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PERMITTEE NAME/ADDRESS (/nc(ude FaciLm NamelLom+ion JDiBerenQ
<br />~~
<br />NAME SEIIECA CGAL CGflElNT
<br />ADDRESSD RAaEB D
<br />AiYDEY CO e1637f"'
<br />FACILITY
<br />LOCATIOf~AYDE1 CO 81630 FROM
<br />ATTN: G. BUD Bk0Y6, GEhERAl BAhAGEH
<br />t -
<br />i(NPOes) Form Approved.
<br />OMB No. 2oa0-oooa
<br />q 11I MC ~ AyQJoval expires 05-37-98 ,
<br />S U E R I i) ~,.,i'..
<br />NUMBER F-[ I l i I FC ~'L 7
<br />--~ DISCflfli6! ZC-6i1S51 CiFEA
<br />YEAR ~ ~O DAY ' ~ - "~ C C C
<br />U ! ~`. jgC111Hi! ~~..-~
<br />Rs-zz/ ~ B~zsl (sea+) NO~d Ipstructions before completing this Corm.
<br /> (3 Cerd Onry) QUANTITY OR LOA ~ - (a Card OnryJ "O ANTITY OR CONCEN fON NO. FREOUENL SAMPLE
<br />TYPE
<br />PARAMETER (4653) (54-6t) (33-45): ~- (46-53) (57-61) E% of
<br />(32-37) AVERAGE MAXIMUM UNITS' ~ MINIMUM y;~~. ~ AVERAGE MAXIMUM UNITS ANALYSIS
<br />f6z 63) (64-68)
<br />69-70
<br />PH SAMPLE
<br />MEASUREMENT x o4 ~cc a ~.
<br />$ • q ` as >do
<br />-~ ~ O `~O
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<br />V /J~ ,~i S
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<br />tPFLUeNT GROSS YALU UTRDM~tai tioa ~- fl
<br />AYIflY;J~.<' SU
<br />SULIDS, TU SL 'SAjv1PLE Cvo4 m; - 40 O
<br />R iaC L
<br />~ ~ L
<br />' ( 75) '
<br />5U5PBNUED MEASUREMENT <.,..___ v ~
<br />DG530 1 0 U !~ ~~ . . S>o4 ;,
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<br />SAMPLE
<br />MEASUREMENT w
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<br />EFPLUENi GROSS YILO M NT , c+t~ ~~ ~~
<br />RON, T AL SAMPLE X' ` ~ a.04 '~
<br />O ~ C.
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<br />(AS FB~
<br />MEASUREMENT . . .
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<br />1045 1 U '0
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<br />EFFLUE~iT GBOS^a 'YALOE , ~1y1~GhC~Nt _~
<br />: ;'~~~ 34D~ flYO- ~I J1 ~ ~t „-'-
<br />IL AND G E SAMPLE :r"k" ~. II#
<br />~ 7 CX. r, ~.t .~ OCALU ,t r
<br />~ ) /'~ '~
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<br /> MEASUREMENT .__ ~k. {,'•
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<br />eY0 7T~eA S7lEII'!. PLA Y7 SAMPLE
<br />MEASUREMENT ~~{{ (
<br />V• ~ {~V ~d 1~~ ( ) . .LUZ4 Vr,CC v4ti C `f
<br />~ f(30 5
<br />70050 1 ~ 0 1 ~ ~~~. . f ',~'~-
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<br />2FFLUEBT 69055 YALO 1 ~' =
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<br />DISSOLVED
<br />SAMPLE
<br />MEASUREMENT .,r ~
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<br />EFFLUEh7 GR09S
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<br />NAME/TITLE PRINCIPAL QEGUTIYE OFFICER I CERTIFY UNDER PENALTY OF WWT}IAF I HAVE PERSONALLY EXAMINED AND \ , ~ TELEPHONE DATE
<br />AM FAMILIAR WITHTNE INFORMATION UBMITTED HEREIN; AND BASED ON MY
<br />INQUIRY OF THOSE INDIVIgqUALS IMM ATELV RESPONSIBLE FOR OBTAINING
<br />/^~ 1^ `
<br />THE INFORMATION, I BEIJEVE THE SUBMITTED INFORMATION IS TRUE,
<br />10 Ln P S
<br />U C ' \ ~ • S ~ !
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<br />ACCURATE AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICAM I
<br />l
<br />J ~ r J ~ PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE
<br />POSSIBILITY OF FINE AND I ISONMENT. SEE 10 U.S.C. § 1001 AND 33 U.S.C. .
<br />SIGNATURE OF PRINCIPAL EXECUTIVE ~7o a7b ~ ~o V O O
<br />~ O
<br />4 1316 (Penalties under the le(ules may include lines up ro Sf0.000 end of
<br />~YPED OR PRI!}TEU maximum impdsonmenr dl6, Zimomhs end 5'yeara) OFFICER OR AUTHORIZED AGENT nREA
<br />CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference ell attachments here}
<br />TSS b IRUM LIBITS VIII BE YAI~BO E S$TTLEAflIE SOLZCS LIflZ7 APPLIED E'Git <=l0Yd,2tllE FEECIF EYE 14; 795,
<br />IROfl E SB2TLEeBLE 9CLIDS LItlIT3 Y/IYED FOB ?lOSA,itlNk PFiECZP FYFli1 '_U tdECT ?G BGE~EI CE FECCF IE I.-."s• ,
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<br />EP.A_.o'rm.3t2 :. OB,951'•: 99ib S:e II "av riE'~.` sad ~ _. G & O AIFL.~O yfHICH.MAY NOT BE USED.) pA~p~oafa.. ~.~t.~as '. ....._--.~-PAGO • .9F_ :~ ..
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