|
PERMITTEE NAMElADDRESS pn... fsreryN../Lrrr.n yDlpwewq
<br />NAME 5_.y'~.i:A DUAL JI:?,'4kA1;Y
<br />ADDRESS }' w V. n U X h/
<br />N'.Yti(;t: CO. x1939
<br />FACarrr
<br />LOG~+~i;,'!L~': CO 41630
<br />`~'~: ~.L.":;:ic:.. (,'•;NSt!AL t!ANAGEk
<br />NATIONAL POLLUTANT DISCNMDF RIMINATDN SYNTFM NPDESI
<br />DISCHARGE MONITORING REPORT (D Rl
<br />PERMIT NUMBER ~ ~" DINCNMDE NUM EA
<br />MONl70RING PERIOD
<br />~XEAR MO DAY - YEAR MO DAY
<br />FROM '~ j TO ~ ~ 3
<br />_ I ~
<br />...: J L: j '~'
<br />: .'~IA;aGL• TO TFtI6/CFT i:nk:L' •~
<br />s..
<br />,fit i
<br />::I ,, :h.,~~ DISCHAkGI;.{,--~ a;rc
<br />I~L~ •rrd Iminredarr b~laitc ~pIr.FMp FhIN form.
<br />PARAMETER QUANTITY OR L - QU81 { Ly OP CORC Ofl NO• FENCr
<br />RIF° SAMPLE
<br /> EX o
<br />ANALrsa TYPE
<br /> AVERAGE MAXIMUM MINIMUM AVERA MAXIMUM UNITS
<br />'JiL n'~u ., ~tA.,: SAMPLE :ar,:r;: ~ ~ ,,~) :rp;; ~::= glgt: ,-. ,} r.: ;.:p.vs ~
<br />
<br />y L~ ~i A L
<br />MEASUREMENT
<br />U `
<br />0
<br />d4J6b 1 ~ 1 .:::..PERMIT . ~.. .:. pi,2'i:'s'S.~FE~.'',e :-r.' .... E,
<br />. ..
<br />~ I rUA
<br />k Fr'LC;.d'I .:eiJa:i YnLLk REQUIREMENT
<br />
<br />~~~~ ~ ~
<br />.~.N. rl!'fIX~
<br />tIU-0 ,
<br />.>-.._ ' ~,
<br />.a...A'I' <at.
<br />~~. ~ ~ u,7'Y~ '
<br />x.~ .
<br />ESQNTi':N
<br />~'
<br /> SAMPLE
<br />' ~ . ,,y~; ~ _
<br /> MEASUREMENT y
<br />.ai '"~
<br />-!'fir '•f
<br /> PERMIT, . ~ ~ ~ r°: ~
<br />
<br />~ a
<br />...
<br /> .'REQUIREMENT ~ ~
<br />(~~~~
<br />:.;
<br />.;.
<br />
<br />. ~::....... ~..
<br />
<br />..... .,.
<br />
<br />.
<br /> SAMPLE
<br /> MEASUREMENT
<br /> .: ~::. PERMIT: ~. ~ .~ ::. ~ : ~:~~ h .:;::::. .~....:~..::.....:,. :::.~: :[F,..r...: ...
<br /> .REQUIREMENT: ~ .. ..~: ~ . ~ •;: s~
<br />
<br />:.
<br />~..
<br />...:...~;.
<br />',3 M
<br />
<br />.:::: :: ::.:.. ...:... ~;n,.
<br />
<br />
<br />::^ .
<br /> SAMPLE
<br /> MEASUREMENT ~-
<br /> :::.:;.:PERMIT.:::. .... ~ ~ ~~ ~ ..
<br />~ ~:: s ~~.:~.
<br />`
<br /> .REQUIREMENT ~.: ~ ~. .: ~ ~ ~ ~ ` .:' s
<br />c~; ::.:
<br />~''~' .
<br />
<br />..
<br />.._ l
<br />.
<br />...,.,.: .
<br />,....
<br />:•:::... ...
<br /> SAMPLE
<br /> MEASUREMENT
<br />
<br /> :REQUIREMENt~ ~:.:::~::::5:::~~:::~::~~
<br />;:
<br />~ ::..~. :: :.
<br />~~~:~
<br />: .. ;
<br />;.
<br />:::
<br /> ..
<br />. .
<br />.
<br />. .
<br />,
<br />:.:..
<br />,.
<br />~.: S:C
<br />
<br />a
<br /> SAMPLE
<br /> MEASUREMENT
<br /> :' . ~' .. ,. MIT ~ ........
<br />
<br />~ .. ..: ....::..::::
<br />
<br />..•..;; ::>:~;.:,:.:..:: ~ :.......:...
<br />.., ... .;
<br />:~:.:.:,..:. ,~ ~
<br />
<br />..
<br /> ;REnUIREMENT
<br />~ ~~ ~
<br />~ ~~~ ,,..:
<br />~~~
<br /> SAMPLE ~
<br /> MEASUREMENT
<br />: .::':.;.:::PERMIT:: ~.~. ~. .. ~ ..... .:.... .
<br />~ .: ..: ::..:...... .. ~ ~ .
<br />~: R
<br />E
<br />QUIREMENT~ ~ :.:.~ ..:.. .~...~•.:::: a .:~r:: .:.. ., : .' ~ .
<br />.
<br />.
<br />.
<br />~ ~ ~
<br />i
<br />~
<br />. .
<br />.
<br />_:........
<br />,. .... ...,
<br />~ ..:. ... ...,. .
<br />..::. s.::.~~~::~.:~.:~:: ~,:. ..
<br />..
<br />...
<br />.. ...
<br />.
<br />....:
<br />:
<br />.
<br />NAMERITLE PRINCIPAL E%ECUTNE OFFICER "`"")° "P`"•')nrl.. un~u
<br />PrtP•"a °waer m) alrtrnnn o. wp hdxgmenl ena .u ell.rnmen~we.e
<br />r.WOan w,a°N.n
<br />wun .
<br />l
<br />ad
<br />M ~ TELEPHONE DATE
<br /> ae
<br />y.
<br />em
<br />N
<br />In .wrt Innl qu.llned pn°nn)1 prvpa) Nnlnei eM e.nlunle the Inrermnll°n '
<br /> f°nmllled. NuM °n m) In9ulr) d ur Peron or R•+np wn° Runge We r)flem. 1
<br />
<br />nr Ihme pemm dlrtcq mpe~laM rx p,NerlnN Nr Inrnrmnllen, the Inrnrmntl°n _
<br />/,1
<br />C
<br />
<br />ruhmlllld n, 1°Ine bpl o(m)hII.wINNe.na nfNe/,Irve, .RLnlr..b [°m/lele.
<br />I.m.w.rtu.nhert.rta
<br />~anunp
<br />m.m
<br />ro
<br />hMm
<br />m
<br />mr
<br />`~
<br />lION
<br />T ~
<br />'
<br />
<br />TYPED OR PRINTED y
<br />n
<br />re
<br />nN
<br />.
<br />N
<br />°nnah.n.
<br />IntinalnN Ue p°mhllu)ornwr.na lmp"snmenl rnr 4n.InN .I°I.NO,a A
<br />URE OF -RIN~-AL EXECUTNE
<br />OFFICER OR AUTHORIZED ADENF
<br />NUMBER
<br />YEAR
<br />MO
<br />DAY
<br />, CODE
<br />~~....-.~........... ~,.. ~...-•..._.- _. ...-. ..-~.......s Inoo mcw w. wuewrnmu nwrq
<br />._., L:•,~P. Ll:i~..~ a1L.. .. WAIYEG Ap:: :in.'."L~..~~1.., ll;., ,:.~ ..I :', n~='il=i. i~! C. :=..JYN.r?»!I; F'rii,CIr ,:YE..i• '::i:i E
<br />r
<br />[rt :)R L[~."I'_'S nA.iY~il Ei-i, ?1JYHr 1r1E: F~~h i•;^I;' r,V =: ~;; ':J FJr C~C "~~ _•. c.. r: :J ui' ['r.O IF i:, I..,.~. aIL .. GiiEA;%c-`; is :~:
<br />EPA'Fohn`1320.1 (R~0'3/99j P~ebious'eBiGons may ~e used ~ ~ ~ 7T'
<br />11 PAGE OF
<br />
<br />..
<br />1 a. p~
<br />us s a- an- ~ m,
<br />%~~4 ~~v
<br />31
<br />~
<br />a
<br /> t
<br />iV
<br />Vi
<br />0
<br />. i. ~
<br />
<br />
|