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PE If ITT[1 E/ADDRE•Y (Imlade NATKINAI. F'01111 DISCHARGE FEIMINAIION UYSItM (.\1'111.1) 'am Approved. <br /> fuclliq Nam atlon I/dllJnenl) DISCHA _ MONITORING REPORT (I)1111) OMB No.2040-0004 <br /> NAME—MIU—CONTINENT_C_UAL_6_ CUKE_CU_--- (216) (17-19) F — FINAL Approve/exprres9-30-85 <br /> ADDRESS BOX 15b 00000.396 02-j-_ b SECT.9 FOR=10YR2HR <br /> --- CARBONDALE ------- CO 81623-- F PERMIT NUMBER DISCHARGE NUMBER <br /> ———————————————————————— MONITORING PERIOD <br /> F&CILITY— ————————————— YEAR MO DAY YEAR MO DAY <br /> LOCATION — FROM TO MINOR <br /> ATTN: DOUGLAS BOWMAN ENV CUORD (20-21) (22-23) (14-2s) (2627) (28-29) (10-?I) NOTE: Read instructions before completing this form. <br /> (3 Card Onl)) QUANTITY OR LOADING (4 Card Only) QUALITY OR CONCENTRATION <br /> PARAMETER (46-53) (54-61) (3845) (46-53) (54-61) NO. FREQUF NCY SAMPLE <br /> (32-37) EX ANALYSIS TYPE <br /> AVERAGE MAXIMUM UNITS MINIMUM AVERAGE MAXIMUM UNITS::�< 1 (6263) (6468) (69-70) <br /> PH SAMPLE <br /> MEASUREMENT <br /> 00400 1 (0 PERMIT ** ****** ** 6e5 ****** 9.0 all EEKL GRAB <br /> EFFLUENT GRUSS VAL EQUIREMENT * <br /> SOLIDS, SETTLEAKLE SAMPLE <br /> MEASUREMENT <br /> 00545 1 0 PERMIT ****** ### * # * ****#* REPORT 0.5 ONCE/ GRAB <br /> EFFLUENT GROSS VALLJ EREQUIREMENT <br /> OIL AND GREASE SAMPLE <br /> FR EUN EXTR—GRAY MET rEASUREMENT <br /> 00556 1 0 PERMIT #*#*#* * # *- ##***# REPORT 10 WEEKL GRAB <br /> EFFLUENT EQUIREMENT ** <br /> FLOWI IN CONDUIT Ue SAMPLE <br /> THRU TREATMENT PLAN <br /> EASUREMENT <br /> 50U50 1 0 PERMIT jj"URT REPORT ****** ****** ****# *** WEEKLV INSTA <br /> .REQUIREMENT <br /> EFFLUENT GROSS VALSOLIDS , TOTAL SAMPLE ** #**## **#IfR11c <br /> DISSOLVED (MG/L ) MEASUREMENT <br /> 70295 1 0 PERMIT REPORT REPORT QTRLY GRAB <br /> EFFLUENT <br /> .` _ EQUIREMHNT * <br /> OIL AND GREASE SAMPLE #*** * **# ***** *** <br /> VISUAL MEASUREMENT <br /> 84066 1 0 PERMIT R EPORT ****** YES=1 **#*** *****# ***#** *#** WEEKL VISUA <br /> EFFLUENT GROSS VALTJ <br /> REQUIREMENT <br /> SAMPLE <br /> MEASUREMENT <br /> PERMIT <br /> REQUIREMENT <br /> NAME/TITLE PRINCIPAL EXECUTIVE OFFICER I CERTIFY UNOFR PFNAt TY OF LAW THAT I HAVE PERSONALLY EXAMINED TELEPHONE D A T E <br /> AND AM FAMILIAR WITH THE INFORMATION SUBMITTED HEREIN AND BASED <br /> ON MY INQUIRY OF THOSE INDIVIDUALS IMMEDIATELY RESPONSIBLE FOR <br /> OBTAINING THE INFORMATION I BELIEVE THE SUBMITTED INFORMATION <br /> 15 TRUE ACCURATE AND COMPLETE I AM AWARE THAT THERE ARE SIBNIF <br /> 7.--A.../ TH(CANT PENALTIES FOR SUBMITTING FALSE INFORMATION I100 11 ANe. ��IQ�/ <br /> THE POSSIB 19 OF FOR <br /> AND IMPRISONMENT SEE tB uSC f 1001 AND SIGNATURE OF PRINCIPAL E%ECUTIVE /�-T(V` a V <br /> 33 U5C S 1319 W.rmllu•. n1, Ihv,,- N.w— ulud.• lrn.. up (" fln nr Xr u mn, u <br /> TYPED OR PRINTED and I,r mu umum mlpn..rn...•.. OFFICER OR AUTHORIZED AGENT AREA NUMBER YEAR MO DAY <br /> CQDF <br /> COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reje•retue all whahrnenlc bete) <br /> IF NO DISCHAkGE OCCUKS KEPOKT "NO UISCHARGE". SALINITY SHALL BE MEAS.AS TDS=70295 MG/L. <br /> OLG NOW 2 PRAMeNU SHEEN:84066=0j556=0.A SHLLN:84066=19 !556=GRAB SAMPLE . <br /> -PA ForfT .1320.1 (Rev. 10-79)PREV10(19 EDITION TO BE USED (REPLACES EPA FORM T-40 WHICH MAY NOT BE USED.) ff� t [-I 1VO& J—� �� PAGE I OF <br /> UNTIL SUPPLY IS EXHAUSTED OC/ J. <br />