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facdiry NdmrlLocorb~ +Fdillasnl/ I ` ~ ~~ <br />1VAM[-1..~~ 1L ~.0 1-L]A~DSIP~AL](-_----- <br />wooeLnLD1.:)xY1L )1I~----_------ <br />-- -S.T3L~T-6~~f S.GH.li L7f _1 ~ ---- -- <br />---11E-EBB-N----- _ _ --CO_ 87.fiRL- <br />LOCATION_ <br />A1'L'f:: NICHAP.D G. ATKINSOH <br />nw11 w rwnl u ;Mln wTIeN SVSrR,M lnr/t]/ <br />eM1DIBGHARGF •~ONITORING REPORT IDMRI <br />110 1~ <br />PERMIT NIrMRLR PlscnwRCE HUMREw <br />MONITORING PERIOD <br />YEAp MO DAY YEAR MO DAY <br />IRON TO <br />l10~211 !12.131 l1d~73/ (26271 1181 I ! 6 I1 <br />HINOR Form Approv <br />(SUER NM) h®M&TNo. zo4u-oooa <br />P - FINAL Expires 9-30-91 <br />STREETER GULCH TO GOOD SPGS CR <br />'~~'~ NO DISCNARGPI ~~ ### <br />NOTE: Resd instructions before completing this form. <br /> (J Cmd Only) QUANTITY OR LOADING (I Card Only) DUALITY OR CONCENTRATION <br />PARAMLTLR (10-13) (1161) (lB~J) (lo6J) (!16!) 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R'n ce <br />g <br />M <br />~~R k 58;ra «A{, <br />g A <br />a <br />~Yr~.°,'a <br /> SAMPLE <br /> MEASUREMENT <br /> `.K'~..ACRMIT~z'~ s`-a.«`..,a8x.~.~~ <br />~s' 'P'~'«~~~'~~~~~~A,Tiw <br />s~ R~ ~$c'n'!'.o-q-&, ~ <br />~ <br />~ l •a"'.~«- .q. <br />d <br />7 :.. ;~_~..Fgey;gg <br />~>~ .,, <br />a a. .. <br />-a <br /> ,HEDUTAeMENT: . <br />B s~~'8 ~z.~3g <br />~ <br />` . <br />y ~~.~.. ~~g .b <br />' <br />~ Ay ~ <br />~ <br />~~ <br />~ <br />~ ~i~, <br />~ <br />3" ~8 ~ a <br />~ <br />° x.° Y b; <br />I a <br /> ,~a..:< w ° ~.. <«: <br />® ~s .La~X;m.: <br />ra <br />, 3 ~ <br />«~;~ ~ <br />~~ ., ~re;~`~a. ~~roa- ¢;; ;, <br />rwe « <br /> <br /> SAMPLE <br /> MEASUREMENT <br /> <br />•'d:~:P./;RA[I7., sY <br />..+i, ~ <br />~„' - <br />° <br />«~.s°a~.w .°.x; <br />; <br />~ N,. <br />;.x~;e "..ro;~H:aM;:w.:; . tr <br />l;q$I"~>°;, 1~b ~ <br />C«. epa; <br />°:; <br />2 <br />- <br /> ~ <br />RLf)S!J EMLN'C~ <br />~ ~. ° <br />: <br />, <br />•~°;Y.,b.A,~9~~i.~.«ra:¢A-°. , <br />_ <br />~a„'n <br />•~"'i'.~~'°'~.& a;s•' wy; m~;rk~~.R~e H°.~-n„ .. <br />: <br />: <br />ti <br />° <br /> „ <br />'+ <br />tl <br />a~ ~w ~'6'<:a Ptia,'ffi.is ,ar4.sm.,°'Y~~mr x.san <br />~ ,°'Aam..4 Poem»'~'.ae SA &.wm'~a. g <br />~ "° <br />NAME/TITLE PRINCIPAL Ex[CUTIVE OPFIGER l <br />CERIIFY UNDFA PENALTY OF LAw THAT I NAYE <br />P[PSONALLY [XAMINCD <br />AND AM iAY1LW WITH THE WFORMATION SUBMITTED HEREIN AHO BASED TELEPHONE D A T E <br /> ON YY INQUIRY OF T1q$E WOIVIWAL$ IMMEOIAT[LY RESP01151BLC fOR <br /> OBTAINING THE Wig1MAT10:1. 1 BELIEV[ TNC SUBWTTEO INFORMATION `yp <br /> <br />IS TRUE. ACCURATE AND COYRETE I AM wWARE THAT THERE ARE SA:~ ~'R'/ <br />i' <br /> NIi1C1NT PEHILTIES (OR SUBMITTING iALSE INFORMATION INCLUDING <br />. 1 <br />IL ~1 \ ~~/m~~ <br />J YYSS G/1 <br />THE POSSIBILITY OF FWE ANO IYPRISOHMENT SEE IB USC 1 IOOI AND <br />3)USC 1 I]19 /P <br />4 <br />M <br />IA <br />urm <br />ld <br />i <br />BIGNATUflE OF PRINCIPAL E%ECUTIVE n <br />_I~D 6'711 (I 1 <br />O (,I~IJ Irl a ^I <br />I 1 /T/ <br />D 1 ~J <br />L~ <br /> <br />TYPED OR PRINTED rlu <br />v. II <br />n <br />rv . <br />n m ur <br />r / <br />nN uV III J14nAI <br />wrdl.rma.Inlwn lmDrlwn^IHII../A.Iw+'nPmI.nlA. and]Inr..I <br />OFFICER OR AUTHORIZED AGENT <br />A A <br />NUMBER <br />YEAR <br />MO <br />DAY <br />L VMMCNf ANO El PLANATION OF ANY VIOLATIONS lK!)frfnCe 4Il u1luCnlntnlJ nflf) <br />S~'fTLEABLE SOLIDS LIHIT APPLIES ONLY IF <= 10-YRe 24-Rk PRECIP EVENT IS CLAItlED. IF CLAZH APPROVED BY <br />k~~l^G, TS.~ E IRON LIMITS HILL NOT BE APPLIED TO REPORTED NEASUREtlENTS--SEE I.B.lAF PG 4 AND I.B.1DP PG 6. <br />i • . P u iB ! y ~ IREPLwces EPw PDRM rrB WNICR MAY NOT BE usE D.l FwoE of <br />00920/920908-1914 <br />