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PERMITTEE NAME/ADDRESS Aad.6Fw#yNaatdLxr,aI(Doimnl <br />NAME <br />ADDRESS <br />BU:•: iii <br />1 G CO 8162E <br />FACILITY . P P ER M 1,",j E <br />LOCATION I G CO 8162 <br />YMOND is DU BOIS, PRES/GM <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDESI <br />DISCHARGE MONITORING REPORT (D RI <br />PERMIT NUMBER aSCHARGE NuMem <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM - _ TO _ <br />Form Approved. <br />OMB No. 2040-0004 <br />MINOR <br />(SUBR JC ) <br />F - FINAL MOFAT <br />DISCHARGE TO EAST FLUME GULCH <br />NOTE: Read Instruction before completing this fwm. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREOUENCY SAMPLE <br /> <br />EX OF <br /> ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE Yt it t <br /> MEASUREMENT <br /> PERMIT ## ##': c L? t5. cal # ##3F . ;+ EE,L I NS I ! <br /> REQUIREMENT M ; . -Al lX <br />TL)Sr TC7': SAMPLE ` <br />ENDF-, MEASUREMENT <br /> PERMIT -31 NC F- `I°RAL <br /> REQUIREMENT r I U AVu A LY MX !'!G/- i' ON T? <br />_t SAMPLE _- <br /> MEASUREMENT <br /> PERMIT ::tt3t ,i## E#- eF *4k I IONAL R PORT 'NCE/ RAP, <br />r " REQUIREMENT , OODA <br />I3' ILY P'{X <br />? <br />MONT <br />i . -;. SAMPLE <br />" <br /> MEASUREMENT I\ <br /> PERMIT !)t# # # # ,k ? # 300G 6000 NC F ! 13 <br />GRO' REQUIREMENT ?- 30DA ty DAILY MX t/G! MONT <br />GR EA'. SAMPLE <br /> MEASUREMENT <br />0 _ PERMIT :.. #et <br />' 10 t-. <br />. R0?', REQUIREMENT INST' MAX <br />ONDU I T SAMPLE <br />-MENT F! MEASUREMENT <br />_ 0 0 PERMIT REPOR, REPORT <br />? rat ? <br />- <br />i rtf' <br />-NT GROSS REQUIREMENT . 01)A A',r?-' t AILY MX <br />T13TAL SAMPLE I ; <br />VF_ r. MEASUREMENT <br />PERMIT si##### ;?###?-: _ r, t <br />REQUIREMENT SODA r •: G , ,A I LY MX <br />1 canny under pens tf o law that Nb docement and all allachme is were <br />TELEPHONE <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />DATE <br />pmpared under my dtrtctlon or salad Islon In aceordsnre with a system designed <br />to assure that quaenrd per,onnel proper f7 gather and evaluate the Inrnne atioo l? (- <br />?y wabmttted. award on my Inquiry ot the perwoo or persona who manage the tram K- .r <br />or those persona directly reeperdbk for tathering the Information, the Information -? . _. L?•?- L?f- i <br />tnbodtted b the best of m mewled and belief, Ime, accurate, and complete. l I am aware that there are dgNne"t penalna roe aubmtlun <br />War inrermatioo <br />SIGNATURE OF PRINCI?AL EXECUTIVE r • -j <br />TYPED OR PRINTED g <br />. <br />Including the padbtory o( Mm and Imptbonment ror ano»tng violatiortr_ OFFICER OR AUTHORIZED AGENT AREA <br />CODE NUMBER <br />YEAR <br />MO <br />DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference 0 attachments hare/ ' <br />P? T= DLIDS LIMIT APPL IFD F0P ,'-= IOYIa, 04HR PRECIP FVFh,)? - <br />!ITORING SEF_ 1. <br />_ :- <br />s - i'iQW-PikV IVd IIri iii' d?.® FG?PGRTF? <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used : ,, t j3 -pagj'r tl. PAGE OF