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PERMITTEE.NAME/ADDRESS Qnclude Facility Name/Cacanon jD~erenq NATIONAL POLLUTANTDISCHAfiGE EIdMINATION SYSTEM pJPDFS) ~~ FO[m A(JPrOVed. , <br />NAME ~ A PP ° R h I N I N 6 , I?I C. DISCHARGE MONITOAING REPORT (OMR) ![I N 0 R ,A OMB No. 2040-0004 ~~- <br />ADDRESSTRAF?ER lIINE (BURR WY) ' <br />P.©. NOR 1H7 PERMIT NUMBER' DISCHABGENUMBER p _ FINAL - !(OFAT <br />FACILITY ..R/)I6 CO 131626 MONITORING PERIOD DT5CNRG TO il,Ul!$ .:GOLCN <br />LOCATION' - -. '~ Y ~R MO DAY -' YEAR MO DAY ~ ~ ,- ~ ' <br />~~ ~ FgOM TQ 2 - ~1 X00 NO DISCN~;R ~E ~~~) ~#'~ <br />AT.TNS Y. CORDON PET°H5, PfLES/G6N [7 G3 NOTE: Readlnstruction5 etora o (pletingihisform. <br />OUANTIIII.O)i LOADING - QUANTITY OR CONCENTRATION ~ ~ N0~- FREOUENC .SAMPLE <br />. PARAMETER ~ ~ ~ ~~ ~,'EX~ -oF TYPE <br />- AVERAGE ~MAXIMU1ut-. ~ UNITS" ~~ MINIMUM- AVERAGE .-; MAXIMUM ,:ZINITS- 'wurss <br />OIt AND,; REASE SAILIPLE ~~ axA ( 9+IJ ;' Oa40 4MOOdtR #$IRt~rkR <br />VI:SUAL~ MEASLREMENT ,, t: 'y ,; _ <br />EPiLUEBT GRO55 YALV !E, <br />MEAS EM~NT t :r rF ~' 7 tit,?'. . ,' ` I*~'ti' i "'~~ ~ ~? ; ~ <br />a ,~ 1 z <br />~ 1 <br />-~ SAMPLE I .. •' .. .. <br />• ~ MEASUREMENT ~- <br />.. _ ! ~ ~ .d u~ ~ ~ - - <br />4 ~. ~ ~ t:,'.e ~ ~.:, .+'41° x ; i t "4,h .Yr: - <br />! P "f <br />. SAMPLE '~ <br />F ~ MEASUREMENT C - <br />{ - 1 ~; ~P' a L '.~ iW a ~~aXf ~~ 5 ~{~~~ ~ . <br />f ~~'~ L .~ f i. ',r ,`~ <br />I - ~ SAMPLE <br />f ~ ~ MEASUREMENT ~ - <br />I <br />~ C. -'ti ~..fiY ry M._ .-1~ F S ~V <br />-Y .fi T [ ~". ~l• v ..L~:- ~ .SM a~" G.i~ Rte.. yj~i... <br />y , <br />SAMPLE ' <br />MEASUREMENT <br />SAMPLE <br />- - - MEASUREMENT .. ~ ~ ~ - <br />y <br />NAMERITIEPRI`CIPAL E%ECUTIVE OFFICER ICenlryun er penalty of law Nat this document and ell attachments were ~ TELEPHONE'_~ -DATE <br />' ~ prepared under my dheaiorror supervision in accordance with a system tlesi n - _ - - - - - - - - - '- - <br />' _ ~ - -tdesamethatquafifiartperSOnnBIpT6pErlTlialheri'an~vau e(he information . /~ ~ ~ ' <br />W, GO*ddu~Peters' ~ eWmiped.;BasadLn mylnquiry.a(thsparson or persona who manageiheayetern, ' ~~. r Q~aef~4r/~4D 1, •~1 QL 1 <br />- ar NOS¢personsdirectlyrespansiblatar gathering them/ormaiion, the irdormation ~ - <br />Praaidattt/G~era1 Maal4gar aWmi@adis',tolba4CatofmykrgwlefJaeandbeliel',true,accurata,andcomplato. SIGNAWREOFPRINFrIP/~LEXECUTIVE' - <br />DORPRINTED tam Mare lhattnare are s' nir~wot p9gal4es lonsubmitling.le7se lnlorma0dn, QFFICER OR AUTHORIZED AGENT <br />~ihcWdl" the ossibil' o Band im risonment~br owln violations. NUMB F~' YEAR' MO OAY <br />COMMENTS AND'. PI,ANATIONOF ANY VfpI,ATIONS(fie/edence alf attachments hgre) ~ ~ - .. ~ ~. -. '~ - ~ ~ _, <br />TS5 E 70T~L IRONt'LI3lITS MILL B$ YAIYED, AND SETTLEABLE SOLI85 I,IdTT APPLIED POR,<=90T~,24~R P~ECIj EVENT- <br />5EE BURBEII OF PBOOP.REQUIREl1BNT5 UNDER I.A.3. TDS lIONI?ORING - I.H.3. OIL'6 CREASE ~-SEE I.8.1.(.D). <br />PA Form 332 -1 ) revious a Iho s may a use _ - ' _ ~ ~ _ - _ ~ -THIS IS A ¢PARr 1=nap. PApC .+~ <br />-w- <br />