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PERMITTEE NAMEIADDRESS,In, lade /ix iLtt ;Vmnr'Loc'nuon rf Dr(jrnmri <br />NAME : LEMP Y <br />?NADDRESS ri CRi-c>`. LOADOUT <br />rU BOW'. Rosin <br />`•I I A D 6 7 4 <br />FACILITY <br />LOCATION , 1 I A ?, O S 3 4 <br />,Fzc;z r f-nPr;4. Pf?FC r nFNT•• <br />i 1 <br />Form Approved. <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) 1 I OMB NO. 2040-0004 <br />DISCHARGE MONITORING REPORT (DMR) - N0F <br />PERMIT NUMBER DISCHARGE NUMBER - FINAL DELTA <br />MONITORING PERIOD 'J i FOND TO N FORK GUNNISON <br />YEAR MO DAY YEAR MO DAY. <br />FROM TO X <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY <br />OF SAMPLE <br /> ? TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT #: > ### #+ ? ? = %T REPORT t: T F;?.Y F?A <br />- " _ S REQUIREMENT ?• r ,," DAILY 1`1 X <br /> SAMPLE t r94 } <br /> MEASUREMENT <br /> PERMIT ii•i x##sf RFF'CIRT 'r' 5 =' ##ir#ir It si##iE?lii ###utr# ir?Fr z l-t r_;iiAL. <br /> REQUIREMENT ? iy -- T WAX <br />'= Cr <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 />NAMEfnTLE PRINCIPAL R?FC6iIVE OFFICER I certify under perwlty of law that this document and all attachments were t TELEPHONE DATE <br /> <br />?I 0_r \ <br />?r. prepared under m, direction ,,r supervision in accordance with a system designed <br />ssure that quaffed personnel properly gather and evaluate the information <br />toa <br /> <br />tubmtred. Based, ? my inquiry of the person or perwns who manage the system, r <br /> <br />? <br /> or ih,we perms directly responsible for gathenng the information. the information j ' v b <br />70 ?? r? I L <br /> <br /> submitted is, to the lYtit of in%, I ii(ik%ledgc and bcltef, true. accurate, and complete. <br />f <br />h <br />i <br />ifi <br />lti <br />b <br />itti <br />f <br />l <br />i <br />f <br />ti GNATURE OF PRINCIPAL EXECUTIVE <br /> <br />R-P orma <br />I am aware t <br />at there are . <br />Lm <br />cant pena <br />es <br />or su <br />m <br />ng <br />a <br />se <br />n <br />on <br />f f <br />t f <br />k <br />nc <br />vi <br />l <br />[io <br />l <br />di <br />th <br />ibdi <br />d OFFICER OR AUTHORIZED AGENT AREA <br />NUMBER <br />YEAR <br />MO <br />DAY <br />TYPED O <br />RINTED tp o <br />ine an <br />Impnx,nmcn <br />or <br />mg <br />ms. <br />nc <br />u <br />ng <br />e pus <br />m <br />o <br />a CODE <br />COMMtNIb ANU MAF'LANfi14VN Ur' MrIT vrvL.filrvrvo IriClert711gC all <br />EPA Form 3320-1 (Rev. 3!99) Previous editions may be used. <br />11 CI C? <br />24-HR PRECIP EVENT IS CLAIMED <br />1'hi$ is 4-part fvnn.