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<br />PERMITfEE NAME/ADDRESS Pr>ry FrWq NwdLeculm dDl~.a)
<br />NAME COL04YO C0111. CO°PAkY L.D.
<br />ADDI~ESSCOLJWYO tlINF
<br />5731 STATP. NIG.NYAY 13
<br />MEEKER- CO 81641
<br />FACam
<br />LOCATION ~
<br />ATTli: R. D. USILTON. PRESIDEVT
<br />~T ~DISCW4ROEDMONRORINO REPORT % MRIPDES)
<br />11-16/ 17-I9/
<br />r_ocRrlDOi ~. ~ :~~o~n .
<br />-~ PERMIT NUMBER:. ~ DISCHARGE NUMBER
<br />' ~ MONLT;ORING PERIOD
<br />YEAR ~ MO ~ . DA~Y,',`r YEAR MO DAV
<br />FROM • ~: "TO 9 B D 9 30
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<br />.:'110.111 'Y71=131 iU7-X151"- /P6I71 /18-191 130.3!1
<br />Fonn Approved. -
<br />°. TATLOk POND TOOMSNoy~ODao~ooaaER
<br />(SOAR RV) Approval eX3 rpS 05-37-98 ,
<br />F - FiHAL 12.44 ; ,•`;/"~
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<br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTIFY UNDER PENMTY OF UW TMAT I HAVE PERSONALLY EAAMI
<br />AM FAMILIM WITH THE INFORMATION SUBMITTED HEREIN
<br />AND BA NED ANDS
<br />SED ' TELEPHONE DATE
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<br />ON
<br />MY INQUIRY OF THOSE INDIVIDUALS' IMMEDIATELY RESPONSIBLE FOR ~
<br /> OBTMNINO THE INFORMATION, 1 BELIEVE THE SUBMITTED INFORMATION IS
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<br />~ TRUE, ALCUMTE AND COM0.ETE. I AM AWME THAT THERE ARE ~
<br />SIGNIRCMIT PENALTIES FOfl SUBMITTING FALSE INFORMATION, INCLUDING -~>.' ~ '
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<br />• THE POSSIBILITY OF RNE AND IMPPoSONMENT. SEE to U.S.C. ! 1001 MID ]]
<br />' gIGNATURE OF PIIINCIPAL EXECUTNE .
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<br />TYPED OR PRINTED uWwmu~imn %eAdaamurtbMfrwn enlmdia uq b.Yir+l ~ ,.. :.OFFICER OR AUTHORIZED AGENT CODE: ,NUMBER YEAR MO DAY
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<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS IRsterencs ell sftechmsnfs here/
<br />SETTLEABLE SOLIDS LICIT APPLIES ONLY IP <= 1D=TR, 24-AR PR EC]
<br />fJQCD, TSS 5 IRON LIMITS SILL NCT BE APPLIED TO REPORTED '1EA51'
<br />Z IS CLAItlF-D. I/,tF~;1xM APP&OVED 3Y
<br />3--SEE I.B,lA, PC•;:1~ND T•8.1D, PG 6.
<br />EPA Fam 3320-1 108=95) Previous Winona may be~ueed:~ ~ '. '. :r: -~'~~ ~~°IREPl~°~u-°^' '-'--'O,WHICH.MAY~NOT'BE~USED.1:.,~ - - a II ~ PAGE
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