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PARAMETER <br />QUANTITY OR LOADING <br />QUALITY OR CONCENTRATION <br />NO <br />EX <br />FREQUENCY <br />OF <br />ANALYSIS <br />SAMPLE <br />TYPE <br />AVERAGE <br />MAXIMUM <br />UNITS <br />MINIMUM <br />AVERAGE .. <br />MAXIMUM <br />UNITS <br />-7s1 iCit,:1 1. it <br />"a: 1 UFA', T C•FZI3Sr -t V41,1,, <br />SAMPLE <br />MEASUREMENT <br />3F•3[si•• ••I}•t <br />?f ;,b *•;F* " <br />k ** <br />1•• • <br />*:-: - * F'"r <br />t £ ) <br />=,t t <br />H <br />J ~ ?et.°` <br />?ii <br />• 5 <br />Ivi I N T. MUM <br />; i <br />, . " ' �It c <br />PERMIT <br />,1:: *iZ•- • <br />3 1,q ..t 'r .nz, <br />i '2L... 1 DS. to 2'r.L <br />SCOSPEilDED <br />a!`.er a.:; (:) 1 0 0 <br />' -. .7,4...t- 17.v"41 a !I R S:� V; .fl.i <br />SAMPLE. <br />MEASUREMENT <br />**if*** <br /># •':f•di - <br />tr FRS•31• <br />•7.r3t••3i• #3i••31• <br />( 19) <br />CI€Z/ ,.. <br />:, - )f•* $ <br />:WM ^• AVn <br />n S "rah AV <br />PERMIT <br />REQUIREMENT: <br />4 k • . '?s > ' <br />*4i * ?A-* <br />. . ;'.0 t 'I`'' AL FtE ;C <br />IZSRASLt <br />':S"}'n 7. a 0 <br />77 FLUENT (ilt:ISS f AL-t.l <br />SAMPLE <br />MEASUREMENT <br />.5# #' Sf:1•?4• <br />. . <br />: }•L ?3i• 2•*iti <br />tt.-2,a9gi: <br />3#•4fi•'t = fir? + <br />t) ✓.f 4 _ <br />M ,'.'.;. <br />s:'PFO$ <br />#F Sa?s <br />M <br />(). 1 it"v lC <br />i; � 't ii <br />t<i ?M_N 6 Ji <br />PERMIT <br />REQU <br />:? r.# ,a' <br />3}a ., h -. ;I. * <br />§Rti"'..NIC' r 1 —r AL <br />( AS AS) <br />J1.002 ,:, ) <br />i=FFLUENT GROSS` VALUE <br />SAMPLE <br />MEASUREMENT <br />•#•3i •ii•°h Uz <br />*it* *i..-1- <br />:'•** <br />:t'•.'x•3f <br />•' ••1i:;t•i8 i•hk <br />( c. 3 ) <br />UG: <br />f <br />t w?;i_. ‘f <br />t)i = i'. ) ' <br />if "s.:;** <br />100 <br />) ' i AVCS <br />NEPO T <br />DA Pi <br />P ER MI T <br />REQUIREMENT <br />•;t• ;tt rid <br />II•?a- • -*:H4 <br />INC , <br />TOTAL. F !OQVERAaLE <br />l.t 7 1.. \: 0 <br />F L.t..' 'NT GI ilsS VALUE <br />SAMPLE <br />MEASUREMENT <br />*** 3t• <br />•:#=a:r3i F• <br />*?f <br />n••tt -• sr• ' <br />*;r•:f•Fi k <br />( 2 ) <br />UCtIL. <br />� <br />t..,.�e...F'c5...``(' <br />"at t "ti § <br />hk #•* ; <br />t. t <br />. z A t'ta <br />"s 1'i� <br />PERMIT <br />REQUIREMENT! <br />'. 5 '• « . ;;•.•E <br />*~wx•?* --i' k <br />s''tM'i ',' 1 <br />r oroL G;a. ER As Lr <br />3 � "k <br />)111: . 3 ( 0 <br />EFFLUENT GROSS VALUE <br />SAMPLE <br />MEASUREMENT <br />3,:•.2k•'.�• ••Ak3• <br />***...*.t <br />K ** <br />:;•,'k•T <br />•3t•?t••F4t• ••• <br />( 25 ). <br />Uf . i <br />; r ..;• '•?S <br />'t � <br />(DA t t`+3( <br />R �� <br />1"i �+��Yti i <br />TAU .*. 1 ) <br />t <br />t+� <br />!` <br />aril ii..��ai <br />t fi t i <br />PERMIT <br />REQU <br />it- .3f st + <br />t.L,..j�. '�' <br />: * ' ' r <br />- X L AND tx cr'n. :.A :BE <br />)3567:?. ). t"r C <br />'EFFLUENT G O S VALUE <br />SAMPLE <br />MEASUREMENT <br />**it.*** <br />,•4F #'"r <br />L —* *3t• <br />•i# *r3'••?i• e• <br />•3 z'fit•i! •#S•* <br />( L 9 <br />NO/L-. <br />•'rti <br />*'*3t4k* * <br />:t: 5T r" <br />)4 <br />GENT <br />I.'z1 <br />P <br />REQUIREMENT <br />• '* k°'x?1..' <br />'SI'* *4..** **** <br />NAME/TITLE PRINCIPAL EXECUTIVE OFFICER <br />t certif under penalty of law- that this document and all attachments were <br />prepared under my direction or supervision in accordance with : system designed <br />to assure that qualified personnel properly gather and evaluate the information <br />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 />submitted is, to the best of m knowledge and belief, true, accurate, and complete. <br />Y K P <br />1 am aware that there are significant penalties for submitting false information, � <br />including the possibility of fine and imprisonment for knowing violations. <br />j "�� • �"• <br />TELEPHONE <br />DATE <br />�,� <br />G {-`t \�„ (et <br />PA � 1 V S =' /� 1 <br />t <br />SIGNA OF EXE UTIVE <br />OF OR jUTHO D AGENT <br />, , <br />y <br />l <br />� '•') I!� 7 10 <br />CODE <br />NUMBER <br />YEAR <br />MO <br />DAY <br />TYPED OR PRINTED <br />PERMITTEE NAME/ADDRESS (Include Facility Name /Location if Different) <br />NAME -. 2 tom! CORP. <br />,• (.;•i G,.,s RESOURCES CORP. <br />'ADDRESS T TtLW IND PROJECT <br />FACILITY Wf 3 <br />LOCATION O`: t P`t ;=Y Ca F-3 <br />CO S?.42 <br />'4 7' <br />• <br />EPA Form 3320 -1 (Rev. 3/99) Previous editions may be used. <br />FROM <br />NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM NPDES) <br />DISCHARGE MONITORING REPORT (D R) <br />PERMIT NUMBER <br />YEAR <br />'1, "1 <br />MO <br />O ; - <br />MONITORING PERIOD <br />DAY <br />TO <br />OW. A <br />DISCHARGE NUMBER <br />YEAR <br />COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here) <br />, 73.JAR kERLY fiAM L.SNO R" REPORTING /('ISl'RUCTIONS -- SEE I. C. 9, PAGE 9. <br />MO <br />DAY <br />11 0 <br />( SUBN <br />lr F'!�llt <br />POST 'lr4ivINT P <br />* * NM r)TSCHAR'G <br />NOTE: Read Instructions before ■co <br />OIL AND GREASE — SEE E. C. 15. <br />00101 01418 a paMprm. <br />Form Approved. <br />OMB No. 2040 - 0004 <br />ME '6A <br />SCr _ _i LUG ;` ?DEN CR <br />pleting this form. <br />PAGE OF <br />F 4, <br />