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COLORADO DEPT. OF PUBLIC HEALTH & ENVIRONMENT <br />Water Quality Control Division <br />WQCD-P-B2 <br />.4300 Cherry Creek Drive South <br />Denver, Colorado 80246-1530 <br />Make enough copies of form for each reporting year. <br />Check box if this is a <br />new name, address, etc. <br />Petmittee (Company Name): ~,~ti I ~ N D I ~e z ~} <br />Facility Name: <br />Mailing Address: <br />Facility Phone Number: <br />Permit Certification No. COG-SO~~QQ <br />Reporting Period: Jan. 1-Dec. 31, 20 ~_ ;Form is due by Feb. I S of the following year) <br />**Each section must be completed. Please print or type.** <br /> <br /> <br /> <br />A. A report on the facility's overall compliance with the SWMP. (Include here a summary of any measures taken <br />to comply with your Storm•.vater Management-P-lan (SWMP), to-fully implement-it; changes or improvements <br />made in any of your Best Management Practices (BMPs), employee training, spills, other problems <br />encountered, etc. How is your plan working?) , , _ - <br /> <br />Were changes made to your SWMP? ~No ^ Yes -Describe changes on a sepatate sheet. <br />B. A summary of each comprehensive stormwater facility inspection made, including date, rndinQS, and action <br />taken. (The petrnit requires at least two comprehensive facility inspections per year -see page 8 of the <br />permit. Include here a summary of those inspections, plus any other comprehensive inspections made. It is <br />not necessary to summarize day-to-day inspections, unless significant problems were noted.) <br />First Inspection -Date _/_/_. Findings, and action taken: <br />o?dO.v1~ ~ E ~i!/~oyz.~y6' t~4-S Ta ~,ozsg <br />~PUgT~L.t! D <br />