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_._. .....~ ~W`1G al..o-.-r:Jaw•Yio~.::myvylRw:J. ' <br />NAME POODEkRtlEM GOAL [OtlPAlI1'-' ' <br />ADORESSkOADSIDE NINE, N 6 S PORTALS <br />P.O. BOY 1430 <br />FALI3ADE CO B1526 <br />FACILITY <br />LOCATION <br />nTTN: JU;tA A. ':CyAu. Ft;ESILENT <br /> O - e <br />le <br /> O 4 (SUBR iC) xj~gJ <br />pprova <br /> PERMIT NUMBER DISCNMDE NuMeER F- F I I A L <br /> <br /> MONITORING PERIOD rIAGR <br /> YEAR MO DAY YEAR MO DAV _y <br />FROM u TO ~~~ NO DISCRARCB (yy4 #Y# <br /> Hann nzasr rae-zsr rz~zn rza-zsl r3a3u NOTE: Read irutruetiar before eompletlnp thu form. <br />PARAMETER !3 GrO OnIYI QUANTITY OR LOADING !~ Grd OnrYl QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE <br /> 146531 I50-5lI 138-~51 !46531 !SCSI EX L T <br />PE <br />131-37I rss <br />MA Y <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS rst~ssl 154-6g1 !5&701 <br /> SAMPLE ++.-#3: # ###•4x'.,7 ###### ( I2) <br /> MEASUREMENT ~ ~. <br />U4UU 1 0 J PERMIT ' ###f. #$ +Y#4t~tRf7 <br />` ### ~~.. ::. 9fd lr9## 9i4 :.: .: .E$K'~'I M$SiU <br />:FFLUi:y"' GROSS ti ALU REQUIREMENT `:.:. .: • : <br />: t ##4A <br />tll.1l~AtlN: <br />!! 1EI4tfJtt:- ~ <br /> <br />~ <br />SGLLD~', :UTAL SAMPLE #####'~I #O###~ ~I+ObI.#!# i Ig) ~ ' <br />~U:iPEt. '. ... MEASUREMENT - ~ ,. <br />0530 1 U 0 PERMIT ##~IRO#..: ;?.:0.. <br />, <br />: <br /># ,i## ~ i?N±~1#>tl:. ~~ 7~i _ ,..'. ; '::.:: <br />: ~ ,y.. Iilt` <br />L/ il)18 <br />-'FFLUk:6T L,ROSS YALU REQUIREMENT . <br />. <br />.. <br />.: <br />„p...~.~,s.'. 4##dl ;:.3.ODA''1L"YC . <br />'713 Tt''x2 . <br />lt4NTlt <br />Oh, U A SAMPLE ###### ##¢##'J ###t0## (19) <br />(AS YE.) MEASUREMENT <br />J1U4S I ~': O ~~• <br />1 PERMIT #tCO~IR#.: . .:.. #tRA!7~tYti ### :P§+014## ~.5 TeQ. NCY! iRAB <br />] . <br />r'FLU6h'1' GRfD]H.i Y~R.U <br />REQUIREMENT'. .. <br />...: :.''..:.: . <br />.. <br />C#4# .. . <br />3dDA.,LYG <br />DAT <br />!IG L <br />r: <br />lSORTH <br />;iL AND GREl4E SAMPLE +##.#G #####~Y ###e#3 ( 19) <br /> MEASUREMENT <br />J3,tl2 I U U PERMIT RM!R,~B!.~ ###Ik01* ~ #3#4## RE FORS ZO OgTIN :RA9 <br />FFLGcNT GROSS YALU :PEgUIREMENT '"-~; ' ,: ### 30Di AYG ' INS'(' lfA2 G N <br />LilSF, IN CONDUIT OR SAMPLE ( U3) #####C cr>:##~.~ ~Lv~t# <br />LnnU ThEA'I'dE10T PLA NT MEASUREMENT <br />UU~J 1 U U PERMI.7... • : RE~pt3T ' :RI;PI7RT 0~.#laltC>lk# : .. +OI+ROlOt#i/ #ctiT#'## >; ### EIRLY : NS?AN <br />'FFLUzHT GHOSS YALUF :REQUIREMENT <br /> <br />3oDA:;AY.6 <br /> <br />R<r1(XL.t'I!x <br /> <br />tlGD <br /> <br />.., :•.' <br /> <br />:•:..' :: <br /> <br />##>aal <br />...'.. <br />.. ,"; <br />. <br />: <br />COL DS, TOTAL SAMPLE ~##~:1## ###6## 409#>•# ( 1~; '' <br />'ISSOLYtLU MEASUREMENT <br />70195 I U U PERMIT +xir###~, :; :°#a#ol~# >>i #x #~#### AEFdRT HEfCP.T TRLI iRAB <br />FFLUENT GROSS 't'° LCE REQUIREMENT #### ~A2F' ~IMC :pRTB t!AX tlG/L <br />J NU 'v' A~ ~ SAMPLE '<-##### ( 94) ###### ###4#: rA#;## <br />I ~ U A L MEASUREMENT <br />J4U66 I U 0 PERMIT ~~ # # ~#~~..~ ~ $EBA.$~T I ES=1 ~-~~~~*~## ~ ##tik#~ . ~'-~###### #t# EBKL[ USUAL <br />'FFLUENT GROSS VALUE REQUIREMENT ':: `. ::. ': j~53:.RA$.:: YG=O #t#~ <br />NAMElTITLE PRINCIPAL EXECUTNE OFFICER I cERn FV UNDER PENALrv DF uw TNAT I NAVE PERSONALLr E%AMINEO MD TELEPHONE DATE <br /> AM FA MILIM WITN THE INFO RMATION SUBMITTED HEREIN; MD BABED ON <br /> MY INQUIRY OF TNOSE INDIVIDUALS IMMmIATELY RESPONSIBLE FOR <br />~, E. Stover ~qUE,NIA000IUTEFANDACOM0.ETE.IEVE TAM SAWMEETHATORTMHEAE ME <br />INCLUDING <br />SIONIFICMT PENALTIES FOR SUBMITTING FKSE INFORMATION <br />Agent , <br />THE POSSIBILITY OF RNE MD IMPRISONMENT. SEE tB U.S.C. 1 100t MD 73 610NATURE OF Ri1NGPAl EXECUTIVE 4 -!{~ ~ ~ <br /> <br />TYPED OR PRINTED U.B.C. f 171 a. IMWU.. uN.r N.r mNna nt.Y IxAq. rt., w ro t 10,000 <br />...lwwnrinun irpiamtrrr.rMrwwn enmN..tw eY....l <br />OFFICER OR AUTHORIZED AGENT AREA <br />CODE <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY v1ULA 710N, l1reEWenes en srtscnmsnrs Here/ <br />THSS OUTFACE IS NOT ELIGIBLE POH 2YEtlPTIONS PROeI TOTAL SUSPE9CED SCLICS (TSS), TCTAL IRON AND/03 <br />Sr;TTLEABLc SOLIDS LIEITATIUNS - SEE I.A.2. <br />EPA Form 3320.7 108-951 Previous editions mey ba used. (REPLACES EPA FORM T-00 WNICN MAY NOT BE USED.) D O 35 7 / 9 R C 3 2 3-125 6 ~ PAGE IOF <br />....._! <br /> <br /> <br />