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PERMITTEE NAME/ADDRESS 0weY6 FrdiryNwr/Locn,m dD(~fnwr)
<br />NAME T12El~f?1' "•I:JIM1;i, IYC..
<br />ADDRESS T ~ n P i L li !' :\ ~'
<br />P.~. !-IIK 1,'.7
<br />C t't. 7'!
<br />CO 81u2'i
<br />FACILITY
<br />LOCATION
<br />aiia: w. .~~:L~J:, 'r.".•~6N~, ri91:~/•~E7. H,;ft
<br />NATIONAL POLLUTANT UISCMMOE ELIMINATON SYSTEM (NPOES)
<br />DISCHARGE MONITORING REPORT (OMR1
<br />/1.161 /7-191
<br />CODD3 115 ~~~ A
<br />PERMIT NUMBER DISCNMGE NUMBEA
<br />~-MONITORING PERIOD
<br />YEAR MO DAY YEAR~~'''~MO D~~AV77
<br />FROM ~ u TO 1
<br />(16111 (11-13) (14151 (1417) fIe-19/ (36311
<br />POND Oi TO EAST
<br />(SUER !Y)
<br />P - PIOAL
<br />uI r1~!I
<br />Form Approved.~ry~y
<br />7~-f~04Q~ /7:l f{
<br />ApprovelLaxp~r~4 05-31-98
<br />•-:' NC ~ISCHARr,E ILZI `~"
<br />NOTE: Read Mtructlone 6~fue eompletlnq this torm-
<br />PARAMETER 13 Care OnlYl QUANTITY OR LOADING !~ Grd OnlYl QUANTITY OR CONCENTRATION NO• FnEDUENCr SAMPLE
<br /> 1e5-53 /545/1 13951 !1659 15451 DF
<br />131-371 EX
<br />MALYSIS TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS let-eJl )5/-5gl (69-701
<br />°"r SAMPLE x044:} 440fi;:4 %{r,»7s r,. ( 12)
<br /> MEASUREMENT
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<br />i, i/4 JG 1 C 0 ~,.: PEHMIT~~`.; ~pir..rgc ~ :~:,. >:`#?31G##~~~ 0=i4 b.S. ~~~~~~~~ 1pa>as~ar. ~~ ~n~.C .~~~ ~:~~`: it F.;PKLY I~NSIT~
<br />~FFLOEN'P :ROSS VALU nEnEtF3EMENT :;. '
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<br />L. .+, Gi: E SAMPLE 4{:{f*#4 rP:Lts40 x010-9
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<br />` MEASUREMENT y ~~,J~ .rte
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<br />.~ L ~R SAMPLE, 01~+0
<br />b d R# 440 ~ 00»400 ~. ~0{00rt>a ( 19) .
<br /> MEASUREMENT
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<br />~. .7 '~02 1 ,, 0 ~ U - ~ 'PERMIT :. •. ~ ~..
<br />~ - ~ iti'Y#xi# ~ 04# ~~ >fi 000»0 0=740»<+ ,j ~~ . ~ ~ -- ON'C ~ ~
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<br />c Fr LUENY GR055 VALU ':REOUIREMEN7 ~ ~i;{_q ~
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<br />:~,.~~ , 7 SAMPLE ( G3) L';Ct~x {. q{04'~'.~ »!Ct'rT „/.
<br />li.ul THcAT M~C YLA!7 MEASUREMENT .~
<br />~U35G 1 O U r;::PE)iM1T RE ORT RF:POAT {x000»d flo40>g0 #11.i0~sK+ :asL: S`2KLY IllS .
<br />FPLUENT GQ"O5 YALU `AE41. MENT
<br />.... jUDA .AYG. DAILY CY. li~U ' _. #4L#
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<br />Sn PLE {:¢4:tYF~- .•^•,x,r44{< »S0»Od ( 19)
<br />~L:i `-;OLYED MEASUREMENT
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<br />R# 4 ~ ( 941 »!L{10C 1p{0»4b 4Y4b4#
<br />'! I ~ U A L MEASUREMENT ~ .
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<br />,4ii76 ~ 0 0 PERMIT..:. .:.~:R ~ T ES=1 'x^FaORL 0{v>G#t q.sR,R{+V~ 'CA`.r ~~ F,Sx.LY I:IGA
<br />~p-rLUEtiI Li~055 VALU. REQUIREMENT. - S>dST t!AX' NC=U 4{:^#
<br /> SAMPLE
<br /> MEASUREMENT
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<br />NAME(TITLE PRINCIPAL EXECUTIVE OFFICER I cERn FV
<br />uNDEA vENAIrY of LAw THAT I NAVE PEnsoNALLY ExAMiNED MD TELEPHONE DATE
<br /> AM FA MI4M WITH THE INF011MATON Sl1eMITTED HEAEIN; MD BASED ON
<br /> MY INOUINY OF THOSE INDINOUALS IMMEDIATELY RESPONSIBLE FOR
<br />OBTNNING THE INFORMATION, I eEl1EVE THE Sl1eMITTED INFORMATION IS l
<br />~~~ `~~~
<br />R J
<br />W. Gordon Patera SIONINCANT~PENALTIESD FOR SUSMITTINO FALSE NPoPMATION INLCLUDING 970 824-4401 99 QL 25
<br /> THE POSSISIUTY OF RNE MD IMPNSONMENT. SEE 11 U.S.C. E 1001 MO 77
<br />1 $IONATIAIE OF %IINCMAL EXECUTIVE
<br /> U.S.C. E
<br />J10. (PYnMtl,1 MIOIr sew NMIF neY ~~. M14w. W ro 510,000
<br />TYPED OR PRINTED ra rmuYr.n inpriowwnr e/htw'wnemmtlu..d a Ywra/ OFFICER OR AUTHORIZED AGENT CODE ~ AR O AY
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<br />COMMENTS ANO EXPLANATION OF ANV VIOLATIONS (Reference ell ettachmenrs heel
<br />-, ,:1"iLEP.nLL ~01.7~~.> !.'(. dY f" cdIVF.:i ~Oi? ~luYft,74MF SiiECIP EVPi'T - EFE .4LTERNA7E' LI°.ITRTIC65 UtiCc!i
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<br />EPA Form 3320.7 (08.95) Previous editions mey Da used. , (REPLACES EPA FORM T40 WHICH MAY NOT B SED.1 U 0 C 3 5 / 5 71211-16u Y, PAGE lOF I
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