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PERMITTEE NAM[/ADOR[!! (1nCIYd[ <br />F[Liflry NRn[lGonrbn ifdifJerenr/ <br />~::hULiY000 ----~-~ - <br />rwcs LI TM--------- - - - - - - - - <br />LOCATIOM ~_ <br />., r, r. -A ~~ 11 ----- L ---r L -- <br />NATIONAL PO LLVTANT OISCN AgGE ELIY INATION IVST[M /NPDESI <br />DISCHARGE MONITORING REPORY /DMRI <br />Z'(6 /~ .., .. Form Approved. <br />-- / - - ~ ~= / i ~ ~ • ' •) OMB'No.~2040-0004. <br />PERMIT NUMBER DI[cNwwa[ n~Y[[w - , , ~. ,.:Approval expires 6-30-91. <br />. ., .. .. [ ,. ~ I.,_. _. S <br />MONITORING PERIOD - <br />c <br />YEAR MO OAV YEAR MO OAY <br />FROM l J .1 -• TO l~- vi _ ~ .': .. .•.. 4 -.- ~ .. 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F, L i] T A L' S ° 'L r •~ ~ MEASUREMENT <br /> <br />e^PEPMiT°o. ,q. <br />x¢,~~.€~ywe4; <br />"9d f, <br />s, <~irt~'~e <br />'!1`~'.' e <br />` s~.~ <br />~eA~3ST~'3`~-<e <br />v <br />srR,` ga'~5;89,'a"1e 4~ y <br />ds~'~S'aT(r <br /> <br />~ <br />°~x <br />a• <br />~, !&.,0 <br />~• il• <br />~a1~ <br />~&7 <br />T` <br /> <br /> <br />S Y <br />YsIEQUiREM ENT 1 <br />a4 < <br />§ <br />r ~» <br />Y , <br />' <br />4,,¢¢ 8,,$$ ¢ <br />~~ <br />B <br />' <br />~ <br />~ ~ £ 4~ <br />@'Y® <br />° ms <br />s .°e• <br />~e¢s .av <br />8o-os aaAe B d4 <br />s R <br />' <br />¢ 4 <br />~ <br />~ 5 <br />~ <br />~~ <br />LU,n <br />.,nl: :1 tiALUi d <br />x . ~~ <br />R.[b <br />r3. ~i <br />i Y <br />°i$~A <br />g FS .rL v <br />~ae <br />en ~, e <br />~ <br />€t;S <br />~e oe. :: a <br />< ~ma"~ <br />~L AIIL ., ..L _ ~ ~'l~%)'}~r :: <br /> SAMPLE <br />4 L~UAI MEASUREMENT <br /> <br />.il/L S) 1 I <br />eY r'Y.. 1 F~ e gg,, <br />YY~~ Y`w, <br />~ <br />°«ge a@raj~ <br />a <br />_ <br />, 1 <br />nrg° [y Sr~S.'~.l.o <br />' <br />.a r~~t ~:rtlS~R <br />, ~! <br />$a~&a~e@.&I~`~®® <br />~ <br />nY <br />~'M <br />~qf <br /> rREGWlf6 ENT °a <br /><°R< ~ <br />a <br />4.¢ <br />~ ' a <br />~~ 4e ~R` <br />~~ A <br />; ~ ~ <br />3 <br />@ <br />~ Y&q+` <br />'f.. 'J .hl .,1"._ y s <br />9~n ~ <br />41eA° <br />'atr~Aw <br />4~ ' m <br />a <br />a~ <br />8 a«mn a <br />6mY° sa n~®YB <br />k~ff a< d <br />~ <br />~ . <br /> SAMPLE <br /> MEASUREMENT <br /> a`PE'RNITmR 858'YRSC®664> '90 acme bm 6n$ eAS®6&n <br />e oar~°an gv n®<<@.°6j<.A °v6 'P &° b®' <br />eB@ 'b 'n $~. <br /> REgYriREM.ENT r <br />eaan x°agx xw <br />~a.w r'>a'e<~eoggg, <br />® g <br />kb. <br />is R,s•ac~s< bW4 <br />ac ,~¢<°adg ®°ea@,Yg <wa< <br />° e~° 4 <br />n m~.a® <br />@ ~<<a. <br />' <br /> 4s&baea xd. nF%®eam.• ®m ®Gd8a a6e Y$a.k~a s6®d <br />n <br />n B.@w X r$ F88' <br />NAME/TITLE PRINCIPAL E%[CUTIVE OFFICER I CERTIFY uhDER PENALTY OF LAw THAT ~ NAY[ vERSONALLV E[AMInED <br />AHD wM FAMILIAR WITH THE INFORMATION BUBMITT[D HEREIN AND BASCD TELEPHONE D A T E <br /> <br />~\I [. i1:Ird I III1J ON MY INQUIRY OF THOSE INCIVIDUwLS IMMEdATELY REBPONBIBLC FOR <br />OBTAINING TN[ INFCRMITIO.V 1 BELI[VE TN[ SUBMITTED INFORMATION '' r <br />.~/ / /l <br />~ <br />/ <br />/ <br /> IS TIIUE ACCURwTE AND COMPLETE I AM AW1RE TNAT THERE ARE SIG l~ <br />///~ <br />1 <br />/r <br /> <br />~ [ <br />F,.•: Ironrlent~~ ~ ."~'I ,.^r <br />NIFIUNT PENALTCS FOR SUBMITTING FALSE INFORMwTION MCLUdNL <br /> <br />TN <br />P0551BILITr OF FIhE AND IMPP50NYEM SEE <br />f 1 <br /> <br />.' L, ..... <br /> <br />~ <br />(970 870-Z71. <br />0" <br />LG O <br /> <br />n <br />S <br /> [ <br />IB USC <br />001 AHD <br />]] VSC 11319 IRnalbr. uMrr tAry r rutr. n nrlulr (mr u <br />mrI <br />I^ flu Pn <br />~ BIGNATU RE OF PRINCIPAL E%ECUTIVE <br />TYPED OR PRINTED Y <br />.•d,~,mu.~nlwl~nlPnn.xlnlrnr,./Arruwnfim..nrA. awtl.;.r[r•• OFFICER OR AUTHORIZED AGENT A A NUMBER YEAR MO pAY <br />EPA Form 9320.1 (ReY.9$9) PfeVI0U3 Bdi(ions maybe used. IRE-LwcE! EPA -owM Tre wH1EH MAY nor EE ulEO.l f - _ - PAGE of <br />I_ <br />