Laserfiche WebLink
F'ERMITTEE NAMEIADDRESSp~fIF~rM~gN../Lerrr.nl/D~Gr...r1 <br />NAME <br />ADDRESS <br />BOX 483 <br />,,•dIA CO 62428 <br />FACam i E NO. 2 F1 I NE <br />LOCATION ;' i~ I A C 0 8 i 428 <br />. ~ ~ ~ t T nM n CCnO 10 MThdC MCL7 <br />Form Approved <br />NATIONAL VOLLLRANT dSCHMOE EUMINATON SYSTEAA INPDES) OMB No_ 204D'0004 <br />DISCHARGE MONITORINQ REPORT (D RI I.1 ? j~;~-~ <br />~:_ ri ;I}Bk MH ? <br />. PERMIT NUMBER ascHAaaE NLIMeEn ~ - FINAL DELTA <br />i'i I P~iE DR A i (`.IAGE TO GI~NN T SON R i r <br />MONITORING PERIOD <br />Y R D Y 0 D- __ <br />FROM TO .. <br />NOTE: Reid k»tructlort. b~for~ compbtin9 th{s form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO, FREUUENCr <br />of SAMPLE <br /> EX TYPE <br /> ANAlysrs <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> <br />SAMPLE ~; <br />' <br /> MEASUREMENT <br /> '~ <br />! <br />r~. PERMIT #'.F••k#•ii•ih ##it•'.t•## :~. #####91• L' ~ <br />I~R+]~ ~_: . ~,, , . REQUIREMENT i~ I (+i i ['iUt` I'iA X I P'iUM . . <br /> SAMPLE `~ .: is > <br />_I~yJ_=j) MEASUREMENT <br /> ~ s r <br />~ ~ ; r~ • <br />'r3 1 G PERMIT - <br />- <br />.-. .. '•~ REQUIREMENT i 3CiDA AV% F'il~i:_''( i•i:~ "N <br />P'ft~l~i <br />. ~ ~ SAMPLE <br />FE .' MEASUREMENT <br />~~_.c 1~ ~~ PERMIT ~~~-:, .~~ , ; <br />~_' r=.~•J ; ~~:. - . REQUIREMENT '~.:GFt ~'•', DAILY P''iX MONTH <br />.._ 1 _. _. SAMPLE <br /> MEASUREMENT <br /> PERMIT _ : , . ,. I ,: ; it : ;~ ~, :. ,~> <br />~, ~ j. REQUIREMENT Ii~c i Mfa'~ G~+•dT <br /> SAMPLE <br />- MEASUREMENT <br /> - . <br />. . , , <br />1 <br /> PERMIT C c .. ,. .. ... <br />. _ <br />.-~':~ REQUIREMENT =•,ILY f'lX <br /> SAMPLE <br />.. MEASUREMENT <br /> - PERMIT ~ ~ ;, -: ~ :• , ..,.. ., <br />_U~:P•f REQUIREMENT QRTR TiAX <br /> - <br />•- •_ SAMPLE <br />=, 1,, : :_ MEASUREMENT <br />PERMIT .. -, . .. _ , . _ <br />REQUIREMENT I NuT MFi:{ <br />NAMElTITLE PRINCIPAL EXECtlTiVE OFFICER 1 Ce^i1Y ° " ~"' l~ o le. Ufel Uht dorvmenl end en elLChmenb were TELEPHONE <br />pr•per•d undrr m~ dlreclion or wper.4Aon I. .rcordence rllh . q.fem darned DATE <br />le court Ihel queNfled perwnnel proyeA7 ~Nhtr end e•YVele the Infnrnwtbn <br />eobmllled. 6.eM en m~ Inpulry or the perwn or per.one .ho m.nge tM.7stem. - . <br />a Ihoee persele dlrerllf re.perdbk fa =.1herln~ the In/onrullon, the Inlorm.Uon <br />wbmllled b. b the bar or Im kne•rled~e end beret, Irre, .ccvnle, •nd cempkle. <br />I <br />EXECUTIVE <br />_ I .In.w.re uu uer..r<.Irdnrnl pen.llla hx wbnrlnni Kerr Inrornrdon, sIONATUfIE OF M <br />INC1rAl NUMBER YEAR MO <br />TYPED OR PRINTED Inchdln~ the poedblrlr ornne.wd ImplNoruwrnl ror -no.rnr •fd.Uaet OFFICER OR AUTHORIZED AoEMT C OAY <br />COMMENTS AND EXPL/-NAIIUIV yr nni vlv~nllvna rrt~r~rmc• «r ~lucrnrl.r.w r..r-~ INSTRUCTIONS ~ I . C. 2Or PG. 20. <br />~_, :~__ <br />EPA Form ?1320-7 (Rev. 3/99) Previous editions maybe used. OCt4e~ ~ ~~~1~SJt5~ ~ 4-~$T~ ~tTTt. <br />