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PERMITTEE NAME/ADDRESS hi, hide k.wiNn- NameZocation if Ixf er na <br />NAME <br />ADDRESS '"OADOL7'1 <br />?40 BOWIE RDit , o <br />±NIA CO <br />FACILITY R Q? C I c E: K L. <br />LOCATION I A C <br />AMFC- T i.nnp!=R PAT-STnF{\ <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />DISCHARGE MONITORING REPORT (DMR) <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO DAY YEAR MO DAY <br />FROM TO <br />M CR <br />(SUBR MH) <br />F - FINAL <br />BF-11-71I POND #1 TO N FOR <br />Form Approved. <br />OMB No. 2040.0004 <br />LTA <br />Nr)TF• Raarl Inetrttefinne hafnra nmmnlatinn this form <br />PARAMETER <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> <br />EX OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT c#itit F * # : **4 REPORT i RLV R'=,'. <br />I- ? ?Ll!' REQUIREMENT 3QDA AVM <br /> SAMPLE = .. ;"4 <br />: <br />?s 7 t . ;t tf <br /> MEASUREMENT <br /> PERMIT jt#iiiF =? ##t?#o #iE•iF# #ttitaif is ,ref IEEKL ISUAL <br /> REQUIREMENT li'iS =lJ <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law tire! this document and all attachtm Ls were TELEPHONE DATE <br /> :,!spare, under my direction or ur.mmon to accordance with a system designed <br /> :o assure that qualified personnel properly gather and evaluate the information <br /> <br />,ubntuted. Based on my inquiry of the person or persons who manage the system. , <br /> <br />L <br />?1 <br />I <br />x <br /> or those pcrs.ms directly requ)nsibie for gathering the information, the information r •y <br />• ?' <br />'i <br /> <br /> <br />T submitted is. to the f e r of m-% lnoyviedge and belief. true, accurate, and complete <br />1 <br />h <br />if <br />k <br />h <br />l <br />i <br />fo <br />b <br />t <br />i IGNATURE OF PRINCIPAL ECUTIVE i r j <br />' 7 <br />TYPED OF? PRINTED am aware t <br />at t <br />ere are sign <br />icant pena <br />r su <br />t <br />es <br />mnnng <br />a <br />e informat <br />on, <br />ncludin <br />sibilit <br />th <br />f tin <br />nd im <br />ri <br />n <br />nt f <br />r k <br />wi <br />vi <br />lati OFFICER OR AUTHORIZED AGENT CODE NUMBER YE <br /> g <br />e pos <br />y o <br />e a <br />p <br />so <br />no <br />ng <br />o <br />ons <br />i <br />me <br />o AR MO DAY <br />-.UltnMrF'4IJ Mrvv CAruArvA1IUI4 ur AIY1 vtvuaI IUrrva Irreverence au cluacnmenis nere) <br />14-HR PRE <br />EPA Form 3320-t (Rev. 3/99) Previous editions may be used. -:)0006 This is-a.4-!part form. PAVE