry N.,/Gxadu l/DIAGnwq <br />NAME 'I :iA i~~'F. .'' "I~,: AI:~ i_. <br />ADDRESS T n i+ i' r F. ^ ' j 'i r. <br />P.G. •7:i 1.17 <br />Cd.+1 :, <br />Cu "162b <br />FACILITY <br />LOCATION <br />;I'! ,. w, I_C)"r J.. !. Pc?ii! :, i'nt~/CF9 `!C =i <br />NATIO D16CHARGE DMONITOORMIG REPORT ~OMR/FOES/ <br />7-15/ 717-I9 <br />nc003Z LI ~ 7 <br />` PERMIT NUMBER DISCHMGE NUMBEN <br />MONITORING PERIOD <br />YEAR MO DAV YEAR MO DAV <br />FROM - TO • •. ~ - <br />I10711 l77-131 !74751 !7617/ l78-791 !36311 <br />Form Approved. <br />A c u T F ti, F z T e s T I u c°MRC4'R• z92°>°O~4 <br />(<n ~.9 TR~ ApprovaLexPlfgsS -31-98 <br />F - Fif•AL 1 <br />rzvcR <br />=~''° RC JI3CfiAR~E I__I ` <br />NOTE: Rssd Instructlarr Eslors compMtinp thin form. <br />PARAMETER !3 Grd Onlyl QUANTRY OR LOADING !I Grd On/yl QUANTITY OR CONCENTRATION NG FREQUENCY SAMPLE <br />l31-971 !16591 751-517 !%-151 !1653 151-51) EX MNY515 TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS s7-ss~ 756587 159-)OI <br />:. ~:5 ~ STA1'!iE 4bY.~ l,C~ - SAMPLE :'r t~'f G+k is ~r~6+k;` r,:-{C.-;:; •,{,;•~•I ;7 ~ 23~ <br />~ e: fi I O D A F .1 N I A MEASUREMENT <br />Ar~35 1 U 0 PERMIT. ~ 'rT#rA.ar~a~ ~~ C0.=aEtl4# O~`.# lOD ~ ?QCCQ~K: ~Oxtar:Sl.. F.R- "~T~:tLY G,RA~? <br />~.FPLUeVT I:RDSS YALU REQUIREMENT ~ ~ ~. ~ ... ~: rrlr,:p ~~.. ~ .0 ~g <br />L~~u STAiHE `1bHi•. AC SAMPLE ;-4#,•;.- ttauTAC~ »oaata OL><0:}4 ( 23) <br />i' i P! E 8 it A L L S MEASUREMENT <br />~ <br />A.ioC 1 O 0 PERMIT. .. ~ TI~ ~illCt< .'S3XlL..bl ~: t/=5. ::. <br />Lf~~ .'' .. <br />aaa:+o>++(~ .. <br />-.~r,px:>>a.u: . <br />ER- :; ~ ~~^'I <br />LIL~c <br />i;4AP. <br />:.FFLUF,FT (; kJ$S UA LJ REQUIREMENT pgy0 „. ~~. E.UB cA <br /> SAMPLE <br /> MEASUREMENT _... _._.~.^--- ---~~ <br /> <br />_. ~ <br />- ~- <br /> PERMIT ~ ~ ~ ~ . <br /> REQUIREMENT ~ - <br /> SAMPLE <br />MEASUREMENT <br />r4~ <br />l~- .~u <br />- ~ /' <br />' G,~/~ <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> .PERMIT <br /> :REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~ ~ ~ ~ ~ ~ . <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />- <br />- <br />-- - - - <br />- <br />- - <br /> ._ .PE. _._7iM1~- <br /> REQUIREMENT ~ ~ ~ ~ - <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDEq PENALTY OF <br />AM FAMIUM WITH THE INFO LAW THAT I HAVE PERSONALLY E%AMINED MD <br />RMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE <br /> <br />Gordon Peters <br />w MY INQUIRY OF TNOBE IN <br />T <br />NI <br />M <br />F <br />A DIVIDUALS IMMEDIATELY gESPON9BLE FOR <br />EEVET~S <br />HERE M <br />ET <br />T <br />/~ ' <br />970-824-4401 <br />~ 98 <br />4 <br />28 <br />• RUE, <br />ACCUMTE <br />CO <br />AND <br />IRC <br />ENALTIE <br />FOq <br />T AWME <br />HA <br />T <br />PLET <br />E <br />BMITTINO FALSE INFORMATION <br />INCLUDING <br />9 /E.. <br />Preeldent General Hans ar <br />g M <br />P <br />S <br />MGN <br />THE POSSIBILITY OF RNE MD I , <br />u <br />MPRISONMENT. SEE 1B U.S.C. ! 1001 MD 3J iIONATURE OF MIINGNAL EXECIfTNE <br /> U.S.C. f 1J1B. I/YnYdI, YIIdY dN„ Alum, mPY AKAW BM, up ro S/0,000 <br />- <br />OFFICER OR AUTNORRED AGENT <br />CO <br />E <br />NUMBER <br />YEAR <br />MO <br />DAY <br />TYPED OR PRINTED ,Mwmui,x,n 4rw4a,~r+r alatw,., a Alwrm,.,ds Fw <br />a) D <br />COMMENTS ANO EXPLANATION Of ANY VIOLATIONS lRs/wmcs N! st»chmsnls hers) <br />,,E I.A.I. PP /-9, FLn UE'iAILS OF TEST PriOC'~UUd°. kP.P3dT LC `.0 - STA7I5?I!'!L FCIF~ ESTI"ATF ~HIC}~ I~i <br />.,:T.iAL TJ S0; %F "fE`T ~R.;AhISNS, AND -~:TACH ACU?E TOYI~IPY Tf°T FffCl~7 FOA° 70 [1'P:, COPiF.3 OF ALL <br />w. M+I: T v F1 n <br />EPA Form 3320-1 108.951 Previous editions mey be used. 1 EPLAC ~ EPA FORM T 0 WHI AY NO BE US •I q O 11 3 / 9 ° C 113- : 0 5 ~• A I <br />