|
FENIry HcY 11fE(trH1 (/dl/Jssw// ~••
<br />p~N-~P RCHAIiD~~.~EY C0~1}. LOA--
<br />Ae~Rtf[~C1~) VALLBYLO_Y_YeST HSMES_-
<br />----u~ vo 0 0~?Y.fi.?-a• ._9Y .129--
<br />---~OjIIA _- CO 8I112d -
<br />----------
<br />~rwuurr ' If
<br />-----------------
<br />~oewrtoN ________ __ __
<br />ATL'NS RONALD STUCK I, VICE•PRESIDENT
<br />nal •ouu(.nr uo~n wnee (umnwl~oH Sa((Y G~'PU!'JI
<br />or D19CH ARG ONITORING REPORT /DAlRI
<br />1-! 17-19
<br />Co0U33 OUG
<br />PERMIT NUM Y[fl ol(<HARC(nuY,(w
<br />MONITORING PERIOD
<br />Y[AR MO OAY y{AR MO OAy
<br />rnoM -(~-3 yo
<br />170711 l17~IJ/ !71' fl 116 l l7B~1 / ( J
<br />tl I HO R ~ Form Approa
<br />(BOOR YC) ODYBANo. 2040.0004
<br />F F 111 A L Expire[ 9.90.91
<br />Na %LNI: AREA TO E. ROATCAp CRK ~
<br />a:l i, NU Ui SCHA RC6 )-_j aaa
<br />NOTE: Reed Int4ruetlom b{}ors completing thi[ form.
<br /> (J Cmd OR/y) CUANTITY OR LOAOIHO (1 Card Only) QUALITY OR CONCENTRATION
<br />
<br />-ARAMR[R
<br />(A(JJ) (Jlfil)
<br />(JeaJ) (16JJ) (!IQl)
<br />NO. Fn [DU ENCY
<br />DF
<br />BAMPL6
<br />TYPE
<br />(JIJ7) ~ Ex wHw(Y{le
<br /> AV[RAO[ MA%IM UM UNITY MINIMUM AVlRADE MAxIM UM UNIT[ 676J) (61x) IIe9•le)
<br />PH YAYIL[ OPOOPa #44i(aa ( ) a#~x#arA ('12) :
<br /> ,
<br />(..~^
<br />00400 1 0 . 0
<br />• a#a . ~
<br />~ •
<br />`~ r~~~ EYE'
<br />ePPLUeN2 GROSS VALU aaaa ~~~}j`'
<br />'"
<br />'' ~=f ,4
<br />€N
<br />r,.-;''
<br />~ rt '
<br /> R. ,
<br />i
<br />-, ,. ~• ~
<br />SULIUS, fUTAL YAYPL[ oo0aaa aali0:la ( ) aar.aaa Iy
<br />( ) . '
<br />SUS1'BNUP.U Yu[(IR[M[Nr ~ ~ G ~ G ~~/~ - Lam'
<br />0 0 5:f 0 1 0 0
<br />~ g110iq:.,:
<br />~
<br />`
<br />° aaa :.I
<br />}p?p;~+
<br />'a~-~ •,
<br />'~Sr~~r).;w'
<br />+E
<br />ki'>'ir,t ~,:,
<br />,.',,~`
<br />10
<br />;~`''
<br />Nt7.~' ~
<br />~~°
<br />~
<br />EPPLUEN l:
<br />I R09:i VALU
<br />a;.'°r
<br />~
<br />{I#:/b '~:;rv
<br />~
<br />,.,,`°% (.~. :~~,1 :,
<br />,~,:
<br />~
<br />~,
<br />a,
<br />a.
<br />, .
<br />,
<br />r
<br />,
<br />.
<br />.~i.;
<br />sUL1DS, GLTTLEADLE .APPLE oaaa#a #ai,a#c ~ ) oaa:a:;la 25
<br />
<br />~ a u a ~ ~. la
<br />~
<br />~ .4` ,x
<br />~(7~.yjY~'t=
<br />I 'O.i ..,,-r~`,. .y
<br />(:%. ,
<br />'
<br />Y
<br />! ~„
<br />
<br />
<br />E P F L U 8 N
<br />T GROSS Y A
<br />L U
<br />Vii.
<br />
<br />~
<br />(} IJ (: a j
<br />
<br />~ .:,E~
<br />Y;z ° ~(
<br />'()=;, ''"• (
<br />m
<br />. i
<br /><
<br />:~a
<br />[,,,`I „
<br />e
<br />z
<br />~ r 1
<br />
<br />;-.
<br />UIL AND GkCASL ^AMPL[ oaa~oa aoaoila ( ) tlai,ilaa v~~#aaa Lg
<br />( )
<br />FBEUN EXTR-GRAY ME1 YG[UR[Y[NT i/J U ~~jl !N.1'
<br />OUSSo
<br />1 0 0
<br />A,~,~.
<br />arra
<br />^~,Id~Y!6?ii1Gd~~
<br />'~r?;C;rCt`dO~Ii0i5Li3r.
<br />~.;~~ ~y~"";v-
<br />~~y
<br />ZqK'~~'?
<br />„!
<br />*`?"
<br />~
<br />
<br />EPF:.UENT GROSS 'YA LU
<br />~:i~
<br />})#{:#
<br />ir.() T.).~ i;1
<br />:r(T yrril 5sr^.;
<br />;n~
<br />x"`+'
<br />`` (?
<br />"~
<br />
<br />IAOh, TOTAL -YAYPL[ 04#aaa aUliatra ~ ) aaa#aa ('19)
<br />(A y F t) Yu{VR[Y [NT G'
<br />'/ U /~G
<br /> , I
<br />
<br />~ "f Y
<br />~ i y
<br />q
<br />arPl'LUENT GROSS VALU ..
<br />~ (;.;; .ybrru ° +
<br />!(," .
<br />~. ~~~
<br />.4
<br />c
<br />'?Yx~ ,
<br />i ,
<br />s;;yc„b,
<br />F YOY, IN CGNDUI. UN •AMPL[ ( U3) ;Y #:xCGil Oi~G:?o K+ aal)ilab ( )
<br />
<br />TNRU THk.AThE-IT FLAN
<br />YU[UR[M[NT
<br />G.G//~
<br />G'•L//f /
<br />,~J/;~
<br />50050 1 0 0 -
<br />EPPLU6hS sAG95 YALU f(
<br />a •';,
<br />#) aaAY
<br />~
<br />
<br />~ ,_
<br />SUL IUTAL •AMPL[ OOOaaa 4aaaa;: ~ ) #o;%GC(I,I ~ 19)
<br />DI9SOLYF.U Y[A{UR[M[NT ~^~. / G / /N~
<br />70]95,_ I 0 0 aao _ (~ ~~~~~°
<br />EPPLUSNT GROSS YALU as#4' ;: ; ~,},~ , ; "s;
<br />NAY[/T 171[ PRII~C IPAL [%[C VTIY[ OI/IC[R I C(w1P• UNIXw Pl NA(T• p LAw iN.I r Nwv[ w[RSONwII• IIIAYINID T[L[PHONC ,
<br />.
<br />D A T [
<br />•MD 1Y I.YI(Yq aITN iN[ EMI p1Yw}ION GURMNI( O H[R(IH 1H D R15f0
<br />
<br />'
<br />lY/ Yv RgU~w( OI iHpSI INOVIpI.IG 1YMf (11(}fir q[GPONSIRIf I(Y, / ___
<br /> rMr.bq^. yT bI(q u.rpv nllnv GupulnlO n.(Onu. vnn
<br />w tRV1 .CC VR.11 wN0 CCYn.I rl •n1 ~.l rV(R( •RI Sn.
<br />• 1 /
<br />/,
<br />~
<br />
<br />N+K.NI ryNq u16 IOP 6VIWrT nHp
<br />aSl In.OeY.}pn rna Unnc _
<br />jam
<br />
<br />TN( ROSi RYHV OI IM( I.MD iYOg50HH[NI $C( IR VSC 1 1001 wno
<br />~ ~ 3 SJ~~/
<br />ll
<br />Y/ ~
<br />O/
<br />~`
<br />
<br />»USC 1 I)lf rA.,Ygr. .b.. rA.r n.r.b. ..a• ~n.rdr /..w •p r.. ImYn
<br />eIONA URE OF PRIM AL E%ECU IVE .
<br />i
<br />TYPtD OR -IIINT[O .+1 •u .,. n...w ~.an..,nr...r .1 /.. r..-n s n...nr+. an/ i ,....,
<br />OFFICER OR AUTHORIZED AOCNT
<br />'NUMOCR
<br />YIAR
<br />MO DAY
<br />GOYYIHT AMD @PIAWTr((Y f.I .arv Y.w. ... emu. .0.. ..,, .... ..•
<br />L.
<br />c ceBASe--see
<br />Y- IP <~ 10-tN,
<br />POOTNOYE P/, PAGE 3. QR'INLY SAHPLING--FOOTN02t D/. SETTLHAdLE SOLI05 LIMIT APPLIES
<br />24-NA PBECIP EVENT CLAIHEO. IF' CLAIM APPROVED 8t YVCO, T5S G IRON LIMBS PILL NOT BE
<br />a_Y wMw -
<br />---° -,,----- - s----•- --( - •--+~----~•. .. n.y M Ya.Y. rwviwu• vw •DwY i-ae ~nIDN MAY NOT [[ V[f D.l PRO[ of
<br />'I` `~ OU193/920+IU3-1213 1
<br />H
<br />
|