Laserfiche WebLink
PERMRTEE NAMUADDRESS pwrb6iarWry Na.?re stun tfD(QFseu) <br />NAME <br />ADDRESS <br />BOX 493 <br />NIA CO 834.' <br />FACILITY 1E NO ? ti I NE <br />LOCATION. N I A t;I0 614 <br />1 T A td ., 11 r- A n In M T Ai= Mr %C <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM /INPOES) <br />DISCHARGE MONITORING REPORT (DMRI <br />PERMIT NUMBER DISCHARGE NUMBER <br />MONITORING PERIOD <br />YEAR MO AY YEAR MO DAY <br />FROM 17D TO <br />Form Approved. <br />OMB No 2040-0004 <br />MINOR <br />(surf- <br />f - r INAL }c? <br />SR;DEER TRL DTC OR UNMD TRIt <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. <br />EX plEaOFNCr SAMPLE <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> <br />Q PERMIT y ri :=.-'Uk i s l <br /> REQUIREMENT <br /> <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 /> SAMPLE <br /> MEASUREMENT <br />PERMIT <br />REQUIREMENT <br />ME/TiTLE PRINCIPAL EXECUTIVE OFFICER 1fert1y that this document and atf attachments were TELEPHONE DATE <br />prepared under my dirrrtlon or super.tsfon In accordanre with a system deigned <br />NA <br />to asoare that q..Hned personnel ptgwriy gather and r.ah+ale the Information <br />sebmltted. Board on my Inquiry of the penmt or persons who mairuge the system, <br />or those persons directly respanlble for gathering the Information, the Information <br />mbmlfled fs, to the bet of my kturwkdte and besef, free, at<strafe, and tompMe. <br />SIG <br />WAL EXECUTIVE <br />I <br /> I am aware that them are signitkaM penaltle for wrb"Iting Forte Information, NATURE OF PR <br />NC <br />TYPED OR PRINTED IndWing the potdbnuy of line and Imprisonment for knowing rWatiom OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DAY <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference off arrecnmenrs nerel <br />EPA Form 3320-1 (Rev 3'99) Previous editions may be used This is 3 4-part form. AGE OF