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PERMITTEE NAMES <br />NAME <br />: <br />st4 ..$ . ': <br />ADDRESS 5? ?yRs <br />F . L.: . <br />1DDRESS (Include Faciliti. Name/Loeation if Different) <br />F!-0 ¢``t-..'',N`-- <br />FACILITY i ctc ± s <br />Fif-iff'k <br />LOCATION CO- 1430-n??9 <br />•??'?• #'Rt • t`?r=f -'T :?-t= ?J i= t'?i"'Y'":'.it? ='.i'lai - E?'i::.ii 4t"?t;' <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 ; Q,,? <br />Form Approved. <br />OMB No. 2040-0004 <br />C'f'ii:i H? r <br />FUND rt T'?114 10) t,.;i;`',•31..` S`? R!VT-'% <br />:N :: ST' SV2.7 i/r, 1.M r-.??,{"if•jY', i•vll:• •C'cl.'"?'. <br />NOTE: Read Instructions before completing this form. <br />PARAMETER QUANTITY OR LOADING QUALITY OR CONCENTRATION NO. FREQUENCY SAMPLE <br /> OF <br />TYPE <br /> ANALYSIS <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS <br />PH SAMPLE <br />' <br />1.12 <br /> MEASUREMENT <br />004013 Y CA , PERMIT ?t ? :t . >. _ .> ....- 4 •. 3c ?z t' ? . ":1 ? ?. ' J...._ ' ;'. : <br />F•M_UENT 0,"05S Ve-= t u} REQUIREMENT i. t S'U <br />SOLIDS; w --•!TL.T-,A6{_u" SAMPLE :#4#C§ii? ' :; #'.iss•?r a :'r':'f=f:f { 2S) <br /> MEASUREMENT <br />00545 1 0 0 PERMIT zr :f•? c_ .i r,:?,?. a? ? r. -*. z?? ris??i w' ? t ._ <br />r:. <br />s-? <br />EFFLUENT Gi. ,R. Sa VALUE REQUIREMENT <br />C1 s rL <br />ri_, r <br /> SAMPLE •i>•i1.9:?•51•^:;,; =?•.^r : ':I?:i ;:••1':•i..?•;::?. ?:;•= jet - <br /> MEASUREMENT <br />` C'- is PERMIT <br />E 11k:iry+7wj€ tfct.°a}. REQUIREMENT A?i. ;• :'r ;' i'f'! k <br />FLOW, :".Ni CO ND!)? T 73.z SAMPLE ? 4Y?! ?: .. h r ?:?? f4f r5 {fi i1z <br />THRU TF ? i CHENT PL•F'.At MEASUREMENT <br />r^y ? y 0 0 PERMIT i) .. s; +.,..: r h sr ... :? '. .: •. ., ? ., T.? * <br />{?^ p-g?•j }{, fir. ?'A r"9f" ?I" ?_'Z.)`" REQUIREMENT .Ir + s? `(•-i ''r Mori i:'• •?i it i "? ?t <br />©lr A[.1}Rt.fy,E.?, SAMPLE ia;.. L•..z. ( ?o ?. t?:F:rt#.. 3. :#? x.k : :rdr?f;: si <br />V I Wn- I- MEASUREMENT <br />?J?a 1 C+ PERMIT <br />.. x <br />Z-V- •'LUEINI'-? CGROt150 VAL_U,-_ REQUIREMENT ;: :`'lh;,: i'l}?O ? t <,•..L <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT I <br /> PERMIT <br /> REQUIREMENT <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I certify under penalty of law that this document and all attachments were <br />i <br />h <br />d <br />i <br />d TELEPHONE DATE <br />Richard A. Munson a system <br />gne <br />prepared under my direction or supervision in accordance w <br />t <br />es <br />to assure that qualified personnel properly gather and evaluate the information <br />Vice President submitted. Based on my inquiry of the person or persons who manage the system, <br />or those persons directly responsible for gathering the information, the information <br />970 723-4338 <br />09 <br />07 <br />08 <br /> li <br />f <br />d <br />l <br /> , true, accurate, an <br />comp <br />ete. <br />submitted is, to the best of my knowledge and be <br />e <br />nalties for submittin <br />false information <br />m <br />ware that there are si <br />nificant <br />I GNATURE OF PRINCI AL EXECUTIVE <br /> <br />Q TYPED OR PRINTED g <br />, <br />g <br />pe <br />a <br />a <br />including the possibility of fine and imprisonment for knowing violations. OFFICER OR AUTHORIZED AGENT <br />' AREA <br />CODE <br />NUMBER <br />YEAR <br />MO <br />DAY <br />GUMMtN I, ANU r-APILANAI IUN Ur ANY VIULAI IUNJ (Kererence all anacnments nere) W <br />:,FTC -.i:)._ ? ?" `> _'.' ?. " s ,'i? ?-- 4 a s ,c F' a:4?L::i?; r ut^I'r s.1'r e JS?% %' PROOF €LS1'r? fr ,a?!° I N <br />PART 1'. ra . %+. !`'3V ' CNN- a TO T !HE' V l: 311) *•jAl } `i H 0 U R <br />EPA Form 3320-1. (Rev. 3/99) Previous editions may be used. J?d,,.y, ^o ?4sj U 4,par? €Orm. PAGE