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PERMITTEE NAME/ADDRESS (Inelude Factliry NmwlLw^M'on ifDij(errny
<br />NAME
<br />ADDRESSi~C:i1ERAJ:i "I :'
<br />FACILITY K`'~~', LY CO bI'.4~
<br />LOCATION
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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM {NPDES)
<br />DISCHARGE MONITOgING REPORT {DMR)
<br />PERMIT NUMBER DISCHARGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM l ~ TO O 1 O r 3 I
<br />Form Approved.
<br />OMB No. 2040-0004
<br />( !"' '7)
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<br />' •NOTE: Read Instructions before completing this form.
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<br /> QUANTITY OR LOA QUANTITY OR CONCENTRATION NO. FREOUENC SAMPLE
<br />PARAMETER EX of TYPE
<br /> AVERAGE MAXIMUM S MINIMUM AVERAGE MAXIMUM UNITS avA~rs/s
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<br /> MEASUREMENT
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<br /> MEASUREMENT
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<br />TYPED PRINTED I em aware that there ere signMrare penalties for submining take In/ormation,
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