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PERMITTEE NAMEIA '~l7klL Fxerry NsWLennen l/DIQ.mrl NAME Upl,t: ._U.4I. CUt1_uANY L. P. ADDRESS COLU:, , i! INF. 513.1 STAT" R.LrIIYAY 13 ;1 iiF:Ke:N CO 91641 FACrILITY LOCATION ~ 1~1 I,(cyJ l'Y1, OA1 J~~n N..FfA~ McYW/X{,~ A 7i}I~-1 " r F3 .---li4r-r=. NATIONAL POLLVEANT VIDE ELIMINATION SYSTEM (NPDESI Form A DISCHAR ITORINO REPORT OMRI ~ r R S 7-r 17-79 ST ReET PG (; CILCR To°'[',~' Po oa ,B (S [I IfR NN) APPro _ U~ PERMIT NUMBER DISCNNiGE NUMBER F - F I N.4 T.. MONITORING PERIOD FIINOE YEAR MO DAY YEAR MO DAY _ FROM 99 UU O]- TD 98 0(i 3U #'.:. Nfl f?I iCRA7.G 1. •`•~'~ 110-171 171-131 114161 !16171 116-791 130-3I1 ~ NOTE: Rrrd Inrtructloro 6elori complaclnQ thb form. PARAMETER !3 prd On/YI QUANTITY OR LOAOINQ !4 Grd Onhi QUANTITY OR CONCENTRATION ND FREQUENCY SAMPLE !16631 5461 (38-46 4663 646/ OF !37-371 EX ANALYSIS TYPE AVERAGE ~ MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS reJ-eel 164587 15a7o1 I'll SAMPLE ###%k#'k #####=f 1 ~ ~.##=k=? ~ S s ( ~~~~ 0 I/ G MEASUREMENT . r 7 UU1iU0 1 !1 U PERMIT. - : 'sk~{~!k;;t$... . ' :' '#."-~tY: ~: #fi: 6:5 :;:;:.'.::: :.::. `:':.::ts.Ye #'sf?f?k::.'.: '~'. Q'': : :. : .`: ' '... RERI.Y ;RAFJ };h'F'LUE`IT ;tt0`iS VALUE REQUIREMENT. . .'::.. :.::::: ... ' . F1,... ... . . td :iOLIDS, .l'UTd.L SAMPLE :;:;,##~# #r###:~ ###### $S 6 ( 1~) I S1J~11c N1);:U MEASUREMENT 29 O /3p G UUSJU 1 U U 'PERMIT. #>S:#~.##::. :: ' ~ .- r~%k:M%k... ~ #;r: ;ip„ok>r,fi::: 3`J ..:'~::' i N CE/. ,RAB ':F"r Ut: '1' .. ~ SS I I. II FLU V.1L IE .REQl11REMENT~ ... , :': :: ' '.:~::::~.i:..: ~. :...:~..'..:.:,..:':~ ~~: ::... ~~ '':: .~.~.::'~ ~..~ ..:::~....:. .. :k ".~,- +- ':::~~~~~~.:~,'.:.;:.:~.~~. ~:::: !: . 70L1DS, :iliT1'I.F:Ai+I. F: 'r#r#;k ##-'f,:`•sk,';• ###v## ..'k##:`- ~D C ( 2 i~ Q I /` MEASUREMENT . J 3iy 171 UUSIiS 1 ll U PERMIT.'. '. ...#####a::'..' ~ ':: ;:##sI#~#.:.' ~ ~ ~ ;t:;k {~(<f#?t#:::. : ::'#>k ~ .. : '~` tr .S. : ' / . N 'R AB I F .:F F Lu .N r ,N,).r-1 vA t.u.. REQUIREMENT' . ~..'.'..:.:..: ~:~ ~:~:: ~~:'.: .. ~:: ~ ~: ~. ~:.:. ~:~::: ~~ ~:. .: ...::....':.: ......., ..,-,..f . ; :;.::•:.:::•, . :' . .....:..: D T ~Y ~ ~ L L ON . II. AND ~: ii F'A'i f; SAMPLE :kv ~X rf## #%k###:k ###### =f###~`:`• •' ( ].~~ N ' 1 N A F'l{Y:ON ::X'i'({-Gr1AV ME'P,. MEASUREMENT IY/A A //~ (• ~ lU'DSb I U U "PERMIT _ ';':'•~#r###.'-: :.'::####YS"-. ~ #;=r ;.:X~# ##.##h~'L:.`: :~:{~: ONT Z N A r- ,.FF'I.U1:VP vfi?)S, V.ALIIt REQUIREMENT; '."' ' ... :'.:.::' ,: #;YR^^• ... . ST' 11:11'H ii". 1. .N . 1.HU!F, TI)CAL SAMPLE .##;=## ;#;'%•'.: #####=f r { 1.9) 1 (A i F' S ~ MEASUREMENT ~r 1 ~ y O /30 , U 111110 1 II U ~': ~.PERMIT.~~. ... ;~:kiS.##+s. ~. ~.' i:'..#L%?k?R;#~ .. ': ~`•: '~.~#iti=h~?R;~` 3 :.:: 5 .'.:'. '.::`: • ~~~:,Q.':~..::..::.;'~:'~ ~ i r / N E rRAB r;i!'LUh'N'1' ,;NUS': vAf.UF REOUIREMEN? . . ~' ~ :..~~' :.::.:::,~:'. ~" ':~.~~:~~.~';.~':: ~.''.~::-: ..+-,. +. ,•,.,... ~~.:'~•~~~ ' ~ODA'~::~AY.C~ :. ~~:.7..:LY~.:M. ~ F1C L .~ PLi)WF Iiy CUNUULI' Oh SAMPLE Q 13 ~ 31 ( U3j ##fi%.`•# +;=:do;`•#d: :}+:;::;::,~: NIA L ," ~- TIII{U '1'dEATl9EIiT ULAN MEASUREMENT . r ~ ~ a.) ZrK UilUU 1 U (I ?ERMIT':::: PTZO:HAL.: ;`;REPO.NT :~~'.7rif ..... .. '~:' : •'.:.7=ka~.t~:". ...::~:%>:f,;~rd::% :~;:~~ RN, IIC.T NSTAN ': ^ ~ .^ ~ „rPLUr'.,iC ,S10S5 VALiy} REQUIREMENT. :.. ... ..... 30DA::'AV.G:': ....:.. :AAILY: h$ MFD .. . . . ` ' ,;ULIUSF 'l'UTAI, SAMPLE %k-k#•;r;rr #####:% "A#### #####%k ` 9~ 2 ( 19) NSA ~~ U.I.:iSOLVF:U MEASUREMENT N 90 )Ul9'i 1 U '~ PERMIT ~#L`•: .y.# ... +F##4:fi :; ,., w..~...x+..::: a A `: F'F'LU F: IV'C IinJ'i5 VALI)F REQUIREMENT. ':?: ~' :: .... ...........: ....::. :. . .:.~ '..: .::...: : NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENUTY OF LAW THAT 1 HAVE PERSONALLY E%AM1NE0 AND TELEPHONE DATE AM FAMILIAR MATH THE INFO RMATON SUBMITTED HEREIN; AND BASED ON MY INOUIflY OF THOSE INDINDUAl3 IMMEDIATELY RESPONSIBLE fOR OBTNNINO THE INFORMATION 1 BELIEVE THE BVBMIREO INFORMATION IS n..~ [(/' , TRUE. ACCUMTE AND COMRETF. I AM AWARE THAT THERE ARE + SIGNIFIC/WT PENALTIES FOR SUBMITTING FAISE INFORMATION INCLUDING ~ {~ N , THE POSSIBILITY OF FlNf INO IMPNSONMFNT ! 1001 AND S] SEE 1B U S C 7p ~ g ~ I 1 ~J ~ Ll. armon . . . . u ~Ir Ih le d x r s e F d d J 0 B NATVflE OF PRINCIPAL EJ(ECIIEIVE ~ . . rr .. nr .nrl.na nrr .A n.. y N . . 1 r. en . /0, 00 TYPED OR PRINTED .nsrmupnm Nwr.wvrl.,roF e.n.„n e,..mn..cee r«ral OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAV COMMENTS AND EXPLANATION OF ANY VIOLATIONS lRelerence ell etfechmenls here) ti':'I"L'LF:A!tl,'i :;:1LLD5 Li7.L'P 9PPLIF.S ONLY IF ~= 10-YR, 2U-IiR P9BCIP P.VP.NT 75 CC,AI?7Tp, IF CL A. i'4 .4PDgOYED ~lY ~i11_UF 'L'S-; .• CRO:: LI'7IT: I1LLL NOT UE APPLZCD TO RF.PORTrD '",EASUCICM,ENTS--SP,E 7. F.1 A, or: EI ^:qp L, f{,1DF F.: 6, c•111 '.~A"4'i .1F. F"C^L:OT n'I Cd •~fl •5 }-1 -:],~ EPA Form 7320.1 108-951 Previous edltlone mey be used. IREPIACES EPA FORM Td0 WHICH MAY HOT BE USED.) , PAGE OF ~, ~ nn~n, r~ ~ ~ .