HYDRO30070

• Permit No: C1981010
• IBM Index Class Name: Hydrology
• Doc Date: 4/2/1998
• Doc Name: COLO CDPS WET TEST REPORT FORM ACUTE
• Permit Index Doc Type: NPDES
• Media Type: D
• Archive: No

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NAME/i1TLE PRINCIPAL EXECUTRJE OFFICER I cERnFr uMDER PENALTr DF EAw THAT I HAVE PERSONALLr ExAMINED AND TELEPHONE DATE
AM FAMILIAR MATH THE INFORMATION BUBMITTED HEREIN; AND BASED ON

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GOrd00 PAIL BLB MY INQUIRY OF THOBE INDINDUALB IMMEDIATELY RESPONSIBLE FOR
OBTNNINO THE INFORMATION, 1 BFLNE THE BUBMITTED INFORMATON IB
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70-824-4401
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. I AM AWARE THAT THERE ARE -
~~IHCAHT PENALTIEB FOR SUBMITTING FKBE INFORMATION
INCLUDING c
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President Geq~ral Mana eT
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THE POBBIBILITY OF RNE AND IMPRISONMENT. SEE 1B U.B.C. F 1001 AND ]]
U
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OFRCER OR AUTHORIZED AGENT
CODE
NUMBER
YEAR
MO
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COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Rdersnce ell ettechments here/
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