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PERMITTEE NAME/ADDRESS QMrb ixu~ryNw//or,ua I/p/Qiwq <br />NAME L-yF'n~;S tNF'Lkr f_Ct;W~.,.•ATL'..'~• <br />ADDRESS Y.' ~_ ni.,A .I ~, <br />Lrt~.J LU oLoC~.. <br />j <br />FACILITY l,Yr'nL.S cNr'lNE LU><t'lil•.Al'LL'11 <br />LOCATION I.I+FLb CO 41615 <br />:<ll~: MILIiALL n. LUUIfi... .?SFitOI Mf..2 <br />NATIONAL POLLUTANT DISCHMOE EUMINATON SYSTEM /NPDESI <br />DISCHARGE MONITORING REPORT /OMRI <br />2-161 I7-I91 <br />4: <br />PERMIT NUMBER DISCHARGE NUMBER <br />., MDN11'O~tING PERIOD <br />VEA ":ti/10 DAY YEAR MO "DAY <br />FROM 1 TO - 0 30 <br />/10-I11 .?I /14461 /76-I71 /1B-I91 /36311 <br /> <br />Form Approved. <br />_ ONlB Fto, 2040-0004 <br />Approva~explre9 85<31-98 <br />J' .'. l1• LLJY <br />r I-l~YNL <br />M 1.V Oit <br />NOTE: Reed Inetruetlarr before om tlnp thb form. <br />PARAMETER !3 Grd OnlYl QUANTITY OR LOADING 14 Grd Ontyl QUANTITY OR CONCENTRATION 0 FIIEOUENCY SAMPLE <br /> !4653 !50.61 /38-16 /4663 ~ 60.6/ ~ OF <br />132-371 EX <br />ANALrsls TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS le7'e71 /60.68/ 169.701 <br />uIL AIYU untA~t SAMPLE •i i'O#ti•~• y4 •f*+Y'k ~ YA {•+k fA## #!r YA •,<s'i A\ <br />+I]•JNL MEASUREMENT <br />uY~~o i U ii ...: ..PEHMIT~ "~ ~ iA4~d+.#>~# ~ .. .,: <br />:::~~".... <br />" <br />E 5 1 " <br />;~ .~~>~ <br />#:!i#~ <br />~ : : ~:Ikalll+111#'It~ ~~:~f-0i1[(~:l~I'~" <br />.:~ ir49 ::;~"ti ~~ A <br />'" <br />1 <br />Sii <br /> <br /> <br />~!`r LUUNI u,c;~~J JALUE 'REQUIREMENT <br /> <br />" .. <br />. <br />.:. .. <br />: . <br />. <br />., <br />.. <br />~.> ..:..:...:.. ....' <br /> <br />..: . <br /> <br />•.>(.{,;, , <br /> <br /> <br />;:z-' <br /> <br />. : <br />: <br /> SAMPLE <br /> MEASUREMENT <br /> ~~~. ;: ,l <br /> REQUIREMENT. ~ .~ ~ ~ <br />,- :.`: ~:'%:r~?;~:.:~:~ <br /> <br />: . <br /> SAMPLE <br /> MEASUREMENT <br /> " <br />::.PERMIT ~..:. ': <br />~~ <br />~ ": ~ ~ ^ ::?'sij:4.r ~.:~: <br />: ~ ~~ ~~ <br /> .. <br />REQUIREMENT . <br />. <br />. a. <br />.. <br />... .:. <br />: . <br />:.F:. ,;..: ;.. <br />:,.,~.-,:,..:.~:. <br />. . <br /> SAMPLE <br /> MEASUREMENT <br /> ~:. PERMIT: .. :. ~: ~ <br />.... .. ., <br />,... .r:.. <br /> <br />:. <br /> .REQUIREMENT <br />.. ~~ <br /> <br />.. ~ ~ ~ ~~ .. ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> .~. PERMIT" ~ ~~ <br />-. ..., <br /> REQUIREMENT ~ ~ ~ ~ ~ ~ ~ " <br /> SAMPLE <br /> MEASUREMENT <br /> .. PERMIT .. ~ ~ '~~s;".. <br />~.. <br /> <br />REQUIREMENT <br />, <br />.. ~ , . <br />~ .. ~ <br />~ ~~ <br />~ <br />~. <br /> SAMPLE <br /> MEASUREMENT <br /> :. PERIu11T~ ... ... ~. ....... ...: <br /> REQUIREMENT ..~ ..:~.. :.:. ~~ ~ ~ ~ ~ ~ .: .. ~.:..: <br />NAME/TITLE PRINCIPAL EXECUTNE OFFICER I CERTFY UNDER PENALTY OF UW TMAT I HAVE PERSONALLY ExAMINED AND <br />AM FAMILIAR MATH THE INFORMATION SUBMITTED HEREIN <br />AND BASED ON <br />' TELEPHONE DATE <br /> ; ~ ~ j <br /> MY INQUIRY OF THOSE INDIMDUALS IMMEDIATELY RESPONSIBLE FOR I <br />~ <br /> <br />F:IriT~.rci ~rfli~5 <br />OBTAINING THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IS <br />.~ j .' ~~ <br /> <br /> <br />` <br />' TRUE. ACCURATE AND COMPLETE. 1 AM AWARE THAT THERE ARE <br />BIGNIFIDANT PENALTIES FOR SUBMITTING FALSE INFORMATION <br />INCLUOINO (/ ~/ <br />~ <br />=nvirm:mental ~i <br />an.. er , <br />THE POSSIBILITY OF R <br />S <br />T <br />D • ~9] <br />l 1870-_7I~ <br />1 ~ i0 iY <br /> NE AND IMPR <br />I <br />ONMEN <br />. SEE 18 U.S.C. 1 1001 AN <br />]] SIGNATURE OF PRINCIPAL EXECUTIVE <br /> ~ <br />~~ <br />~ ~M <br />r <br />mm~ <br />~ <br />~ ~ <br />~I ~ ro f 10~~ A A <br />TYPED OR PRINTED W <br />w a•mu <br />~ <br />,+ <br />iar e <br />d <br />, <br />EVr OFFICER OR AIIfHORQED AOENi <br />CODE NUMBER YEAR MO DAY <br />VUMMLrv IJ AI?U CAt'LArvAI1Vrv Vf•ArvT VIVLA IIVrvJ I/fere/eI101 M/eReOD/rle/I G901/e/ <br />.,~IiLL>l~LC ~'~L1LiS L[i"iI r+AIyEU FuR lUYRF24riri PKCLIF,Ly~rrl-,LL i..+.U, P; [V. FL1X nEdUleiEMLt1T1, L.1L <br />L,1<~A~E bl<Ab SAIsPLE Ar+ALY~15 nEJUIkEU 1F V[~1dLE ~HEcty I5 U~~:.n`/~U. dnTrtLY ~AMFLING IhSfRUCT10f.S-I.L:.or <br />JI ~ <br />EPA Form 3320-1 108.96) Previous sdiGons may be used. (REPLACES EPA FORM T40 WHICH MAY NOT BE USED.) U U 1 / 3 / 9 V I J O I - L 3 1 L PAGE lOF <br />