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.. <br />PERMITTEE NAME/ADDRESS (ynclade Facilin•NamelLacation ifDi$erent) <br />NAME BLUE M.OUNTAI:I E'+E~~Y, I3C. <br />ADDRESSDESERADD PINE <br />3607 ~OUNTY ROAD 63 <br />FACILITY NANGLY CO' 81643 <br />LOCATION "` ~~ <br />ATTN: JBFF UIINk-BdP <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDESf <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERT <br />Y '~ "~ O DAV YEAR MO DAY <br />FROM : • 4 Q TO O1 ~ h 30 <br />Form Approved. <br />OMB No. 2040-0004 <br />J:. <br />(~UdF NW) <br />F - FINAL fiDLA! <br />Rp~4 SEDI.POND TO RED HASH <br />:},{IO7E: Read InsiructlonS befor~'Ehlpleting this form. <br /> QUANTITY OR LOAOING <br />~ QUANTITY Oq E, <br />: NATION NO. FREOUENO SAMPLE <br />AMETER <br />PA , <br />,., <br />~ ~~ ,y , <br />. <br />~ EX of TYPE <br />R ~ '~ aNUrs/s <br /> AVERAGE MAXIMUM UNIT, IMUM <br />~ AVERAGE MAXIMUM UNITS <br />PH SAMPLE aaa'zaa aaaata :;Y-~e-~:;. ( i2) <br /> MEASUREMENT <br /> <br />EPPLUE4T GkJ55 VALU RE~ltJIfiEM~i3T . ~..., y3-..=,.. ###s ~~ _ <br />SOLI05, TOTAL SAMPLE ``°~~'+~ '"'^rar aa' 0 ( 19) <br />SUSPEkDEU MEASUREMENT <br />U U 5 3 U 1 U U ' . °.~EF3Awlt:: _ s;4 ~ NQ-~ ~=rt#~ ~= w,~:. it ~ ~ -~, ~ ~jb... , <br />~ <br />EFFLUENt GROSS YALU Eg4)IAEN(ENT ;r= J `" <br />JIL !: CREASE SAMPLE .. aax.~ `r-r. raas as#a aaaaaa ( <br />14) <br /> MEASUREMENT ' <br />DJ S S b 1 U . 0 : p ~`#b~t' : ~gttie¢~r.- -^ ~ ~: ~`y~ <br />~ ~' <br />~ <br />~ <br />,x <br />EFFLUENT GR]55 VALU $~.~EMENfi ~ '" <br />e ~ S <br />: ~ 4, <br />IRJN, TOTAL SAMPLE =`: ;:" ^ .. ":":` nfiaa#a <br />~~ ( 19) <br />(AS FE) MEASUREMENT <br />U l U 4 S I U ~ ~0 :~ <br />,v T~ <br />`~' -'3 # iPicQ'd"~ ~ ' ~ r <br />;; r :,, ;. - i~t - <br />~~ <br />'c'FFLUENT ~6ROSS YALU .. <br />. <br />T~ ~ ..~ f: .tr.,: r <br />;,:'" p ~ "" ~ ~ '~ <br />F'LJii. IN LQNDOIT JR SAMPLE ( ')71 aaaalgl. r 1(rIR#asr aaa;r~,r <br />TH~tU YkEATtl6PT PLAN MEASUREMENT ?'. <br />~ U J S J ~ D '0 M ±'s . s .:c1t~1~t ~ <br />~ IgL~4~ , ~` # a ^ _~ ; ~ ~ <br /> <br />tF'YLUENT GROSS YALU <br />fl T' . ,,.- <br />Yfi1i1 - '~~' <br />'' ~ <br />CGD <br />*'~"`'. <br />~~"*~ ' <br />a#rt,- . , <br />~ :" . <br />°~. ~ . <br />;~ `" <br />:ILL AND GREASE SAMPLE sc=hz' ('r~l #"~>rfi p~##~+= ###aa. <br />V I S U A L ~ MEASUREMENT <br />BNU66 1 0 0 ~" ~~~.sr;~ .,a1tIOtIF <br /> <br />`~ <br />~ ,~§. :. £5=1 .~#?Atii}#4t"` <br />- ~` <br />~ <br />~~ w <br />'"~ ##a .i ., <br />FfLUF:NT GRO55 YALU ~'irtI1REMN~NT. "~ <br />+i.°^' ~^ Np-U `n :~+._ #r#.x e.' <br /> SAMPLE <br /> MEASUREMENT <br /> ,. ~ <br /> :~ <br />NAME(TITLE PRINCIPAL E%EC TIYEOFFICER lCenily under penalty of lewthat llirsd9ttanent and al atlacnmems were TELEPHONE DATE <br />~~" ~l!/~ <br />S prepared under my tlireIXion aratfpaMSiod in ecwrdance wlth a syslam designed <br />to assure that qualified persom9Cproperly gather and evalu9te the information <br /> <br />. <br />submided. Bazed on myinqulry dlhe pemnor persons who manage the ayslem, ~~/ <br /> the IMOrmation <br />atherin <br />the information <br />r N <br />ns tla <br />onsiblaYOr <br />9 <br />s / <br />~/ <br />~h g <br />, <br />g <br />o <br />ose perso <br />ec <br />y re <br />p <br />submitted is, to the bast W my knowledge and ballet, true, eaurate, end complete. SIGNATURE OF PRINCIPAL E%ECUTIVE ~ ~~]J`` (/ 1 <br />/J _ /J ~ ( / <br />dJ 4 <br />~ 1 <br /> <br />TYPED OR PRINTED I am aware that there are signifmant peneales for aubmming false inormation, <br />includi the sibil' of We end im nsanment br knowin violelions. OFFICER OR AUTHORIZED AGENT NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Re/erence all attachments here) <br />iIIL 5 GREAS£ REPOdTING-iEE: I. B. 1. F, PG VIZ• QRTRLY SA'!PLTNS INST!:9CTI7N5-I.C.~I~ pG II• <br />EPA Form,332p,t (R~(3(99) Previous editions may be used. IS I ' vAtil r.OHM rout <br />,~..:~r,: .. ..y. 00627/OOA71 -1. 1 <br />