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PERMITTEE NAME(ADDRE$$ (lnrlude Facilrry Name4omnnn fDfferent/ <br />NAME SlihE'CA CCAL ccr.FANx <br />ADDRESSG fl A r E it D <br />H1~YDEiI <br />CO tl1639 <br />FACILITY <br />LOCATIOI~)1YUL•h CG 81630 <br />ATTN: (~. bUD EHGMN, hENE4AL rANAGFA <br />Form Approveq~ e„. ° ,,;;pp <br />!' I h C n" OMB No. 2040- 4 <br />Approval expires OS-37-98 ~ <br />(SL;:h 11) <br />F - FI~F1 ~ EIiUST <br />LISCHAECF TC•=lIE/E79H CFkEf§ <br />~~~ NO [IECHAECE ~ iAQ <br />NOTE: Read InstruIXions before C~~pleting this form. <br /> (3 CtW Onty) QUANTITY OR LO (<Card Only) QUANTITY OR CONCENTRATION ~N FgEOUENC SAMPLE <br />PARAMETER (46-53) (54-61) ~ (3H-45) (46-53) (54-61) EX OF TYPE <br />(3Z 37J AVERAGE MAXIMUM MINIMUM AVERAGE MAXIMUM UNITS <br />(62-60) ANALYSIS <br />(64-66) <br />69-~0 <br />Ph SAMPLE OtL4YV :T .LSt;r L' ,+r4'.0 ( I~ <br />' /, <br />/ <br />~ <br /> MEASUREMENT e ~ ~ ! ~ t ~1 `~ 3 (~ ks <br />U4UU I U 1 PERMIT -oa#?pr1~4 ' ~ ~ O'>a40##" +'4:+ ~..'' <br />:: AAOCO# •~ ~ 1~~/ 15~3I11 <br />G FYLUEFT C:HO55 YA LUk REpUIREMENT - XrCC , <br />''Y ~ ., EtjYY10! SL MtIYH <br /> SAMPLE <br /> MEASUREMENT <br /> pEPMIT s -~ <br />t ,.`..~ <br /> fA~Q)llEi~)11ENT t <br />- t 9 w ~'~-.,; .. - <br /> SAMPLE <br /> MEASUREMENT <br /> <br /> REQUIREMENT ~ - : a y`lr ~ .. - <br /> SAMPLE <br /> MEASUREMENT <br /> t <br />~~ <br />EG <br /> iUl <br />i <br />l;NT <br />p <br /> SAMPLE <br /> MEASUREMENT <br /> -PERMIT - ~" ' <br /> FIEOUIRfv~AENT <br /> SAMPLE <br /> MEASUREMENT <br /> ~~atrtlr ~~5~. ~~ <br /> . <br />AEQUlREN1E137 • ~=' <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT- - ~ ,` <br />~• <br /> I~EQUIREME}I1T ~ , <br />... . <br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSO <br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HERE NALLY ExAMINED AND <br />IN <br />AND BASED ON MY ^ TELEPHONE ~ DATE <br /> : <br />INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR OBTAINING <br />~ <br /> THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS TRUE, ~ <br /> ACCUMTE AND COMPLE-rE. I AM AWARE THAT THERE ARE SIGNIFICANT <br />BMITT <br />PENA <br />TIE <br />F <br />R <br />N <br />FAL <br />E <br />NF <br />RMATION <br />INCL <br />DING THE <br />A <br />,( <br /> L <br />I <br />I <br />, <br />U <br />S <br />O <br />SU <br />G <br />S <br />O v /\ I <br />~ <br />v U <br /> POSSIBILRY OF FINE AND IMPRISONMENT. SEE 18 U.S.C. § t Wt AND 39 U.S.C. SIGNATURE OF PRI IPAL EXECUTIVE {,J <br /> <br />TYPED OR PRINTED § 1319. (Penetties untler these sretNeS may indutle M1nes up to 510,000 end or <br />me..imum lmpnsanment or beNrsenfimonthr end5ytrers./ OFFICER OR A ~ ORIZED AGENT AR A <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Relerence ell attachments here) <br />1'5:: LIMIT GILL of ~AIYh•L' RNLI SE4TILAFLE SGLIDS LICIT AbFLIEC €CA <=lUYF.,~hHL PnFCIF FVE11: ~9S E <br />~tTTLEAELc SOLIGS LIF.IT 4ALVED POE ~10Y8,24Hh PAECIF EVENT 5UUJECT TC EGnCEN G€ FFCCE II I.A.1. CIL G <br />ro_r~v_c~~c r u n n any +ICM ~7'Q ii;M6-SfIB ~ ~ ~ € <br />EPA Form 3320-1 (08-95) Previous editions may not be used. (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) 0 C U 7 7 / 99 C E i 7 - ] b 5 3 PAGE .I OF <br />