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PERMITTEE NAME/ADDRESS pnd,d. RaNryN..dlecaN~. r/D14•.*np <br />NAME Col,u'•~Ya ~~A1. Cnr,PdBY I,. P. <br />ADDRESS (,Q LUWYO `iIUE <br />ti-»I sT~Tr tITCHNAC 1~ <br />;Ili e: iC ~: '. c0 81641 <br />FACILITY <br />LOCATION <br />IlR ^il L'•:Tnc vm <br />NATIONAL POLLUTANT 019CHAROE EVMINATION SYSTEM //NPDESI <br />OISCNARGE MONITORING REPORT (DMRI <br />1-I6 17.19 <br />PERMIT NUMBER DI9CHMOE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM 98 01 O1 TD 98 09 30 <br />116111 171-131 174151 116-171 118-191 !34311 <br />Form Approved. <br />NA!1f?ft011iI.'; SP.D7 Tt)AVpIBSe~'d~C~re~6`~~YBR <br />(;, r1EIR. NN) 12345 <br />F - FT NA I, <br />M.INOF•. <br />NOTE: Raed Inetrucllone balor~ Cem~letlnp thle form. <br />PARAMETER 13 Grd Only! QUANTITY OR LOADING ( 1 Grd Onlyl QUANTITY OR CONCENTRATION NO FREQUENCY SAMPLE <br /> !/6-531 1545/ (36-15 <6-5J 545! EX u~ <br /> <br />!JI-371 µ <br />yyq TypE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS r s:-sal 154651 169-7D1 <br />JII• AND li'{F.a.i" O ( ) ~ .~~ ~ O / ~ISUr <br />I <br /> MEASUREMENT 1 ,, <br />VISUAL <br />It I <br />1Llbh .~ ll () PERMIT: :: <br />': .:: «J.'~ ~ ,... ~ <br />.. ,:~`'YY~vr .... <br />d~. ". ~: ~.. .': ~ <br /> <br />E ] <br /> <br /> <br />!. I: J.W J. M~~. <br /> <br /> <br />A yn <br />if ~..'J,S~{S..'. . <br />:.. .-.. y.... ... <br />' Y~r-.t.'. <br /> <br /> <br />'rr'.. <br />. <br /> <br />I <br /> <br />F;~KLY <br /> <br />ISIIA <br /> REQUIREMENT. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT. .: .. :. ... .. <br />.. <br />. <br />. <br />: . . <br /> REQUIREMENT .. <br />. <br />~~~ ' ~ ~~ ~"~~ ~~~ ~~ ~ ~ ~ <br />:. ~~ ~~~~ <br /> SAMPLE <br /> MEASUREMENT <br /> .PERMIT ~ ~ ~ ~~ <br />~ <br />~~~~~ ~ ~~ <br /> REQUIREMENT : ~~ ~ ~~~ ~ <br />~ ~ ~~ ~ ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT. .:.:: .. ~ :..... ... .:. <br /> ~REOUIREMENT ~ ~' ~~~~~ ~ ~ <br />:,.:. ~ ~ ~ ~ ~~ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~~,~ ~ :... ... ~ :. .. .:~.:::..:~ <br /> REOUIREMENT~ ~~~: ~ ~ ~ ~~~ <br />:... <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT~~ .. ~ .: ...:: ... ... .. <br />' ... <br /> <br />... <br />• .. <br /> REQUIREMENT. :. <br />~: ~ . ~. ~. ~.~: .. .:. <br />.. ... .. .... <br />.. ~ ...~. ~. <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT ~~:.: . ::. .::::~.:~,<':~>..~.: .. ~. .: .. .. .... .. <br />~~ <br />~ <br /> REQUIREMENT. ~~ ~ ~~~~~ ~ ~~~ <br />~ ~ ~ ~~ <br />NAME/TITIE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDEA PENAITV OF LAW THAT 1 HAVE PERSONALLY EkAMINED AND <br />AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN; AND BA9ED ON ~ TELEPHONE DATE <br /> MY INOVIRY OF THOSE INDINDUAL9 IMMEOIATELV RE9PONSIBIE FOR /L ~ _ <br />^ <br /> OBTAINING THE INFORMATION, I REDEYE THE SUBMITTED INFORMATION 19 L(/(~V~ <br /> TRUE. ACCURATE AND COMRETE. I AM AWARE THAT THERE ME <br /> <br />INCLUDING <br />SIGNIFICANT PENALTES FOP 9VBMITTINO FALSE INFORMATION n <br /> <br />J - NG..f r . <br />THE POSSIBILYTY OF FlNE AND IMPRISONMENT. 9EE 1B V.S.C. 1 1001 AND 77 <br />8 TUBE OF PRINCIPAL E%ECUTRYE _1~~ <br />_E ~~ - - I 9e 1D <br /> <br />TYPED OR PRINTED U.9.C. 1 1]1P. lh,WW. uM~r fMr mNN. nvr I.cA.d. 6rN. w ro 110,000 <br />.newnwtnl.n inPdaomNnr orMMwn enanrhs .ndsrw.l <br />FFICER OR Al7EHORIZEO AGENT AREA <br />CODE <br />NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS ANO EXPLANATION Or ANT vIOLA I lurva lnererencs en errecnmsnrs nerel <br />5FTTI,E9.`IL" 57LIDS LI`1L?' APPLIES ORLY IF C= 10-YR, <br />+JUCD, ~P:;`.~ Iilil?! t,I`17?j NZLL NOT BE APnLIED TO RE <br />orm O•. IUS-951 Prevloue edlione mey be used. (REPLACES EPA FC <br />H PR P.CIT' P,VF,NT T S CT,AIT11iD. IP ~L!! T" LP~VF,D BY <br />D 'IERSUARMF.VTS--SEE I.D.lAE PG N A'1'E I. D, PG 5. <br />WHICH MAY NOT BE USED.1 ~ ,. rAGE OF <br />