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PERMITTEE NAMEIADDRESS (include FaciWY Aameltaradan if lkfferrm) <br />NAME '_0KAD0, LLC <br />ADDRESS <br />Ct28 <br />FACILITY i GO E11424 <br />?; I XGr r: I -4F <br />LOCATION A CO 81421A <br />LANCE WADE, M i NT: MANAr_FR <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDES) <br />DISCHARGE MONITORING REPORT (D R) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY M <br />FROM TO YEAR DAY <br />Form Approved. <br />OMB No. 2NO-0004 <br />MNT RS <br />RIB TO TUTTL.E DR <br />Nt-)TF• Raarf Inafrttr•finne hafnra rmmr?latinn fhie fnrm <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO• FREQUENCY SAMPLE <br /> OF <br /> EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br />_ MEASUREMENT] <br /> PERMIT ; <br /> REQUIREMENT 1) NX <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT - 2 REP€7R <br /> REQUIREMENT -10UA A',?-G- Dt; I L.•T' <br /> SAMPLE - <br /> MEASUREMENT <br /> PERMIT 1 yt- <br /> REQUIREMENT CDr; <br /> SAMPLE j <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT DA!" r' N X <br /> SAMPLE <br />_IL v:-i MEASUREMENT <br /> PERMIT ,:.. <br />REFURT- <br /> REQUIREMENT I `r4':'? ;Fi I1__Y MX <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br />- REQUIREMENT _. t. DAILY T <br /> SAMPLE <br /> MEASUREMENTI <br /> PERMIT s• c; ., - ;i t_ Ut; <br /> REQUIREMENT r=; sJA i L_ s' <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certif% under penult? orlaw that thisdocument and all attachment. wrrc TELEPHONE DATE <br /> P-Pared under my direction or vupeni+hm in Accordance with a q+lem drataed <br /> to w-.wre that Qualified Pcnoanel Pruperi' gather and evaluate the information <br /> wbmitted. Rased on m) inquiry of lhr Person or perm. who manage the,%wam <br /> or Iho a pemont dirmd\' resporWhIc for (fathering the information. Ita, information <br />J wbmiued i, b, the hot army knowledge and belief. true. accurate, and complete. <br />I mi.. am that there <br />ci <br />ifi <br />f <br />lti <br />h <br />f <br />i <br />f <br />l <br />SIGNATURE OF PRINCIPAL EXECUTIVE r• Jr <br />- i <br />- ,? r / <br /> Are <br />can <br />pena <br />es <br />gn <br />or w <br />ning <br />se information, <br />en <br />a <br />nesua.raRO ,Y?P CD OR PRINTED r w uv vases, including the rx-ibi16 or fine and imprimumnem for knowing.uolation, <br />I OFFICER OR AUTHORIZED AGENT AREDA NUMBER <br />CO YEAR MO DAY <br />EPA Form 3320-1 (Rev. 3M) Previous editions may be used. 001 17fn_rMi '4=pact form. <br />