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PERMITTEE NAME/ADDRESS (Include FaciliQ• A`am: •!.o aID•n :1 Ayfpz•nrv NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES) <br />NAME DISCHARGE MONITORING REPORT (DMR) <br />ADDRESS JVN_; rION MIr_,. <br />PERMIT NUMBER DISCHARGE NUMBER <br />)1 D .1tr (.KSHORO IiT r'' ' <br />1 I TA FALLS MONITORING PERIOD <br />FACILITY 71 ftJniC T F C3il TI I NF YEAR MO DAY YEAR MO DAY <br />LOCATION ANGO CO 131"' FROM TO <br />Aht nI IZ' c n=c r nc•nir Ar197nlr <br />Form Approved. <br />OMB No. 2040-0004 <br />t btJf K l:f: <br />F - F I NAL ?- <br />POW-) Tf] r r.:`f;nil JIJNCT <br />NOTE: Read Instructions beforw , pleting this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION I NO. FREQUENCY <br />OF SAMP <br /> EX TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE I MAXIMUM UNITS <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT W I C E <br />E. - I:_ `i r tit; .1?•5 t, REQUIREMENT ('i 11kiN 10NT <br />? ._ SAMPLE i <br />Sll.:?i';_I:D MEASUREMENT <br />r,t 5i1_. PERMIT is r i!##### ;3 CI i 45 <br />L- FT LiJENIT ::Rb,55 VAI_t•)f REQUIREMENT 3.it?f A?+ 7 <br /> SAMPLE 4 <br /> MEASUREMENT <br />:??•. r-,. •- .- PERMIT .-.- <br />>-; - REQUIREMENT * <br />t SAMPLE - <br /> MEASUREMENT <br /> PERMIT Items # s ! ?F?iT i (1 SR ? <br />V,%i; r REQUIREMENT =FN i <br />T SAMPLE a. <br />THE U TREA i t-JE Ni PLi:-, i.: MEASUREMENT <br /> PERMIT R E;7, " <br />? <br /> REQUIREMENT O' <br /> <br /> SAMPLE +t <br />?J <br /> MEASUREMENT <br /> PERMIT sr its ....-s # PEi?JRT 'EPCf?T i ?L t>" <br /> REQUIREMENT ODA AVL- - ;:ziI L r i- ; <br /> SAMPLE t< :. ,. r ! 4 tt t fi k # :r ## i <br />Vi MEASUREMENT <br /> PERMIT #' c F;` ] #it#### tx':t'. #it##? i,•:T,:-? 1`•'?AL. <br /> REQUIREMENT s: N.. <br />NAME,TITLE PRINCIPAL EXECUTIVE OFFICER I tfy under penalty of law that this &u umcnt and all.atachimnt...erc <br />- TELEPHONE DATE <br /> <br />r? t .. 1 ?'.__L C .'?`• r "t- • eparcd under my direown or supra isiun m auurdance with a vyaem desi!c <br />ne.l <br />to ac ure that qualified peru,mtcl propcrh gather and e%aludte the mtirrmt{ti,.n <br />i C '•? <br />_ _ .?-A <br />{ i ,I l e <br />V V ( submntcd Based on my mgwn of the per.on or rwrsonc who manage the ar,tem, <br />or those persons dire th responsible for gathering the mtormannn- the information <br />{ <br />, uhmnt d is r,. the h st of m <br />know <br />e and belief <br />true <br />acorate <br />and com <br />lete <br />d <br /> y <br />p <br />e <br />g <br />. <br />, <br />. <br />I <br />h <br />th <br />if <br />t <br />l <br />i <br />f <br />b <br />itti <br />f <br />l <br />f <br />w $I NATURE OF PRINCI AL EXECUTIVE A <br />W <br />TYPED OR PRINTED es <br />or su <br />ton, <br />ji .- ore t <br />,a <br />ere arc ign <br />ican <br />pena <br />t <br />m <br />ng <br />a <br />se m <br />orra <br />n tLc pti-biluy of fine and imprisonment fur knowmg %,olations. OFFICER OR AUTHO 12ED AGENT ARE <br />um <br />CODE BER YEAR MO DAY <br />COMMENTS AND EXPLANAtwN OF ANY VIULAIIUNb (He?erence an arracnments nere/ <br />:IF EVEN <br />'n t _ J THE DI <br />EPA Form 3320-1 (Rev. 3199) Previous editions may be used. <br />40423,, ,-1 ??is- is ?a =}-pest; Conti.