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PERMI77EE NAME/A 9~uLb F.rILryNwJ1«mm UDlprmq
<br />NAME CUL( COA1. COl7PA!IY L.P.
<br />ADDRESS (.OLOI 1 M.INP,
<br />S"/31 STAY: fIIGR{lAY 13
<br />*iEr:3"R CO U16'll
<br />FAauTv
<br />LOCATION
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<br />NATIONAL POLLUTAN 90E ELIMINATION SYSTEM NPOfSI
<br />DISCHZR PORING REPORT ~ 19/
<br />PERMIT NUMBER DISOHMOE HUMBER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM 911 D4 Dl TD 9B U6 30
<br />I1a2t/ 111-231 /14151 u6-a71 rasasl E3o-3l/
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<br />EX OF
<br />l31-371 ANALYns TYPE
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS l s:-sal 16
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<br />NAMERITLE PRINCIPAL EXECUTIVE OFFICER I cERTIFV UNDER PENALTY QF LAw THAT I HAVE PERSONALLY ExAMINEO AND TELEPHONE DATE
<br /> AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN; ANO eASEO ON
<br /> MY INQUIRY OF THOSE INDINDVKS IMMEDIATELY RESPONSIBLE FOfl
<br /> OBTNNINO THE INFORMATION, 1 BRIEVE THE SUBMITTED INFORMATION 19
<br /> TRUE. ACCVRATE AND COMPLETE. I AM AWARE THAT THERE Al1E
<br />SIGNIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION
<br />INCIUOINO
<br />
<br />J D ~ ,
<br />THE POSSIBlL1TY OF FlNE AND IMPRISONMENT. SEE IB U.S.C. 1 1001 AND 7a
<br />
<br />810 ATURE OF PRINCIPAL EXECUTNE
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<br /> U.B.C. 1 t are. nY.r~tY. ra.drr dww .num. mry hcANr /M. W ro F ro,DOD AREA
<br />TYPED OR PRINTED .M OrmuMl.rr Mnplvn~nraFbrwrrnemrnma rW eYr.n.) FFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV
<br />COMMtN 15 ANU [:ArtArvA I wrv yr nn T vwLn I was Inoarancs sn euecnmems narsr
<br />51:'I'TL6AHLr; SOLID; LIi7I'f APPLIES ONLY IF C= 10-YR, 2U-NR PRECIP P,YI?RT Ii CLA7NF.D. IF Ci.Ai'"I APPROVED FY
<br />NJCD, 7'S:i I!I04 I,I17IT5 HILL NOT RE APPLIED TO RP.PORT?D MEASURRI7F.NT5--S F. P. I.R.1.A, FG El A'iD I.D.lD, PG 6.
<br />EPA Form 3320-1 IDS-961 Previous editions mey be used. (REPLACES EPA FORM T-AO WHICH MAY NOT BE U6ED.) nnnH .~ , n n n-r+ ~ ~ ~ ~ PAGE , OF
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