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PERMITTEE NAME/ADDRESS pncbd. F.cNry N..,/Lennal pDlp...nq
<br />NAME I:O Li)~d YJ C~,S [. r0'1n4ttY L. p.
<br />ADDRESS CO L'J IJY ~I it L.:+(•;
<br />5/31 STt1T%? !!~.T +N44Y 13
<br />ht P•t'r: (; `i CO 91641
<br />FACILITY
<br />LOCATION
<br />~=L'$---,-1's I IS T FPfT+I Ia.fi:~FY.d'.7Y
<br />NATIONAL PDLLUTMT OISCHMOE ELIMINATON SYSTEM NPDESI
<br />DISCHARGE MONITORING REPORT lD R1
<br />Z- f 61 77-191
<br />PERMIT NUMBER DISCHMDE NUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM 98 Ol O1 TD 9 0 3Tt
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<br />Form Approved.
<br />App~dJhF'ex 'O -31 ~8
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<br />PARAMETER 13 Grd OnlYl QUANTITY OR LOADING ~
<br />~ Id Grd OnlY1 QUANTITY OR CONCENTRATION NO FREQUENCY SAMPLE
<br /> ld653/ 154-611 138-46 /46-63 16d-5I DF
<br />l31-371 EX
<br />MALYas TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE' ~ MAXIMUM UNITS
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<br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF
<br />AM FAMILIM WITH THE INFO LAW THAT I HAVE PERSONALLY E%AMINED MO
<br />RMATON SUBMITTED HEREIN
<br />MD BASED ON TELEPHONE DATE
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<br />MY INONRY OF THOSE INDINDUALS IMMEDIATELY RESPONSIBLE FOR
<br /> OBTNNINO THE INFORMATION, I BELIEVE THE SUBMITTED INFORMATION IR ~~
<br />J TRUE. ACCURATE AND COMPLETE. I AM AWARE THAT THERE ME
<br />}, SIONIFICMT PENALTIES FOfl SUBMITTING FALSE INFORMATION
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<br />THE POSSIBILITY DF FlNE MD IMPRISONMENT
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