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PERMITTEE NAMEIADDRESS ilnrlade Faeihi.r.kamdLocaian if Different) <br />NAME <br />ADDRESS <br />BUX ,'-v7O <br />EN U 810 <br />FACILITY EGA MIP?,'F COMPLEX <br />LOCATION DEN CO 8162 <br />UAS7P1. gtr'I ,&MGT T RN MwU&r?FA <br />NATIONAL POLLUTANT DISCHARGE EUMINATION SYSTEM NPDES) <br />DISCHARGE MONITORING REPORT (D R) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />O <br />MINOR <br />(SUB P <br />F - FINAL RDU- <br />L+SCHC TO TR I B/SAGE GREEK <br />NOTE: Read Instructions before comoletina this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO- FREQUENCY SAMPLE <br /> <br />> <br />< <br />EX OF <br />TYPE <br /> ANALYSIS <br /> - AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br />i <br />/ <br /> MEASUREMENT <br /> t <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> <br />1 <br />/ <br /> MEASUREMENT <br />( <br />, <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />- j <br />_ <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br />' -•? J LJ <br />? ? <br />1 <br />? <br /> PERMIT 1..:, r. „ ., , .. ) ) <br />, <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />' I •i. j T i <br /> SAMPLE <br />r <br /> MEASUREMENT <br />I <br />(J • v ' .v <br />l <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> <br />R <br />M <br />?- r <br />(/) <br />f <br /> MEASU <br />E <br />ENT Q <br /> PERMIT <br />R f L;; ; <br />_3 <br />- <br /> REQUIREMENT RTR A' ' r• `L L.i <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certif> under peoail) of law that this dIw'wnent and u11 altachnuni, were <br />ared under m) dir-tion or -Iwn wus in ---dance with a -tem deci <br />re <br />;md TELEPHONE DATE <br /> p <br />p <br />l <br />to assure that qualified perv nnel praperl% gather wW evaluate the information -? <br /> suhmiued. Bawd on my inquin of the pervlu or person, whn manage the %I%tem, ?j <br /> or Ihlw• J r,a_ dimedv n ponvihle for gathering the information. the info rmation <br />.- <br /> whmitled 6. to the t-I of In, kmlwledge and Ilclkr. true. a vurale,and panplete. <br />an a.. are that there arc significant penalties for vuhmilling ralve information <br />I <br />SIGNA RE OF PRINCIPAL EXECUTIVE <br />i `i <br />TYPED OR PRINTED . <br />. <br />urcludin_ the pmsibilitn of fine and imprhomnenl For knowing violation.. OF CER OR AUTHORIZED AGENT AREA NUMBER <br />CODE VEAR MO DAY <br />%,UMFVlcn IQ MI\L/ I- Ar'L-MI'AM l tvn yr #.%IV r nv6M l lvtw ("Wiwi 6r I- all aua-n lul Igo I tutu/ <br />S L] <br />HR F <br />EVE.t <br />Form AD ved. q <br />MB NoT40-0004 <br />EPA Form 3320-1 (Rev. 3/99) Previous edibons may be used. 0045This is iL 4-pdit'i'Ann.