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PERMffTEE NAME/ADDRESS (!nclmie Fucillry Name/Lameon ijDigerenr) <br />NAME dU W I :: k ° ;' ; "i ( " ~ 1.; ' . ~ ..., <br />ADDRESS BU W I d N r) . - t !I ~ <br />P.U. P~~v ~~ ' ;!~ <br />~;' <br />FACILITY P A O.Y [ P CQ ''!1 i If 2 S <br />LOCATIONN O J I .. <br />CO 81 4 28 <br />A'PTM: YT ).LT Ar .._ ,I ~. ac sn MTUrr Oro <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) Fortn Approved. <br />DISCHAR GE MONITORING REPORT (OtMR;9) y OMB NO. 20440004 <br />L N D 4 Approval expires 05-31-98 <br />(SItnR YC) <br />:! PERMIT NUMBER DISCHARGE NUMBER _ F I M A L D E 1. TA ~ <br />MONITORING PERIOD *15f 9G OF _°N TO DEF.'R Ti.iIL `~~TCR <br />YEAR MO DAY YEAR MO DAY _ <br />FROM TO ^I 09 "1~ '`#~ 9~ ,r.'TSCHAR6F. ~_ ~ t'?°'• <br />rxon m.n~ n~.~al na.on na.~m mruan NOTE Read Instructions he}0rw rmm~letinn this }ONTI. I <br /> (3 Caro' Ony) QUANTITY OR LOADING (4 Certl Ony) QUANTITY OR CONCENTRATION NO. FREWENC SAMPLE <br />PARAMETER (4653) 54-61) (3845) (48-53) (54-61) EX OF TYPE <br />~Z~O AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS ~ <br />~ <br />e <br />3 <br /> ~! sa <br />s <br />) 6&70 <br />OIL AND Gk8A54' SAMPLE "#Cax ( 94) ###o## #;###it #Ci:;^,# <br />Y I S U A L MEASUREMENT <br />U40b6 1 0 J "a' ~,~Ipz ~ . r <br />',j, ~>',i, x <br />: E5=1 • <br />~ ~ ~s r +~M~+lRT ##t ~,~; ~,.~ _~ <br />iFFLUENT i:kOSS YALU ~ ~ <br />Ylhlq~ # <br />- <br />~#)4~ ~ r .s <br />,k NO=0 ,r.i,"~`_ sE3,ItVn~s ":~5"~ f _w Q4>Q3 ~~~r='~ <br />SAMPLE <br />MEASUREMENT <br />SAMPLE <br />SAMPLE <br />C <br /> <br /> <br />". ,?f . <br />SAMPLE <br />SAMPLE <br />MEASUREMENT <br />EXECUTNE OFFlCER <br /> <br />., <br />~, ~ ~ . <br />l <br />a , <br />~. ;"~; <br />TELEPHONE DATE <br />,i rew,unes run suomu nrvu rouse inrumm~uun, muuuuinu Inc <br />/ ~' ~J` ~~ j~/ ~ POSSIBILRY OF FINE AND IMPRISONMENT. SEE 18 U.S.C. 51001 AND 33 U.S.C. $IGNATURE OF PRINCIPAL EXECUTIVE ~~ ~' ~~ /~ -!"~ ' '_~' ~ ~~ J ~ <br />4 1319. (Porettiaz untler these smnrtas may Inclutle lures up m 510,000 entl w OFFICER OR AUTHORIZED AGENT <br />TYPED OR PRINTED nmrimum lmpnsonment olheMeenBmanrlu entl5yeers.) rnnc NUMBER YEAR MO DAY <br />AND EXPI ANATION OF ANY VIOLATIONS /Reference ell etfachmenfs herel <br /> <br />S?TTLEABLE SOLT~S LI"IIT APPLIES ONLY IF C1DTR,2'iRR PR?CLP FvgvT iS CLAI+1£C+. IF ~L~7M APPRCYF.D 9Y dI~CD, i <br />T:,S E IRON LIf7IT5 YiLL VO1 gE APPLISD TD RQPURTP,D MEASpR°NFVTS-S+?F I.A.2, P^ S FOP RgRDFN CP PROOF I <br />EPA ~orln 332 (0 5 Previous editions may noibe use ~ ~' ' ( CES'E A FO T ~ 1 AY NO BE S DJ ~ ~^ ~ ~~ %g !t D I i 2 _ i 2 ~ T PAGE OF <br />