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PERMITTEE NAMFJADDRESS (/nelude Facilirv NamdLomlion i/Di$erenq
<br />NAME
<br />ADDRESTt(AFPY.R f!IliINC, INC.
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<br />FACILITY C''AI ~ CO 5166
<br />LOCATION
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<br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Form Approved.
<br />DISCNARGE MONITORING REPORT (OMR; OMB ND. 2040-0004
<br />(z 16) /n el F. I NC fi Approval expires 05-31-98
<br />r - (SUPS NM)
<br />PERMIT NUMBER DISCHARGE NUMBER F - FIN ! I ! C f i 7
<br />MONITORING PERIOD F C N G i I C 7 C J C N N: C D G C L C H
<br />YEAR MO DAY YEAR MO DAY _ _
<br />FROM OC CI 01 TO OU C: 31 c~~: 9G II'_CNAFGf ~_ ~ tea
<br />(YO-2A (2823) (.4Q5) (26-211 (26-29) (3o-31) NOTE: Read Insttuctipns before rRompleting this form.
<br /> (3 Cab Only) QUANTITY OR LOADING (<Card Onty) QUANTITY OR CONCENTRATION NO. FHEOUENC SAMPLE
<br />PARAMETER (4653) /5461) (3645) (46-53) (54-61) EX OF TYPE
<br />(32-37) AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br />lbau~i ANALYSIS
<br />(sa-68)
<br />(69-70)
<br />H SAMPLE :Y :; 4r.; "r ;°YCvs<`+ CXL•'.'=%i ')
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<br /> MEASUREMENT ].O 8,Z V 1 n../2rh
<br />U4GU 1 U C C~~T,;' ~40CRI'7i ?70l4 SF 'rat: $i5' ,).: ~A4ri~~0 r<' ~~ : FFk11" 'iSaTU
<br />FFLUEhT ~hUSC YALU Fi~liltD, ENT " tar,"o ;' ~ CL'C ::C
<br />OLIUS, ': !:'f AL. SAMPLE *~~~"'-% C4~;~L`.~- >74~CCP 1 ;`)
<br />SUSPEND'cL MEASUREMENT ~(/ ~(~ O ,eAj~'
<br />U053U 1 u G ,p ~ M+t~opl+o $ # zt~
<br />>M , 35 E1r~ © tEl #AE
<br />FP UENT ::ROSS VALUE ENfi~ - ~ 1 ~`-".`r %>r;:Y, _'~~''r .m=,- '~ ` P a-~ .' ti FC I
<br />OLIGS, :i~'CTLEAHIE SAMPLE %:-OG:;:L:1 ,?tL9Y~t trOr+C-i': c
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<br />~ MEASUREMENT ~C O. J ~-O, ~ V / (,,?/Jj
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<br />kUN, TOTAL SAMPLE i'aaz'a'r_ u~*'~?~a o~c~x0. ( I5)
<br />(A S F' E) MEASUREMENT _ Q, ~~'r t~
<br />UlU 1 U C PERMIT' ~'*:~~ A '. >C;r. C+1l~L ', ~ -' 'I$,~~.
<br />EF'F YT. GNO55 YitLCt REQUIREh1' ai t ~ y % ;;qr,.
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<br />JIL A D GFE:ASf SAMPLE ~0.^•:tY'. eI 400 '.4
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<br />' MEASUREMENT /y/j ,N/9 N,¢
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<br />FFLUEAT GROSS VALU~F
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<br />t,Y.U TREA'ClIEYT PLANT MEASUREMENT p, S O,/~,D - ~ 1 ~ ~~0 fTyti
<br />5 v U J O I U U '' 4 ~'"` ~' ~ <„ ~'~ k '~~
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<br />-OLIDS, TCTAL SAMPLE 40~4>r~ Y+XOY4d n>D>09#C
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<br />ISSULYEll MEASUREMENT . ,~Q,BV G V (~
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERS
<br />AM FAMILIAR WRH THE INFORMATION SUBMTTED HER ONALLY E%AMINED AND
<br />EIN; AND BASED ON MY TELEPHONE DATE
<br />
<br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING
<br />THE INFORMATION. I BELIEVE THE SUBMITTED INFORMATION IS TRUE, I
<br />~_ / /1 `~
<br />t'( L /~
<br />W. Gordon Peters ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICAM
<br />R SUBMITTING FALSE INFORMATION
<br />INCLUDING THE
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<br />Pre ' en t /General Mana eL ,
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<br />POSSIBILITY OF FINE AND IMPRISONMENT. SEE 16 U S.C. S 1001 AND 33 U.S C.
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<br />AND EXPLANATION OF ANY VIOLATIONS (Reten3nce a!/ attacnments Here)
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