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<br />PERMITTEE NAME/ADDRESS P.Ard. FrIAry Naw/Locanw r/DrDi..nr) <br />NAME TtRRJH ~RE~{ ~J"!i•.+tiY <br />ADDRESSTEHR9R ~REE:{ LJADJUT <br />1840 RI~RJAT 133 <br />PAOkIA''" C] 81429 <br />FACaITv <br />LocAnoN <br />A2tYi KELLY PRIPbLF.R, ~PZRATI0s5 h3R <br />..- .A' . .~.. <br />Fonn Approved. L <br />D o c. o u l' P ~ o-l n~~ ~ 4b~ ~°• 3°.,°R~'~4n +c <br />(SUER aC) APProvel e~c~I~q~05-31-98 <br />F - PI6AL 1 <br />MI1:OR `'~` <br />v## NO DISCHAR6£ ~~) 044 <br />NOTE: Reed Inetruetlane belore eompletinp tbie form. <br />PARAMETER QUANi1TY <br />u (OADINC <br />!3 area p Grd Onlyl QUANTITY OR CONCENTRATION NO, FaeauENCV SAMPLE ' <br /> / <br />653! 13B-r5) 14653) 154611 OF <br />13Z-3T/ EX M <br />uTes TYPE <br /> AVERAGE MAXIMUM UNITS :7u0NINIUM AVERAGE MAXIMUM UNITS rsa-sal ' <br />1645e1 I5¢TOl <br /> SAMPLE . Y kr,2:k ~ 9J) 304 '.~;~: ~{s . , .- <br />ISUAL "; ~.f":~-,, MEASUREMENT Y <br />~,~ , '_:y ~ <br />4066 1 0 D PERMIT '~#7 i$# 1;.~1~' :`'. <br />" iS=1 ~'4±-:3Y<; ttA>i+R.4 <br />;,. <br />. <br />: ~#0#Off #t:~ EEKLY I5UAL <br />YPLUENi :iROSS YALUE :REOUIREMENT rLY1 $'t" <br />': 0 J <br />: , <br />. <br />. <br />' 3 <br /> .: <: <br />:'z .r!: .: ._ 44# <br /> SAMPLE <br /> MEASUREMENT ~" ~ <br /> S: <br /> `~ 'PERMIT ~ <br /> <br />REnU1REMENT <br />~ .. <br />~ <br />~ ~ " . <br /> <br /> SAMPLE <br /> MEASUREMENT ' <br /> PERMIT <br />.. .. <br />: <br />:: <br />~ y:,.:.; <br />:::. ~ ~ <br />~. <br /> •REQUIREMENT . <br />~ <br />, .. ~ ':'~r: <br />, "" <br />.. <br /> SAMPLE <br /> MEASUREMENT <br /> .~~ PERMIT <br /> :REQUIREMENT ~.~ ~~ ~ , <br /> SAMPLE <br /> MEASUREMENT - <br /> .'.:: PERMIT ~ : ~ ~ ~ <br />":..:. <br />~ `~ <br />r: ~ "~ <br /> ;REQUIREMENT ~., ~ ~ .. ~ .: . ~:.. .~.... ... ~E ~ . <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />.: <br />. <br /> ~REOUIRENIENT ~ ~ ... ~~ ~'"~~~`~ ~~ <br /> SAMPLE <br /> MEASUREMENT <br />~ - <br /> .:PERMIT . ~` ~~"~~~ ~ <br />.. <br />. .. <br /> ~REQUIRENIENT;~ .. :: .~ ~ ~ .. ~~ .: .:. ..~ .: .:; ., <br />". <br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER I cERnFr uNDEA PENUTr of uw TNAr I NAVE PERSONALLY ExAMINED AND <br />AM FAMILIM W <br />TH THE INFOR <br />TI <br />B ~ TELEPHONE ~ DATE <br /> I <br />MA <br />ON SU <br />MITTED NEREIN; AND BASFD ON <br />MV INOURr OF TNOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOA <br /> OBTAINING THE INFOM/ATION, I BELIEVE THE SUBMITTED MFORMATON IS <br /> TRUE, ACCURATE AND COMPLETE- 1 AM AwME TNAi THERE ME <br />SIGNIFCMT PENALTIES FOP SUBMITTING FALSE INFORMATION <br />INCLUDING <br />KELLY FRITZLER, BPERATIONS Mf, , <br />TNEPOSSIBILITYOFFINEMDIMPRISONMENT.SEEtBU.S.C.ir001MD37 <br />O <br />F 7O 2 -5855 00 07 21 <br /> <br />TYPED OR PRINTED U.S.C. 1 1 Sle. lhrrtY, r..0.r elrw mnrl.. re,r NcAef. fin.. rp ro f IO,ODO SI <br />f711NC~R E7(ECITTNE <br />NA RE O <br />~ AREA <br /> rNnrrlA+/nr.nNw:onrrr olbnrrwrr6monNarg6Ewra1 OFFI~ER OR AOTHORIZED AGENT CODE NUMBER YEAR MO DAV <br />..~..... ..., .n r rvr. yr nn. .rv~n I was In.reience sn srrscnmenrs nere/ ; <br />SETTLEABLE 5]LIAS LIMIT rLPPLIES ONLY IF C= LO-PR, 2U-NS ?RECLP 1:Yn9T IS CLA.I`IEn. IF CLRI:7 APPRJYED 9Y <br />Y]CD, T55 c, IRDN LI'7LPS PILL N7P dr APPLIED L] REPORPF.D 1Ea:iUaiNiXTS--:i E I.B.lA, PC 5 AND I.B.1D, P, b. <br />STOHIIY AT7.R NA YI :F.N PNT Di /1N llrl `w t-1 -qq_ - <br />EPA Form 3320-1 108-95) PreNOUS edlDOna may be used. IREPLAC 'EPA fORM T40 WHICH MAY NOT BE USED.I PAGE OF <br />o>,6ai4~oRi9-1ZS4 z <br />.-... _ h <br />