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PERM ITTC[ JADDRE88 ILu'IuJY NATIONAL POLLLIT DISCHARGE ELIMINATION SYSTEM 1•`/'/l/..l) O//FlApp/OYed. <br /> Patdiry Nam Lion tJ dilJerrnl) DISCHAF•MONITORING REPORT I041R) Z6No.2010-000I <br /> NAME_ M _C_UNTINt_NT_LUAL t: COKEC11 --_ ,.r-Ihl (n-l9) F — FINAL OXpprove/expires9-30-8b <br /> ADDRESS f 9? 158 _ CU 0390 SECT 11 j<OK=10YR24HR <br /> 3 <br /> ___ CARBONDALE __---_— co 8 161 _ _ PERMIT NUMBER DISCHARGE NUMBER <br /> ------------------------- MONITORING PERIOD <br /> FACILITY__._ --- YEAR MO DAY YEAR MO DAY <br /> LOATION -------------------- FROM TO [�C 1 - .7 MINOR <br /> ATTN: DUUGLAS BOWMAN LNV CUORD (20-21) (22-23) (24-25) (2627) (28-29) (30-,it) NOTE: Read instructions before completing this form. <br /> (3 Carr) Only) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION <br /> PARAMETER (46-53) (54-61) (3845) (46-53) (54-61) NO. FREOUENCY SAMPLE <br /> OF <br /> (32-37) EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM I UNITS>< (6163) (6468) (69.70) <br /> PH SAMPLE <br /> MEASUREMENT <br /> 00400 1 0 PERMIT *# *** ** *** fF lia 6.5 ( ****** 9.0 �d EEKL GRAB <br /> EFFLUENTGROSSVA REOUIREMENT * <br /> MAXIMUM -SLj <br /> SOLIDS: SETTLEABLE SAMPLE <br /> MEASUREMENT <br /> 00545 1 0 PERMIT <br /> F GROSS V REQUIREMENT REPORT Ow5 ONCE/ GRAB <br /> OIL AND GREASE SAMPLE <br /> FREON EXTR—GRAY MET rEA.UR..ENT <br /> 00556 1 V EO ERMITREMENT *# ** * ** **# REPORT 10 WEE KL'V GRAB <br /> EFFLUENT **** <br /> FLOW, IN CONDUIT OK SAMPLE <br /> THRU TREATMENT PLAN <br /> EASUREMENT <br /> 50050 1 0 PERMIT R REPORT ****** ****** ****** *** WEEKL INSTA <br /> EQUIREMENT <br /> SOLIDS t TOTAL SAMPLE * ** ** >Oclpcl(}(*>dc <br /> DISSOLVED (M6/L ) MEASUREMENT <br /> 70295 1 0 qulReAtENr *'�"�`*'!` �'�`�"�"�"�` *** ***�** REPORT REPORT E QTRLY GRAB <br /> EFFLUENT **** AV <br /> OIL AND GREASE SAMPLE <br /> VISUAL MEASUREMENT <br /> 840b6 1 0 REoPERM <br /> RE T REPORT **** ES=1 **** * *# #�>�* ****** **** WEEKL VISUA <br /> EFFLUENT _ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNDER PENALTY OF LAW THAT I HAVE PERSONALLY EXAMINED TELEPHONE D A T E <br /> AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN AND BASED <br /> J©�� ON MY INQUIRY OF M INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br /> OBTAINING THE INFORMATION 1 BELIEVE THE SUBMITTED INFORMATION <br /> IS TRUE ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE SIG <br /> NIFICANT PENALTIES FOR SUBMITTING FALSE INFORMATION INCLUDING <br /> THE POSSIBILITY OF FINE AND IMPRISONMENT SEE 18 USC I IOOI AND SIGNATURE OF PRINCIPAL EXECUTIVE ^/�ju(�33 USC S 1319 rP.•nalhr.v I,ndrr thrsr smtub•r may urrlydr/mr.. up hi Slu uuu <br /> TYPED-OR PRINTED - oral rrr manmum mrpn.nnmrod rl hturrn R m.nth..and i�ru•.r - - OFFICER ORAUTHORIZED AGENT -AREA. ------.- <br /> COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference till umu'hnlents Mete) NUMBER YEAR MO DAY <br /> IF NU DISCHARGE UCCURS KLPORT "NO DISCHARGE„.SALINITY SHALL bE MEAS.AS -i-US=70295 MG/Lw <br /> OEG NOW 2 PRAM.NU SHLEN:84066=0 9 5 56=0.A SHEEN:84U66=1056=GKAb SAMPLE, <br /> EPA Form 3320-1 (Rev. 10-79)PRFVICUS EDITION TO BE USED (REPLACES EPA FORM T•40 WHICH MAY NOT BE USED.I C1064i�/100686-1646 PAGE 1 OF <br /> U:4TIL SUPPLY' IS EXHAUSTED <br />