|
PERMITTEE NAME/ADDRESS l1MrLisdryNaw/Lxanw dD~mru)
<br />NAME CNEhGY FDELS !IId[R: ^OMPAdC
<br />rr
<br />r'. :ADDRESS50UTIIFIF.LD 11IdC CJAL LDADDOT
<br />a~; 35U INDIRKA STREET, SUITE UpD
<br />t? GDLDEd CO 8011J1
<br />z; 'FACILITY
<br />'" LocnrloNFLJ:tk:hCF. CO 81236
<br />K.A?Td: L:dJfLGE V. PATTF.RSON, GEM. tl,;R.
<br />~k
<br />?'S
<br />NATIONAL POLLUTMT DISCMMOE EDMINADON SYSTEM lNPOESI
<br />DISCHARGE MONITORING REPORT lOMRI
<br />lI-161 17-19)
<br />C7G8SODD6 001 ~
<br />PERMIT NUMBER DISCHMGE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAV YEAR MO DAV
<br />FROM U 1 Uli U TO U 1 Ub 3 C
<br />176711 127-731 /7I-751 !16171 128-19I 130-311
<br />a.. ,
<br />Form Approved.
<br />OMB No-~~040-0004
<br />POND 2 DS CHP.G TO ~..~ os.n
<br />{ SG B R :i E) APProv ~ pi~e~ 05-31-98
<br />P - FINAL JJ
<br />MINOR
<br />0trtr NO DI~CHARGF. ~~ '~rrlR
<br />NOTE: Reed InetructltNa before comPlatlnp thu form.
<br />PARAMETER ~ !3 Grd OnlYl QUANTITY OR LOADING !4 Ord Onlyl QUANTITY OR CONCEN7RATION ND FflEOUENCY SAMPLE
<br /> !16531 !548/1 l38-051 !46531 /5681
<br />l37-371 EX MALYSIS TYPE
<br /> AVERAGE MAXIMUM UNITS ~ MINIMUM AVERAGE MAXIMUM UNITS Is7-ssl !84881 189-701
<br />A SAMPLE trtrtrtrRR R0trtG0 Ui+.~ ~:[: { I2)
<br /> MEASUREMENT
<br />)DuDJ 1 D U PERMIT.::.! .: AOIk'fi10'k .. :R~l~i{1•?~¢:A' 4
<br />~ tro4 >.'~ ......:..... .. _.:,
<br />~ .... O~Ob. rx
<br />~ ~~O
<br />~~ _'";'sj .
<br />x~~
<br />~
<br />'*~¢
<br />PFLUi•.Nt' „K755 YALUE REQUIREMENT. ~~ ~ ~ 10088 ~F[3{;Yj[:jjg- +'fAXTrff!! SI) '
<br />.1,a ~.
<br />
<br />1 i
<br />OLIJ. ~~TT
<br />F LEABLE
<br />PL
<br />SAM E
<br />
<br />MEASUREMENT
<br />01108
<br />a 0
<br />
<br />040880
<br />
<br />- - -- - -
<br />
<br />
<br />
<br />~
<br />
<br />
<br />raaa>~a
<br />---~f- ---~-~ -
<br />
<br />•rEr
<br />v. s ::
<br />E,
<br />----
<br />. .,,
<br />. K.
<br />
<br />, _ -
<br />)DS4S 1 0 0 '::'.AERMI7::.:..
<br />IREME
<br />R
<br />S RIGL1i°RAs:.?s „'"git8F04~>i: p0 », ; ~.•I N
<br />:PFLL:;hI LROSS VALUE EQU
<br />N
<br />.
<br />:
<br />)IL A!!D Gnf A$E SAMPLE atrP000 000000 R04aCAG OAOI./ `
<br />f ~ { I~)
<br /> MEASUREMENT ~I ~ _
<br />13$112 I 0 D ,:PERMIT..::. . .0004.0:.:.: .,: PQCip.Ofd. 91 000 P:4.0:g4~.:. rf>0 4 .: f~ ..` '%`YYY ~N' tRAP
<br />:PPLUi:NT GROSS VALU2 ;REQUIREMENT ..:. : 01048
<br />'-LOk, IN L'DdDUII OR SAMPLE ( D3) 040000 arla +k [: ~ I:;>,r,':}~ ,;;. "~ ;-
<br />tBRD TRhAll7 EdT PLANT MEASUREMENT
<br />4i,
<br />a
<br />i00SU 1 0 0 PERMIT:.:. FT.IDIfAL. : :' RHPDBT OcflFxlRtrr,: a;=.~R *t . ~.:AlpaPr~l~:,:::3 trn
<br />
<br />~I
<br />
<br />NCF
<br />:;
<br />:u~rAl.
<br />:FPLUif:T GBO55 YALUE REnu~REMENT. 3.QD#...:fi.Ty. .n:bTL! ..f9I MGD r.:0 -
<br />)IL Adu l,dP,ASE SAMPLE 000000 ( 9q) GGI};r :Y }(-tr :a r: tr:;. rs .',: ;:4 _
<br />II3UAL MEASUREMENT `
<br />140Gti i U D PERMITr^:. ...RICq. x.1k.:. R.EPORf
<br />Y ES=1 D.O:RG-::r t'F.aG'J.. >'i *rOL!
<br />~!'i
<br />`'" 4r73 ~.7
<br />~ IS
<br />
<br />UAL
<br />:PPLUE`rT I;NO$$ VALUE REQUIREMENT, .
<br />Iil$7 lIAK NOsD .
<br />,
<br />r::"."". .
<br />~
<br /> SAMPLE ,~ `• ~.,..: _ 1~
<br />
<br />MEASUREMENT
<br />~
<br />~
<br />~ ,.
<br />~~~. -
<br />~ ~ ~'~
<br />,~
<br />
<br />` :
<br /> .:~:.:~: PERMIT,,
<br />.... .. , c..
<br />
<br />~ :.:.:: ........:... :. ..
<br />
<br />
<br />
<br />~ ....
<br />.....
<br />
<br />'~;.r
<br />i:
<br />l~
<br />~-'
<br />~~ . ;;
<br />
<br />:.. ... ,:.y,.
<br />~:.:':.; iii; '~
<br />ii
<br />"I'
<br />
<br />
<br />~.¢'';j~
<br />
<br />
<br />'!:
<br />"S;: "; ,'."::::
<br />:;;i:::':
<br />>}.~
<br />
<br />~
<br />
<br />
<br />'Y
<br /> ~REQUIfiEMENT~ .
<br />.
<br />.
<br />~ <
<br />:
<br />.
<br />~ ~ "~ ' .
<br />.
<br />.
<br />.
<br /> SAMPLE _
<br /> MEASUREMENT - i--
<br /> ~.: PERMIT:r:..... .. :: ......
<br />- - - - ~REQUIREMENTt .~..,.,:::-..~,-- •.::~. ~...-.... ~ .: ~ . .
<br />
<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY uNOER PENALTY aF uw THAT 1 HwvE PEflsoNUlr ExAAlwllD MD
<br />AM FAMILIM VATH THE INFORMATION SUBMITTED HEREIN; MD BASED ON TELEPHONE DATE
<br />~J'~,
<br />~ ~G~ ~ _~
<br />KJ 1./(~JT- ~ Mr INQUIRY OF TN03E INDIVIDUALS IMMEDIATELY RESPON9BLE FOR
<br />OBTAINING THE INFORMATION, I BEVFVE THE SUBMITTED INFORMATION IS ~ l~
<br />1.
<br />, TRVE, ACCURATE MD COMRETE. I AM AWME THAT THERE ME ~
<br />~
<br />~ ~
<br />~ ~ SIGNIFCANT PFNAITIFS FOR SUBMITTING FALSE INFORMATION, INCLUDING I r
<br />'
<br />? ~/~
<br />r
<br />~ ~) r ~1 /~
<br />~J `~ •~ r/F~ ~~1 THE P0531BILITr OF RNE MD IMPRI30NMFNT. BEE 18 U.S.L. E 1001 MD 33
<br />131 BIONATURE OF %IINgPAL EXECUTNE ~ ~
<br />y
<br />i -~ I J
<br /> V.B.C. E
<br />0. lPrIYS1 ui0r MY ,owns ra.Y MrCA:dI Fiw, ~ ro t 10,000 AREA
<br />TYPED OR PRINTm .ndwrnuinun irrpiea.+wn Plbw.,nemonoYSW eYrrAl OFFlCER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV
<br />r.
<br />COMMENTS AND EAYLANAIIVN Vh ANY VIVLAIIVNS !/TWBFBOCB eII BNlCnmenrs natal --
<br />$ET1'LEAdL~ SOLIDS LI"(IT iAIVED FOP. iJ-Yft, 10-NA PR!?CCP EYENL' SJDJ::C2 TO BURDEk OF' PCO~?F P,C'~'1CRE'tENTS Ld
<br />PLd'f I.d.1.D, PG. 6. STDRRdATER MA!IAGEI1EdT PLAN DUE I-l-3U.
<br />
<br />EPA Fwm 3320.1 108-951--Previous editions mey_b_e_ueed. IREPLACE6 EPA FORM T40 WHICH MAY HOT BE USED.1 U~36/ 97 D8I 9-I Z °_ U PAGE I OF
<br />,.~ ., ...~, a
<br />
|