|
PERMRTEE NAME/AGGRESS(1wrLirie+h4N../lo~.nm.(/D~...n,)
<br />NAME LL C,
<br />ADDRESS
<br />J~l.1X `it3
<br />~~~~ CO 81524
<br />FACam _ANE CANYdN MSNE
<br />locATtoN 'i C8 815?4
<br />~_TER WHITL_EDGE, f~fINE IWGR.
<br />NATIONAL POLLUTANT DISCHAEtOE ELIMINATION SYSTEM NPDESI
<br />DISCHARGE MONITORING REPORT ID Rl
<br />PERMIT NUMBER OISCHAROE NUMDER
<br />MONITORING PERIOD
<br />YEAR MO DAY YEAR MO DAY
<br />FROM - TO
<br />Form Approved.
<br />GMB No. 2040-0004
<br />F - F- I i•JAL.
<br />5f~t:sl PI~PJi~• DSCf-ti?G T© E SAI
<br />~~f~
<br />,NOTE: Road irntructltx,r b~fon- edtnplatiny thls fwm.
<br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO,
<br />
<br />EX FREOUENCV
<br />of SAMPLE
<br />
<br />TYPE
<br /> ANALr~s
<br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS
<br /> SAMPLE - --
<br /> MEASUREMENT
<br /> PERMIT '.~ #3t #d; •II-~## t. ,~ ~ , ,~ ##8F# 9. D ~ - r ^._ PJw, .•i
<br />.) is t'.; f ;'-: ~.., ~ REQUIREMENT M I N I ML~i•i MA X I f'ftJl''f -. _.
<br />_ ..:,, i .' , = .. SAMPLE ;: ~; .: ~ .. .
<br />ENi))-3 MEASUREMENT
<br />'~,. `i ~ PERMIT :~ •-~# sta•~•it•#it ##~~•~:•:~ _ .. / 'N . _ :~
<br />' L_;.~)= t•J' V,'` ~ .REQUIREMENT ~ ;3UC?A ~``.'+~ DAI1_'Y t'17f ,.!`.> , f^i liiT
<br />_ _ L~ •-_ , - _ SAMPLE
<br /> MEASUREMENT
<br /> PERMIT -~ ':iF3t`it•# •II•'~'it"#'## ##iF##ii ###### , _l t~ ^cr~:.
<br /> REQUIREMENT l:iA I LY M?C ,~;, I`4fii •f •i f
<br />.. SAMPLE
<br />•~.,~~ MEASUREMENT ~
<br />'.~S I l PERMIT ## 'tEif# ####itit• :t~ r.>r'.~•NFdt-s~ _'~,~.:~.; 1GG i•J<. _ ~ A
<br />UENT GRQ' REQUIREMENT 3t3CJr'• 4`Jt3 DAIL'd f•1 Y. MQf~tT
<br />~,t tom) . ~`~ ~ . SAMPLE r .
<br /> MEASUREMENT
<br />-- C• PERMIT ~' :;. ; 3t##-tt•3F~s• ,, ,+ ###3t#~ ~t-#-; +F~fE• 1 J . h T i ~_;r .• '.:
<br />~. ~,:! ,s;~i} ~ REQUIREMENT
<br />-~ Ii`JST f-!AX t~Ef•JT
<br />;Ltl`I, SAMPLE
<br />' `~ATI"IEf i MEASUREMENT
<br />0 PERMIT .. r >r ,, ,:::; .;,~# :, ... - - ._ , . _
<br />r ~;F. _ ~';~~_ REQUIREMENT' OLiI~ r=; . '',ILY MX ..
<br />c„~;_ SAMPLE `;
<br /> MEASUREMENT
<br />PERMIT ## # ~t..~. t '.i dt , .; : - t st ~;..~. ,~ j. #. ~. _ ;a != - . _ '.• 1 r s
<br />REQUIREMENT . - •! ~,
<br />TITLE PRINCIPAL EXECUTIVE OFFlCEA ' "^"~ " r a""~ ° I/w Ih/t NN dorvmenl /nd /11 /tl/rhmenlf wene TELEPHONE
<br />M
<br />N DATE
<br />prep/rad /nder mT dlrertbn or twprr.tlon In utcord/nre with / f~/tem de/1(ned
<br />A
<br />E/
<br />_ to tta/e 1hH ~u/Mfkd personnel propeAT (/1Mf /nd ernlu/le IM Inforwwtbn /
<br />Ir
<br />o(1M
<br />erwn er
<br />enoeu who nrn/
<br />the
<br />m
<br />• l: J~
<br />bndllyd
<br />b
<br />d
<br />m
<br />ul
<br />t
<br />1 i
<br />~ C~"a'
<br />f -" ~
<br />S
<br />p
<br />p
<br />p
<br />_.
<br />- /u
<br />.
<br />re
<br />on
<br />r
<br />ry
<br />(e
<br />sn
<br />e
<br />,
<br />-
<br />G Y
<br />•J
<br />-
<br />or rhos! penore dl recth rerpoinlhk for plMerl n( the Infonrutlnn, the Infortn/lbn - - -
<br />GJ '/
<br />~
<br />~
<br />~
<br />. ~
<br />1 ./-.. wbtnllled N, to the het °f m~ knewW(e /nd brtlef, true, aettnte. /nd tomp4le. /
<br />,~
<br />Y
<br />L
<br />a NATURE Of PAINdIAI EXE CIITIVE
<br />• J~ / L_ ~ ~'
<br />~
<br />"-' - I /~n /w/re Ih/t then /R sl(Nllelnl pen/Itfo for whmlltln( (/be InforrMtlon,
<br />TTYCD OR PRMlTED Indudln( the posdblMtf of floe /nd Iwtprlaonmrnl fa knawin( rld^ttom. OFFICEII OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY
<br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS /R~l~r~nc• •N ~ft~chmtrnta htrr~/
<br />` •?ll_j= SOLTDS !. TMTT~' Af'~" IEP '-f1'-' "7.CtiYR, ~_!+'r-IF2 RFi"rF~ Ft.,rF_-PdT;
<br />~ PAGE dF
<br />EPA Form 3320-1 (Rev 3'99) Previous editions maybe used TI11S 1S 3 •~-P~FI (prfp.
<br />),.;
<br />
|