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rzRMITTEE NAME/ADDREBSR+A•~r7rWdA'r't«wa17MEr.r"U NATIONAL-OILVfMTDIIONMOI LAMINATION /Yf1Q1 //NPDE3) Folm Approved. ;• DISCHARGE MONRORINO REPORT OMR/ 0~IB 2 4 '' :''v~l~{ YAME YI~rIJS Lllr'inL •.Ur.r'U:CAt lLli. -le 17-19 SPi11LS S1~ tijtt„`.rL'E+" Q•I Q~P~ : Af~d~ole1 azbftdi O&~d~88 ~~ . . ° u u L X G tl ~ -' J :i K iv.'+ 1[ •r j ' ~ aeeNMGe NuLleEll PERMIT NUMBER t:,al:; LLJ tilol:; F - F11saL -. FAgLRV (-'I•Y.iLJ i_Kt'ii~i; LUhr:~nal I~IiN - ~~ -' ~ MONRORINOPERI00 1'lr+Uk ~~ - . YEAR MO AY MO V ~ ~ ~ ~ ~~ ~~ > 1; ~ ' • _ ~ , D EA DA : LDCAnor~r{a i u ~ ~ GIJ dl :: ~., - 'FROM 9u Q4 U 1 TC~ y-s- Jo 30 K<+,: NU J 1 SCfIA:i t;E `~ ,~ :: ~~40#` ~ ' ~ ~l NOTE: Rud ImWOtlarr Mf re` Mtl thN f I ' oomp orm. e np . . ~ t I i•. I 1 L ~. H ti E. L T: , L ! 1 J L E, n r 1. [ I ~ C is A L h l i k ~ 126211 127.191 /71.76/ =-. , •!]6771 lie-791 19x91/ PARAMETER /90rd onN1 QUANTITY OR LOADING... f16rdOnM! ' DUANTITY OR CONCENTRATION NO. 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I~~ . rl ~;I•~r.t :, F•L'S$ LliIUL PECUTAEMENT •:: . . . .., ., <*.~i<' .. , > •,v % .. ~ ~ _ ~,~ ;g'r - 1.... ~ SAMPLE ., ,; ;<.p.; ;< {•¢{•.~#:• ~ r<i?~~<y 1~ . i ,. 1_ .:~LUY:ikA';~L~ ~•' MEASUREMENT ~• •• ~ ,,, "O ,l~ •~ 1.1 f~r i U U ...PERMIT.... .:4.tr}~ril o.:. yi,i$~3~yF y <.~rF. ,41air<ie.`i•YS, ,.~%.~ roc'... - •~~~'~~° ~ ^:' ~ t. ~ r• Lvi l+1 t;F:J55 YALJL REOUIREMeNT i<+'4 l ~ ` ~'~ j~'• . ~ ~ t) f. vi I - +..r !.. ~L:.1Luf i u:, SAMPLE MEASU EMENT Qr O 1 0.04 " _~ v> ~ :<ir#s<':•+~ • i•i•ti<•n:<~;. ....:.,~ 20' ? :rt ~ I ~ .. ~ I n L ;~ T T; t N ~ ~ N L A N 1 R Qr,~,+,~.E . ~ }-~ . ~ - , ~~ , ., L. ,~ . U U .. PERMIT.. .. .. .:: ..:::.::... .... ...I/~:.:~~ ::...:.: ::::: .. '<:•::'a":~.::.: :.: :r.. l~ik'ifi r,.~:~.:~.. .......: ~~~?. ti!.4'r3 aEti>•: ~•~ .. . ~. .;.~:~: ~:: is ~ ~ (p'..'::z xy .. . r • I ~ L C .. 1~J5 VALJL ' REOUIREMENT~~ . . .. ......:. ' . t ~1J 4::::A"N ~~y ~ p~ ; . . : : " " ~ i.n ' 4 . s< ' .. .. :.. ..: ..:..~ ... ~ . ,. .. . .. . .. .. . ' i . i ~~ :: :: 'x:~c ,• ' SAMPLE ~. : - ~ , ~ . . .. ~.~ ~ MEASUREMENT i'. -;` ' ~ -w' ' ' - ; ~. - .. . ~• ~ ,. . PER . ..: , ..::: . .. :..:.: .. ... , .: . i+. R .. ... ::...... . .. .. . . . .......... . ,.... . ~ ~ ~ ~ ,~~~ V 1~ pp NAME/TRLE PRINCIPAL EXECUTNE OFFlCER I CERT AM FA FY UNDDI PENALTY OP l MIl1M WITN THE INFOI AW THAT I NAVE -EIIBO IMATION eVSMITT[D N MALLY EXAMIN FgfIN MD BA ED MD . SED ON ,^ + TELEPHONE, •; -: .DATE . ~ ~ - 1}}F ..! IGIId Y[i ic11IIS ~ " . : MY INOUIgY OP THOSE INDINDUALe. IMMEDIATFlY gESP0N91S OBTAINING THE INFORMATON, I eLAEVE TMF BUSMI7TED INFORMA 1E FOq TION IB , : / ~ ~ ' / J ~. ' ~~ 4• f l" Y, `~ , TRUE, ACCUMTF MO COMPLETE. 1' AM AWME THAT TNf 11F MF .. / 1 / /•` ~ ~ ~ - • - - , . q y ~ . ' ~ fllV lt-U:I IRPITt01 r.rlia7C/L!f•{ 'i _ S+ONIRCMT PFNAL71E8 FOIL eUSMRTINO FKeE IMf01WATION, INC LUDING ' , (970 870-27.~12~ _ ~,Q h;~ ~ ~ ~ 9 ,~ ~ +~ 711E P0391BIVTY OF PME MD IMPNSONMEMT. BEE 1e U.S.C. 1 1001 u e e f 77 e MD ]S ~ NONATIINE Op PRINCIPAL EXECUTIVE - T .+ ~, . '+ TYPED OR PRINTED . . . 1 . ~. uw tlw Overt.. ,,.r irArh e... y r ! IOAOO rMrnrori,rlr M,^NrwrwrTMMrrwrlmener~nlerval ~ OFFlCEq OR AUTlIORQED AGENT COD NUMBER,, YeAR. SMO- ~DAr;- • :O MENTS AND EXPLANATION OF ANV VIOLATIONS (Ref~r~nce dl ~ttechmenb hers) , tl Lu,. Llf,lf aNPLiES TU~CUMU11rL.is rt_u;: FRGti UUi, 02~~~L'U24. '~UIL G Gait=aSE ~l:~A~ SAMPLE ANAI,YS-I~S-~K i,ilfL'c StTECrI IS UtiStRYtt1: uli1+:LY ~Af'IYLIrIG 1NSTN,ULT3UNS~I.C.dr NG X. ~ ~ ~ '" ~ ~ PA Form 3320.7 108-86) PrsNow editlora msy be used. IREPLACEB EPA FORM T~LO WHICH MAY NOT B! UBED.1 . , PAGE T` Op.